Lisinopril and Lornoxicam: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Lisinopril
Lornoxicam
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Here's what's going on. Lisinopril is a blood pressure medicine, and lornoxicam is an anti-inflammatory pain reliever (an NSAID). When you take them together, the NSAID can blunt how well your lisinopril lowers your blood pressure. It does this by changing certain chemicals (prostaglandins) in your kidneys, which also helps your body handle salt and water.
The other concern is your kidneys. Taken together, these two can put extra strain on kidney function, especially if you are older, dehydrated, or already have kidney problems. The good news is this is very manageable. Your care team can check your blood pressure and kidney function and adjust things as needed. Staying well hydrated helps too.
Effect: Lornoxicam (NSAID) may reduce the antihypertensive and natriuretic effect of lisinopril (ACE inhibitor) and can precipitate renal deterioration, including acute renal failure in susceptible patients.
Mechanism: NSAID-mediated inhibition of renal prostaglandin synthesis reduces afferent arteriolar vasodilation; additive adverse effects on renal hemodynamics when combined with ACE inhibitor. Neither agent is prodrug-dependent for this PD interaction.
Evidence: Established. Onset unspecified. Severity moderate.
Management:
- Monitor BP for loss of efficacy.
- Assess renal function at initiation and periodically.
- Higher risk: elderly, volume-depleted, preexisting renal impairment.
- Ensure adequate hydration.
What happens
Reduced antihypertensive effect and renal dysfunction and/or increased blood pressure
Interaction Deep Dive
The natriuretic and blood pressure lowering actions of ACE inhibitors or angiotensin receptor blockers (ARBs) can be reduced by NSAIDs. Furthermore, using these agents together may lead to worsening renal function in certain patients, with acute renal failure being a possibility. If combined therapy cannot be avoided, evaluate whether renal function monitoring is warranted when starting treatment, watch for antihypertensive effectiveness, and periodically check renal function for indications of renal decline or failure. This is particularly important in elderly patients, at the start of therapy, in individuals who are volume-depleted, or in those with existing renal impairment. Confirm that patients are sufficiently hydrated1234.
Why it happens (mechanism)
Additive effects on renal function; decreased renal prostaglandin production
How to manage this interaction
If you have been prescribed both, keep taking them as directed unless your prescriber tells you otherwise. This combination is commonly managed with monitoring.
- Your team may check your blood pressure to make sure the lisinopril is still working well.
- They may check your kidney function when you start and periodically after that.
- Stay well hydrated, especially if you are older or have had kidney issues.
- Tell your care team if you notice much less urine, swelling, unusual tiredness, or rising blood pressure.
Ask your pharmacist whether a different pain reliever (like acetaminophen) might be a better option for you.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) A 48-year-old man with hypertension that had previously been well managed on enalapril 10 mg/day developed severe hypertension, psychosis, disorientation, and generalized anasarca four days after starting indomethacin 100 mg/day for gout 5. Raising the enalapril dose to 20 mg/day did not control the hypertension, so indomethacin was stopped. One day afterward, the patient underwent rapid diuresis and marked weight loss. The enalapril dose was subsequently lowered back to 10 mg/day, achieving good hypertension control with no remaining psychosis 6.
b) In a randomized, double-blind, parallel-design multicenter study of 141 hypertensive patients, indomethacin opposed the antihypertensive action of captopril. After one week of taking indomethacin together with captopril, 24-hour systolic blood pressure rose by 4.6 mmHg and diastolic by 2.7 mmHg (p less than 0.001). In total, ambulatory diastolic blood pressure increased in 67% of patients on captopril during indomethacin therapy 7.
c) A 59-year-old man who had been treated for 5 years with lisinopril 10 mg/day experienced worsening hypertension after rofecoxib 25/day was started for arthritic pain. Over 5 weeks, blood pressure rose from 130 to 135/80 to 85 to 168/98. Rofecoxib was stopped. Blood pressure fell during the next 18 days (average, 127/78 mmHg). Rofecoxib was resumed at 25 mg/day because of worsening joint pain. After 2 days of treatment, blood pressure increased, and over the following 2 weeks it averaged 143/89 mmHg. Lisinopril was raised to 20 mg/day, yielding an average blood pressure of 121/81 mmHg over the subsequent 21 days 8.
d) In a double-blind, placebo-controlled, parallel-group trial of 178 hypertensive patients, celecoxib did not diminish the antihypertensive effect of lisinopril. Patients took celecoxib 200 mg twice daily or placebo in addition to their usual lisinopril therapy (10 to 40 mg daily) for 4 weeks. Changes from baseline in 24-hour systolic and diastolic blood pressure (BP) were not significant. The proportion of patients whose 24-hour BP rose by at least 5, 10, 15, or 20 mmHg was likewise comparable between celecoxib and placebo. The placebo-subtracted changes seen in 24-hour BP (1.6/1.2 mmHg) were smaller than those reported for NSAIDs in patients treated with ACE inhibitors 9.
Common questions
Can I take Lisinopril and Lornoxicam together?
Lornoxicam can weaken lisinopril's blood-pressure benefit and strain the kidneys, so your care team should watch your blood pressure and kidney function and keep you well hydrated. Keep taking both as prescribed and ask about pain-relief alternatives. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lisinopril and Lornoxicam interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Lisinopril and Lornoxicam interaction managed?
If you have been prescribed both, keep taking them as directed unless your prescriber tells you otherwise. This combination is commonly managed with monitoring. Your team may check your blood pressure to make sure the lisinopril is still working well. They may check your kidney function when you start and periodically after that. Stay well hydrated, especially if you are older or have had kidney i… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Lisinopril or Lornoxicam need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (9)
- Product Information: Dynastat intravenous injection, intramuscular injection, parecoxib sodium intravenous injection, intramuscular injection. Pfizer Australia Pty Ltd (per Australian Register of Therapeutic Goods), West Ryde, Australia, 2017. DailyMed
- Product Information: SPRIX(R) nasal spray, ketorolac tromethamine nasal spray. Egalet US Inc. (per FDA), Wayne, PA, 2016. DailyMed
- Product Information: CALDOLOR(R) intravenous injection, ibuprofen intravenous injection. Cumberland Pharmaceuticals Inc. (per FDA), Nashville, TN, 2016. DailyMed
- Product Information: meloxicam oral tablets, meloxicam oral tablets. Apotex Corp. (per DailyMed), Weston, FL, 2016. DailyMed
- Ahmad S: Indomethacin-enalapril interaction: an alert (letter). South Med J 1991; 84:411-412. PubMed
- Morgan T, Anderson A, & Bertram D: Effect of indomethacin on blood pressure in elderly people with essential hypertension well controlled on amlodipine or enalapril. Am J Hypertens 2000; 13:1161-1167. PubMed
- Conlin P, Moore T, Swartz S, et al: Effect of indomethacin on blood pressure lowering by captopril and losartan in hypertensive patients. Hypertension 2000; 36:461-465. PubMed
- Brown C: Effect of rofecoxib on the antihypertensive activity of lisinopril (letter). Ann Pharmacother 2000; 34:1486. PubMed
- White W, Kent J, Taylor A, et al: Effects of celecoxib on ambulatory blood pressure in hypertensive patients on ACE inhibitors. Hypertension 2002; 39:929-934. PubMed
Keep reading about Lisinopril
Keep reading about Lornoxicam
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