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| Interactions: | Allopurinol Adverse Effect hypersensitivity reactions (Stevens-Johnson syndrome, skin eruptions)Clinical Management If these drugs are used concurrently, monitor for hypersensitivity reactions.
Amiloride Adverse Effect hyperkalemiaClinical Management Although such increases are usually transient, monitor serum potassium levels for persistent elevations in patients on this combination, especially in patients with renal dysfunction or diabetes and the elderly. Severe arrhythmias and death have been reported from hyperkalemia with such combinations.
AspirinAdverse Effect decreased captopril effectivenessClinical Management Although studies have suggested an interaction between Lisinopril and aspirin, the clinician should weigh the benefits against the risks of combining these two agents.
BumetanideAdverse Effect postural hypotension (first dose)Clinical Management Start with a very low dose of the angiotensin converting enzyme (ACE) inhibitor in the evening and closely monitor blood pressure for a severe hypotensive response for four hours after the initial dose. Monitor for hypotension, fluid status, and body weight regularly for up to two weeks after dose adjustments.
CelecoxibAdverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
ChlorthalidoneAdverse Effect postural hypotension (first dose)Clinical Management Start with a very low dose of Lisinopril in the evening and closely monitor blood pressure for a severe hypotensive response for four hours after the initial dose. Monitor for hypotension, fluid status, and body weight regularly for up to two weeks after dose adjustments.
Clopamide Adverse Effect postural hypotension (first dose)Clinical Management Start with a very low dose of Lisinopril in the evening and closely monitor blood pressure for a severe hypotensive response for four hours after the initial dose. Monitor for hypotension, fluid status, and body weight regularly for up to two weeks after dose adjustments.
Diclofenac Preps.Adverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Erythropoietin Adverse Effect higher maintenance doses of erythropoietin to maintain the target hematocritClinical Management Monitor patients receiving Lisinopril for erythropoietin efficacy. When given concomitantly, doses of erythropoietin may be higher than expected.
Flurbiprofen Adverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
FrusemideAdverse Effect postural hypotension (first dose)Clinical Management Start with a very low dose of the angiotensin converting enzyme (ACE) inhibitor in the evening and closely monitor blood pressure for a severe hypotensive response for four hours after the initial dose. Monitor for hypotension, fluid status, and body weight regularly for up to two weeks after dose adjustments.
Ibuprofen Adverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Indapamide Adverse Effect postural hypotension (first dose)Clinical Management Start with a very low dose of the angiotensin converting enzyme (ACE) inhibitor in the evening and closely monitor blood pressure for a severe hypotensive response for four hours after the initial dose. Monitor for hypotension, fluid status, and body weight regularly for up to two weeks after dose adjustments.
IndomethacinAdverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Ketoprofen Adverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Ketorolac Adverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Lithium Adverse Effect Lithium toxicity (weakness, tremor, excessive thirst, confusion) and/or nephrotoxicityClinical Management The combination of lithium and Lisinopril should be avoided if possible, though the choice of an alternative antihypertensive agent that does not interact with lithium is limited. If lithium and lisinopril are used concurrently, serum lithium levels should be closely monitored and the patient followed for any symptoms of lithium toxicity.
Mefenamic Acid Adverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Meloxicam Adverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
NabumetoneAdverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Naproxen Adverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
NimesulideAdverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
OxyphenbutazoneAdverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Paracetamol Adverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Phenacetin Adverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Phenylbutazone Adverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
PiroxicamAdverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
SpironolactoneAdverse Effect hyperkalemiaClinical Management Although such increases are usually transient, monitor serum potassium levels for persistent elevations in patients on this combination, especially in patients with renal dysfunction or diabetes and the elderly. Severe arrhythmias and death have been reported from hyperkalemia with such combinations.
TenoxicamAdverse Effect Decreased antihypertensive and natriuretic effectsClinical Management Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Xipamide Adverse Effect postural hypotension (first dose)Clinical Management Start with a very low dose of the angiotensin converting enzyme (ACE) inhibitor in the evening and closely monitor blood pressure for a severe hypotensive response for four hours after the initial dose. Monitor for hypotension, fluid status, and body weight regularly for up to two weeks after dose adjustments. |
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