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6 Interactions found for:

Celebrex and lisinopril
Interactions Summary
  • 4 Major
  • 2 Moderate
  • 0 Minor
  • Celebrex
  • lisinopril

Drug Interactions

Moderate
Lisinopril + Celebrex

The following applies to the ingredients: Lisinopril and Celecoxib (found in Celebrex)

Talk to your doctor before using lisinopril together with celecoxib. Combining these medications may reduce the effects of lisinopril in lowering blood pressure. In addition, these medications may affect your kidney function, especially when they are used together frequently or chronically. You are more likely to develop impaired kidney function during treatment with these medications if you are also using a diuretic ("water pill") or if you are elderly or have preexisting kidney disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience signs and symptoms that may suggest kidney damage such as nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, and irregular heart rhythm. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Drug and Food Interactions

Moderate
Lisinopril + Food

The following applies to the ingredients: Lisinopril

It is recommended that if you are taking lisinopril you should be advised to avoid moderately high or high potassium dietary intake. This can cause high levels of potassium in your blood. Do not use salt substitutes or potassium supplements while taking lisinopril, unless your doctor has told you to.

The following applies to the ingredients: Lisinopril

Lisinopril and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Drug and Pregnancy Interactions

The following applies to the ingredients: Lisinopril

Professional Content

AU: Use is contraindicated.
UK: Use is not recommended during the first trimester and use is contraindicated during the second and third trimesters.
US: This drug should not be used during pregnancy unless there are no alternatives and the benefit outweighs the risk to the fetus.

AU TGA pregnancy category: D
US FDA pregnancy category: Not assigned

Risk Summary: Use of drugs that act on the renin angiotensin system (RAS) during the second and third trimesters of pregnancy increases fetal and neonatal morbidity and death.

Comments:
-Adequate methods of contraception should be encouraged.
-Advise pregnant women and females of reproductive potential of the potential risk to a fetus.

Animal studies have revealed evidence of fetotoxicity. In humans, exposure to angiotensin-converting enzyme (ACE) inhibitors during the second and third trimesters has revealed evidence of fetal and neonatal toxicity and fetolethality. There are no controlled data in human pregnancy.

AU TGA pregnancy category D: Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts should be consulted for further details.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

References

  1. "Product Information. Prinivil (lisinopril)." Merck & Co., Inc PROD (2002):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Pharmaceutical Society of Australia "APPGuide online. Australian prescription products guide online. http://www.appco.com.au/appguide/default.asp" (2006):
  4. Cerner Multum, Inc. "Australian Product Information." O 0

The following applies to the ingredients: Celecoxib (found in Celebrex)

Professional Content

Contraindicated last trimester of pregnancy
Between 20- and 30-weeks' gestation: Limit dose and duration of use

AU TGA pregnancy category: B3
US FDA pregnancy category: Not assigned

Risk Summary: Use of nonsteroidal anti-inflammatory drugs (NSAIDs) in pregnant women can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment. Embryofetal risks of NSAID use in women in the first or second trimesters of pregnancy are inconclusive. Embryo-fetal deaths and an increase in diaphragmatic hernias were observed in rats administered this drug during the period of organogenesis.

Comments:
-NSAID use in pregnancy prior to 20 weeks gestation should be based on a benefit-risk assessment; some authorities recommend avoiding NSAIDs throughout pregnancy whenever possible.
-If NSAID use is necessary between 20- and 30-weeks' gestation, limit use to the lowest effective dose for the shortest duration possible; ultrasound monitoring of amniotic fluid should be considered if NSAID use extends beyond 48 hours; if oligohydramnios occurs, discontinue NSAID and treat appropriately.
-NSAID use is not recommended in women attempting to conceive as it may impair female fertility.

In animal studies, embryo-fetal deaths and an increase in diaphragmatic hernias were observed in rats administered this drug daily during the period of organogenesis at oral doses approximately 6 times the maximum recommended human dose (MRHD). In addition, structural abnormalities (e.g., septal defects, ribs fused, sternebrae fused and sternebrae misshapen) were observed in rabbits given daily oral doses during the period of organogenesis at approximately 2 times the MRHD. In animal studies, administration of prostaglandin synthesis inhibitors has been shown to increase pre- and postimplantation loss. In published animal studies, prostaglandin synthesis inhibitors have been reported to impair kidney development when administered at clinically relevant doses. There are no controlled data in human pregnancy. Published reports of NSAID use at about 30 weeks gestation and later in pregnancy have shown NSAIDs may cause premature closure of the fetal ductus arteriosus. Through 2017, the US FDA has received 35 reports of low amniotic fluid levels or kidney problems in mothers who took NSAIDs while pregnant. Five newborns died; 2 had kidney failure and confirmed low amniotic fluid, 3 had kidney failure without confirmed low amniotic fluid. The low amniotic fluid started as early as 20 weeks of pregnancy. There were 11 reports of low amniotic fluid levels during pregnancy and the fluid volume returned to normal after the NSAID was stopped. The medical literature has reported low amniotic fluid levels with use of NSAIDs for varying amounts of time, ranging from 48 hours to multiple weeks. Complications of prolonged oligohydramnios may include limb contractures and delayed lung maturation. In some postmarketing cases of impaired neonatal renal function, invasive procedures such as exchange transfusion or dialysis were required. In other cases, the condition was reversible within 3 to 6 days of stopping the NSAID and in these cases reappeared when the same NSAID was restarted.

NSAIDs may delay or prevent rupture of ovarian follicles which has been associated with reversible infertility in some women. The withdrawal of NSAID therapy should be considered in women with difficulties conceiving or who are undergoing investigation of infertility.

TGA pregnancy category B3: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have shown evidence of an increased occurrence of fetal damage, the significance of which is considered uncertain in humans.
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

References

  1. "Product Information. Celebrex (celecoxib)." Searle PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0
  4. US Food and Drug Administration "FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid. https://www.fda.gov/media/142967/download" (2020):

Drug and Breastfeeding Interactions

The following applies to the ingredients: Lisinopril

Professional Content

A decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Excreted into human milk: Unknown
Excreted into animal milk: Yes

Comments:
-ACE inhibitors have the potential to adversely affect a nursing infant.

References

  1. "Product Information. Prinivil (lisinopril)." Merck & Co., Inc PROD (2002):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Pharmaceutical Society of Australia "APPGuide online. Australian prescription products guide online. http://www.appco.com.au/appguide/default.asp" (2006):
  4. Cerner Multum, Inc. "Australian Product Information." O 0

The following applies to the ingredients: Celecoxib (found in Celebrex)

Professional Content

Benefit should outweigh risk

Excreted into human milk: Yes

Comments:
-Low levels of this drug are excreted in breastmilk and are not expected to cause adverse effects in breastfed infants.
-Some authorities advise women to discontinue nursing or to discontinue the drug, considering the expected benefit of the drug to the mother because of the potential for adverse reaction in nursing infants.

Limited data has shown this drug is excreted into human milk in low levels. Data from 3 published reports estimate the average daily infant dose to be 10 to 40 mcg/kg/day, which is less than 1% of the weight-based therapeutic dose for a 2-year-old. In 2 breastfed infants (17 and 22 months of age) whose mothers took this drug 200 mg orally twice daily for many weeks, blood samples taken 4 hours after a maternal dose were undetectable (less than 10 mcg/L). No infant side effects were observed in these infants.

References

  1. "Product Information. Celebrex (celecoxib)." Searle PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0
  4. United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):

Therapeutic Duplication Warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

Switch to: Professional Interactions

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

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