Lisinopril and Morniflumate: 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
Morniflumate
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.
Lisinopril is a blood pressure medicine, and morniflumate is an anti-inflammatory pain reliever (an NSAID). When taken together, the NSAID can make lisinopril work a little less well, so your blood pressure may not stay as low as it should. These two can also be tough on the kidneys when combined, especially if you are older, dehydrated, or already have kidney problems.
The good news is your care team can manage this easily. They may check your blood pressure and run kidney blood tests now and then, and staying well hydrated helps a lot. Please don't stop either medicine on your own, just talk with your pharmacist or doctor about the best plan for you.
Effect: NSAID (morniflumate) coadministration may reduce the antihypertensive and natriuretic effect of the ACE inhibitor lisinopril, and additive renal effects can precipitate renal deterioration, including acute renal failure.
Mechanism: NSAID inhibition of renal prostaglandin synthesis reduces afferent arteriolar vasodilation; combined with ACE inhibitor efferent effects, glomerular perfusion pressure falls. Neither drug is a prodrug relevant here.
- Direction: reduced antihypertensive efficacy; increased renal risk
- Evidence: established; onset unspecified
- Monitor: blood pressure, renal function/SCr at initiation and periodically
- Higher risk: elderly, volume-depleted, preexisting renal impairment
Ensure adequate hydration when concomitant use is required.
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. Combined administration may also cause worsening renal function in certain patients, with acute renal failure being a possibility. If these agents must be used together, evaluate whether renal function should be checked when therapy begins, watch for antihypertensive effectiveness, and periodically assess renal function for indications of declining function or failure. This is especially important in the elderly, at the start of therapy, in those who are volume-depleted, or in patients with existing renal impairment. Confirm that patients maintain adequate hydration1234.
Why it happens (mechanism)
Additive effects on renal function; decreased renal prostaglandin production
How to manage this interaction
If your prescriber wants you on both, that's okay, this combination can be used with sensible monitoring.
- Keep taking both as prescribed unless your doctor tells you otherwise.
- Your team may check your kidney function when you start and periodically after, and watch that your blood pressure stays controlled.
- Stay well hydrated, since dehydration raises the risk to your kidneys.
- Tell your care team if you are elderly or already have kidney issues, as extra caution applies.
Raise any new swelling, much lower urine output, or unusual blood pressure readings with your pharmacist or doctor.
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. Increasing the enalapril dose to 20 mg/day did not control the hypertension, and indomethacin was stopped. The following day, the patient underwent rapid diuresis and lost a considerable amount of weight. Enalapril was subsequently lowered back to 10 mg/day, achieving good blood pressure control with no lingering psychosis 6.
b) In a randomized, double-blind, parallel-design multicenter study of 141 hypertensive patients, indomethacin opposed the blood pressure lowering 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 while receiving indomethacin 7.
c) A 59-year-old man who had been treated for 5 years with lisinopril 10 mg/day experienced worsening hypertension after starting rofecoxib 25/day 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 over the next 18 days (average, 127/78 mmHg). Because of increased joint pain, rofecoxib was resumed at 25 mg/day. Two days into therapy, blood pressure rose, and it averaged 143/89 mmHg over the following 2 weeks. Lisinopril was raised to 20 mg/day, yielding an average blood pressure of 121/81 mmHg over the next 21 days 8.
d) Celecoxib did not diminish the antihypertensive effect of lisinopril in 178 hypertensive patients in a double-blind, placebo-controlled, parallel-group trial. In addition to their usual lisinopril therapy (10 to 40 mg daily), patients were given either celecoxib 200 mg twice daily or placebo for 4 weeks. Changes from baseline in the 24-hour systolic and diastolic blood pressure (BP) were nonsignificant. The proportions of patients whose 24-hour BP rose by at least 5, 10, 15, or 20 mmHg were also comparable between celecoxib and placebo. The placebo-subtracted changes seen in 24-hour BP (1.6/1.2 mmHg) were smaller than what has been reported for NSAIDs in ACE inhibitor-treated patients 9.
Common questions
Can I take Lisinopril and Morniflumate together?
Morniflumate can blunt lisinopril's blood pressure benefit and stress the kidneys when combined, so your care team will monitor your blood pressure and kidney function and keep you hydrated. Keep taking both as prescribed and check in with your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lisinopril and Morniflumate 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 Morniflumate interaction managed?
If your prescriber wants you on both, that's okay, this combination can be used with sensible monitoring. Keep taking both as prescribed unless your doctor tells you otherwise. Your team may check your kidney function when you start and periodically after, and watch that your blood pressure stays controlled. Stay well hydrated, since dehydration raises the risk to your kidneys. Tell your care team… 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 Morniflumate 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 Morniflumate
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