Loxoprofen and Lisinopril: 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
Loxoprofen
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 loxoprofen is an anti-inflammatory pain reliever (an NSAID, like ibuprofen). When you take them together, the NSAID can make your blood pressure medicine work less well, so your blood pressure may creep back up. Both drugs can also affect the kidneys, and using them together can put extra strain on them.
This is more of a concern if you are older, dehydrated, or already have kidney problems. The good news is your care team can manage this by checking your blood pressure and kidneys and adjusting things as needed. Keep drinking enough fluids, and ask your pharmacist or doctor before combining these.
Effect: Loxoprofen (NSAID) may blunt the antihypertensive and natriuretic response to lisinopril (ACE inhibitor) and increase risk of renal deterioration, including acute renal failure.
Mechanism: NSAID inhibition of renal prostaglandin synthesis reduces afferent arteriolar vasodilation; combined with ACEi-induced efferent dilation, this compromises glomerular perfusion. Additive effects on renal function. Neither agent's effect depends on prodrug activation.
- Direction: reduced antihypertensive efficacy; potential nephrotoxicity
- Evidence: established; onset unspecified
- Management: monitor BP and renal function (baseline, at initiation, periodically), ensure adequate hydration; heightened vigilance in elderly, volume-depleted, or CKD patients
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 diminished by NSAIDs. Beyond this, using these agents together may cause worsening renal function in certain patients, up to and including acute renal failure. If the two must be used at the same time, evaluate whether renal function should be checked when therapy begins, watch for adequate antihypertensive response, and periodically reassess renal function to detect any decline or failure, particularly in elderly patients, at the start of treatment, in individuals who are volume-depleted, or in those 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
What your care team may do:
- Check your blood pressure to confirm the lisinopril is still working well.
- Test your kidney function when starting and periodically afterward, especially if you are older, dehydrated, or have kidney issues.
- Make sure you stay well hydrated.
- Adjust your medications if needed, individualized to you.
What you can do: Keep taking both exactly as prescribed unless told otherwise. Drink enough fluids, and tell your pharmacist or doctor before combining them or before using loxoprofen regularly. Report swelling, much less urine, or rising blood pressure readings.
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. One day afterward, the patient underwent rapid diuresis and lost a substantial amount of weight. The enalapril dose was subsequently lowered to 10 mg/day, achieving good hypertension control with no lingering psychosis 6.
b) In a randomized, double-blind, parallel-design multicenter study of 141 hypertensive patients, indomethacin counteracted the antihypertensive action of captopril. One week of combined indomethacin and captopril therapy raised 24-hour systolic blood pressure 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 receiving captopril while on indomethacin 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. After 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. Following 2 days of treatment, blood pressure climbed, and over the subsequent 2 weeks it averaged 143/89 mmHg. Lisinopril was raised to 20 mg/day, producing an average blood pressure of 121/81 mmHg over the following 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 were given celecoxib 200 mg twice daily or placebo in addition to their usual lisinopril regimen (10 to 40 mg daily) 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 likewise 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 patients treated with ACE inhibitors 9.
Common questions
Can I take Loxoprofen and Lisinopril together?
Loxoprofen can reduce how well lisinopril controls your blood pressure and may stress your kidneys, so your care team should monitor your blood pressure and kidney function and keep you well hydrated. Do not change either medicine on your own; check with your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Loxoprofen and Lisinopril 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 Loxoprofen and Lisinopril interaction managed?
What your care team may do: Check your blood pressure to confirm the lisinopril is still working well. Test your kidney function when starting and periodically afterward, especially if you are older, dehydrated, or have kidney issues. Make sure you stay well hydrated. Adjust your medications if needed, individualized to you. What you can do: Keep taking both exactly as prescribed unless told other… 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 Loxoprofen or Lisinopril 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 Loxoprofen
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