Can Lisinopril and Diclofenac Be Taken Together?
In our latest question and answer, the pharmacist discusses the interaction between diclofenac and lisinopril.
My wife is 81 years old and has been prescribed to take 10 to 20 mg of lisinopril each morning, and now also 100 mg of diclofenac (Voltaren). I’m concerned that taking both at once could be harmful. Which one should she take first in the morning, and how many hours should she wait before taking the other? For safety, I plan to give my wife the lisinopril first, then 4 hours later, give her half a tablet of diclofenac while monitoring her blood pressure before and after.
May 06, 2025- Lisinopril and diclofenac can be taken together but may affect blood pressure control and reduce kidney function, especially with long-term use or in older adults.
- If both medications are needed, regular monitoring of blood pressure and kidney function through lab work is important.
- For short-term pain relief, the risk is lower, but your doctor should know about both medications so they can monitor you appropriately.
Answer
Thanks for your question! You're absolutely right to be cautious here.
Lisinopril and diclofenac can interact in a way that may affect both blood pressure control and kidney function.
The issue isn’t that they can’t be taken together...in fact, it's fairly common for NSAIDs like diclofenac to be used alongside lisinopril on an as-needed basis. The key is being aware of the risks when they are taken at the same time, especially in older adults. The length of use is also a major factor here.
As always, it's important that your wife's doctor is aware of all the medications she has been prescribed so she can be appropriately managed and monitored.
Interaction Details
Lisinopril is an ACE inhibitor that helps lower blood pressure and protect the kidneys. Diclofenac is an NSAID, and this class of medications can reduce the effectiveness of drugs like lisinopril. Even more importantly, combining an NSAID with an ACE inhibitor can reduce kidney blood flow. This can lead to a drop in kidney function, particularly in people who are older or who are also taking a diuretic.
This interaction builds over time. It's not just about what happens when you take them on the same day. So even if you space them out by a few hours, that doesn't fully eliminate the concern.
What Should You Do?
If your wife truly needs both medications, it’s important to keep a close eye on her blood pressure and kidney function. That means regular labs and follow-up with her provider. If she’s using diclofenac for short-term pain relief, the risk is lower, but still worth being cautious.
If she needs diclofenac long term, her doctor might consider alternatives like:
- Topical diclofenac gel instead of oral tablets
- Using the lowest effective dose for the shortest time possible
- Switching to a different pain reliever that doesn’t have this same interaction
Final Words
Overall, lisinopril and NSAIDs can be used together in some cases, but not without some planning and monitoring. How long they’re taken matters too.
Spacing the doses out doesn’t hurt, but it’s not a full solution either. Keep monitoring her blood pressure like you’re doing, and make sure her provider knows she’s taking both so they can monitor things properly.
Thanks again for contacting us!
References & sources
- Angiotensin-converting enzyme inhibition and prostaglandins — PubMed
- Hormonal responses to long-term converting enzyme inhibition in hypertensive patients — PubMed
- Acute kidney injury secondary to a combination of renin-angiotensin system inhibitors, diuretics and NSAIDS: "The Triple Whammy" — PubMed
- More on the "Triple Whammy": antihypertensive drugs, non-steroidal anti-inflammatory agents and acute kidney injury - a case/non-case study in the French pharmacovigilance database — PubMed
Glossary — Terms in This Answer
- ACE inhibitor
- A type of blood pressure medication that works by blocking an enzyme to help relax blood vessels and lower blood pressure.
- NSAID
- A nonsteroidal anti-inflammatory drug used to reduce pain and inflammation without steroids.
- Diuretic
- A medication that increases the amount of water and salt removed from the body through urine.
- Kidney function
- The ability of the kidneys to filter waste products and excess water from the blood.
- Kidney blood flow
- The amount of blood circulating through the kidneys to allow them to filter waste.
- Topical
- A medication applied directly to the skin rather than swallowed or injected.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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