Propionic Acid 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
Propionic Acid
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 lowers your blood pressure and helps protect your kidneys. Propionic acid belongs to a group of medicines that can work against that. It can reduce certain natural substances (prostaglandins) your kidneys use to keep blood flowing well. When you take both, your lisinopril may not lower your blood pressure as well, and your kidneys can get stressed, especially if you are older, dehydrated, or already have kidney trouble.
The good news: this is very manageable. Your care team can check your blood pressure and kidney function and keep you well hydrated. Don't stop either medicine on your own. Just let your pharmacist or doctor know you're taking both.
Mechanism: NSAID (propionic acid derivative) inhibition of renal prostaglandin synthesis blunts the antihypertensive and natriuretic effect of the ACE inhibitor lisinopril, plus additive adverse renal hemodynamic effects. Neither agent is a prodrug; direction is reduced antihypertensive efficacy with risk of renal deterioration.
- Effect: attenuated BP control, decreased natriuresis, possible acute kidney injury.
- Evidence: established; severity: moderate; onset unspecified.
- Management: monitor renal function at initiation and periodically, monitor BP for efficacy, maintain adequate hydration. Highest risk in elderly, volume-depleted, or preexisting renal impairment.
What happens
Reduced antihypertensive effect and renal dysfunction and/or increased blood pressure
Interaction Deep Dive
The antihypertensive and natriuretic actions of ACE inhibitors or angiotensin receptor blockers (ARBs) can be blunted by NSAIDs. Taking these agents together may also cause worsening renal function in certain patients, which can include acute renal failure. If the combination cannot be avoided, evaluate at the start of therapy whether renal function should be tracked, watch for adequate blood pressure control, and periodically check renal function for evidence of deterioration or failure, particularly in elderly patients, at the beginning of treatment, in those who are volume-depleted, or in individuals with preexisting 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
You can usually take both, with some extra care. Because propionic acid can work against lisinopril, your care team will keep an eye on things:
- They may check your blood pressure to be sure it stays controlled.
- They may check your kidney function when you start and from time to time, especially if you are older, low on fluids, or have kidney problems.
- Staying well hydrated matters here.
Keep taking both exactly as prescribed. Ask your pharmacist or doctor before starting or stopping the NSAID, and mention any less-frequent urination, swelling, or higher home 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-controlled 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. The following day, the patient underwent rapid diuresis and lost a substantial amount of weight. The enalapril dose 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 counteracted the blood pressure lowering effect of captopril. After one week of combined indomethacin and captopril therapy, 24-hour systolic blood pressure rose by 4.6 mmHg and diastolic by 2.7 mmHg (p less than 0.001). Across the group, ambulatory diastolic blood pressure increased in 67% of patients receiving captopril while on indomethacin 7.
c) A 59-year-old man who had been managed 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 discontinued. Blood pressure fell across the subsequent 18 days (average, 127/78 mmHg). Because of increased joint pain, rofecoxib was resumed at 25 mg/day. After 2 days of treatment, blood pressure rose, 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 next 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 added to their usual lisinopril regimen (10 to 40 mg daily) for 4 weeks. Changes from baseline in 24-hour systolic and diastolic blood pressure (BP) were not significant. 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 those reported for NSAIDs in patients treated with ACE inhibitors 9.
Common questions
Can I take Propionic Acid and Lisinopril together?
Propionic acid (an NSAID) can weaken lisinopril's blood-pressure effect and stress the kidneys, but this is manageable with hydration and periodic blood-pressure and kidney monitoring. Keep taking both as prescribed and talk to your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Propionic Acid 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 Propionic Acid and Lisinopril interaction managed?
You can usually take both, with some extra care. Because propionic acid can work against lisinopril, your care team will keep an eye on things: They may check your blood pressure to be sure it stays controlled. They may check your kidney function when you start and from time to time, especially if you are older, low on fluids, or have kidney problems. Staying well hydrated matters here. Keep takin… 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 Propionic Acid 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 Propionic Acid
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist