Valdecoxib 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
Valdecoxib
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.
You're taking lisinopril, a blood pressure medicine, along with valdecoxib, an anti-inflammatory pain reliever (an NSAID). When these are used together, the NSAID can make the lisinopril work a little less well, so your blood pressure may creep up. Both drugs can also put extra strain on your kidneys, especially if you get dehydrated.
This is a well-recognized combination, and the good news is your care team can manage it easily. They may check your blood pressure and kidneys with a blood test now and then. Please keep taking both as prescribed, drink enough fluids, and let your doctor or pharmacist know if you feel dizzy, notice swelling, or urinate less than usual.
Effect: NSAID (valdecoxib) may blunt the antihypertensive and natriuretic effect of the ACE inhibitor (lisinopril) and increase risk of renal deterioration, including acute renal failure.
Mechanism: Inhibition of renal prostaglandin synthesis reduces afferent arteriolar vasodilation; combined with ACE inhibitor efferent effects, this compromises glomerular perfusion. Additive adverse renal effects and attenuated BP control.
Evidence: Established. Onset: unspecified.
Management:
- Monitor blood pressure for loss of efficacy.
- Assess renal function at initiation and periodically.
- Highest risk: elderly, volume-depleted, preexisting renal dysfunction.
- Ensure adequate hydration.
What happens
Reduced antihypertensive effect and renal dysfunction and/or increased blood pressure
Interaction Deep Dive
The blood pressure lowering and natriuretic actions of ACE inhibitors or angiotensin receptor blockers (ARBs) can be reduced by NSAIDs. Using these agents together may also cause renal function to worsen, and in certain patients acute renal failure can occur. If concurrent therapy cannot be avoided, evaluate whether renal function should be checked when treatment begins, watch for adequate antihypertensive response, and periodically assess renal function to detect any decline or failure, particularly in elderly patients, at the start of treatment, in those who are volume-depleted, or in individuals 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
Both medicines can usually be used together safely when your care team keeps an eye on a couple of things.
- Keep taking both as prescribed unless your doctor tells you otherwise.
- Your team may check your blood pressure to be sure the lisinopril is still working well.
- They may run blood tests to check your kidneys when you start and from time to time after.
- Stay well hydrated, since dehydration raises the risk to your kidneys.
Extra care is taken if you are older, low on fluids, or already have kidney problems. Tell your pharmacist or doctor about swelling, dizziness, or urinating less.
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 been well managed with 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, and 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 opposed the blood pressure lowering effect 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). Across the group, ambulatory diastolic blood pressure increased in 67% of the patients receiving captopril while on indomethacin 7.
c) A 59-year-old man who had been treated with lisinopril 10 mg/day for 5 years 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 (averaging 127/78 mmHg). Because of increased joint pain, rofecoxib was resumed at 25 mg/day. Two days into therapy, blood pressure went up, and over the following 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 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. In addition to their usual lisinopril therapy (10 to 40 mg daily), patients received celecoxib 200 mg twice daily or placebo for 4 weeks. Changes from baseline in 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 those reported for NSAIDs in patients treated with ACE inhibitors 9.
Common questions
Can I take Valdecoxib and Lisinopril together?
Valdecoxib can reduce how well lisinopril controls your blood pressure and add strain on your kidneys, so keep taking both as prescribed, stay hydrated, and let your care team monitor your blood pressure and kidney function. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Valdecoxib 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 Valdecoxib and Lisinopril interaction managed?
Both medicines can usually be used together safely when your care team keeps an eye on a couple of things. Keep taking both as prescribed unless your doctor tells you otherwise. Your team may check your blood pressure to be sure the lisinopril is still working well. They may run blood tests to check your kidneys when you start and from time to time after. Stay well hydrated, since dehydration rais… 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 Valdecoxib 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 Valdecoxib
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