Lisinopril nsaids

Pro Research Analysisby

Searched over 200M research papers for "lisinopril nsaids"

Analyzed relevant papers

Interaction Between Lisinopril and NSAIDs: Clinical Implications

Introduction to Lisinopril and NSAIDs

Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is widely used to manage hypertension and heart failure. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for pain and inflammation. However, the concurrent use of these medications can lead to significant interactions affecting their efficacy and safety.

Impact of NSAIDs on Lisinopril's Antihypertensive Effect

Several studies have demonstrated that NSAIDs can attenuate the antihypertensive effects of ACE inhibitors like lisinopril. This interaction is primarily due to NSAIDs' ability to inhibit vasodilatory prostaglandins, leading to vasoconstriction and sodium retention, which counteracts the blood pressure-lowering effects of ACE inhibitors 1345.

For instance, a study involving hypertensive patients treated with lisinopril showed that the addition of NSAIDs such as ibuprofen and piroxicam significantly increased systolic blood pressure by 7.7-9.9% . Another study confirmed that indomethacin blunted the antihypertensive efficacy of lisinopril, with an average increase in blood pressure of 5.45/3.22 mmHg .

Mechanisms of Interaction

The interaction between NSAIDs and lisinopril is multifaceted. NSAIDs inhibit cyclooxygenase (COX) enzymes, reducing the synthesis of prostaglandins that promote vasodilation and natriuresis. This inhibition leads to increased vascular resistance and fluid retention, thereby elevating blood pressure 35. Additionally, the competitive metabolic interaction between ACE inhibitors and NSAIDs further complicates their concurrent use .

Clinical Implications and Recommendations

Given the potential for NSAIDs to diminish the antihypertensive effects of lisinopril, clinicians should exercise caution when prescribing these medications together. Monitoring blood pressure closely and considering alternative pain management strategies, such as acetaminophen, which has a lesser impact on blood pressure, is advisable 45.

Special Considerations in Renal Patients

In patients with renal disease, the combination of lisinopril and NSAIDs can have both beneficial and adverse effects. While both drug classes can reduce proteinuria, their combined use may lead to a significant decline in glomerular filtration rate (GFR) and increase the risk of hyperkalemia 78. Therefore, renal function and serum potassium levels should be monitored closely in these patients.

Conclusion

The interaction between lisinopril and NSAIDs is clinically significant, particularly concerning blood pressure control and renal function. Healthcare providers should be aware of these interactions and manage them by monitoring patients closely, considering alternative medications, and adjusting treatment regimens as necessary to ensure optimal therapeutic outcomes.

Sources and full results

Most relevant research papers on this topic

[Antihypertensive effect of enalapril and lisinopril administered in combination with nonsteroid anti-inflammatory agents].

ACE inhibitors should be used differentially in active therapy with NSAIDs due to their metabolic interaction, with lisinopril showing a less negative effect than enalapril.

Non-RCT

2001·

2citations

·M. P. Savenkov et al.

RP-HPLC Method for the Simultaneous Determination of Lisinopril and NSAIDs in API, Pharmaceutical Formulations and Human Serum

The developed RP-HPLC method effectively determines lisinopril and NSAIDs in pharmaceutical formulations and human serum, providing accurate results for quality control and clinical laboratories.

2012·

27citations

·N. Sultana et al.

Non-steroidal anti-inflammatory drugs and antihypertensive drug therapy.

Indomethacin significantly blunts the blood pressure-lowering effect of both valsartan and lisinopril, suggesting that bradykinin-stimulated prostaglandin synthesis may play a role in their antihypertensive action.

RCT

2002·

9citations

·L. Beilin

Interaction between antihypertensives and NSAIDs in primary care: a controlled trial.

Piroxicam and ibuprofen significantly blunt the effects of antihypertensive drugs, while acetaminophen is almost inert, with lisinopril/hydrochlorothiazide being more affected than amlodipine.

Highly Cited

2008·

83citations

·I. Pavličević et al.

Prohypertensive effects of non-steroidal anti-inflammatory drugs are mostly due to vasoconstriction.

NSAIDs' prohypertensive effects are mainly due to vasoconstriction, with minor volume expansion, and no significant changes in body weight, urinary output, serum creatinine, or electrolyte profiles.

Observational Study

2011·

9citations

·I. Pavličević et al.

Adverse Interactions of Rofecoxib with Lisinopril in Spontaneously Hypertensive Rats

Rofecoxib can interfere with lisinopril's antihypertensive effects and cardiorenal protective effects in spontaneously hypertensive rats, highlighting the need for judicious use of COX-2 inhibitors in patients with hypertension, ischemic heart disease, or chronic

RCTAnimal Study

2005·

5citations

·K. Dubey et al.

Additive antiproteinuric effect of the NSAID indomethacin and the ACE inhibitor lisinopril.

The combination of indomethacin and lisinopril has an additive antiproteinuric effect, potentially benefiting symptomatic treatment of nephrotic syndrome.

Non-RCT

1990·

52citations

·J. Heeg et al.

Selective cyclooxygenase-2 (COX-2) inhibition reduces proteinuria in renal patients.

Selective COX-2 inhibition reduces proteinuria in renal patients without reducing systemic blood pressure, suggesting a potential non-hypotensive adjunct treatment for proteinuria.

Non-RCT

2008·

36citations

·L. Vogt et al.

Efficacy and variability of the antiproteinuric effect of ACE inhibition by lisinopril.

The ACE inhibitor lisinopril effectively reduces proteinuria, with a dose and time-related effect, and is strongly dependent on dietary sodium restriction, making it comparable to indomethacin with fewer adverse effects.

Non-RCTHighly Cited

1989·

398citations

·J. Heeg et al.

In vivo Interaction Studies of ACE Inhibitors with NSAIDs on Carrageenan Induced Inflammation

ACE inhibitors and NSAIDs effectively reduce carrageenan-induced inflammation in rats, suggesting their potential use in combination for treating hypertension and musculoskeletal problems.

Non-RCTAnimal Study

2013·

6citations

·S. Naveed et al.

Try another search

percentage of calories from protein

personalized multivitamin

diabetes shot for weight loss

vitamin b1 b6 b12

methocarbamol addictive

what is the active ingredient in marijuana