Drug interactions
Celecoxib + Enalapril-hydrochlorothiazide
Severity: Major
Celecoxib and Enalapril-hydrochlorothiazide: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
NSAIDs can blunt the blood pressure lowering effect of ACE inhibitors and thiazides. In patients taking an ACE inhibitor plus a diuretic, an NSAID adds a risk of acute kidney injury, especially with volume depletion, advanced age or existing renal impairment.
What this interaction means in plain words
Celecoxib and Enalapril-hydrochlorothiazide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Celecoxib belongs to Musculoskeletal; Enalapril-hydrochlorothiazide belongs to Cardiovascular.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces afferent arteriolar dilation and sodium excretion, opposing ACE inhibitor and diuretic effects and reducing glomerular filtration.
What to do
Avoid regular NSAID use where possible and choose paracetamol or another alternative. If unavoidable, use the lowest dose for the shortest time, ensure hydration, and monitor blood pressure, creatinine and potassium.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Enalapril-hydrochlorothiazide
- Aliskiren + Enalapril-hydrochlorothiazide Contraindicated
- Dofetilide + Enalapril-hydrochlorothiazide Contraindicated
- Enalapril-hydrochlorothiazide + Protein a column Contraindicated
- Enalapril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Amifostine + Enalapril-hydrochlorothiazide Major
- Amiloride + Enalapril-hydrochlorothiazide Major
Other interactions of Celecoxib
- Celecoxib + Ketorolac Contraindicated
- Celecoxib + Ketorolac intranasal Contraindicated
- Aceclofenac + Celecoxib Major
- Acemetacin + Celecoxib Major
- Amiloride + Celecoxib Major
- Apixaban + Celecoxib Major
Frequently asked questions
Can I take Celecoxib with Enalapril-hydrochlorothiazide?
MediHelp rates the interaction as major. Celecoxib and Enalapril-hydrochlorothiazide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. NSAIDs can blunt the blood pressure lowering effect of ACE inhibitors and thiazides. In patients taking an ACE inhibitor plus a diuretic, an NSAID adds a risk of acute kidney injury, especially with volume depletion, advanced age or existing renal impairment.
How serious is the interaction between Celecoxib and Enalapril-hydrochlorothiazide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid regular NSAID use where possible and choose paracetamol or another alternative. If unavoidable, use the lowest dose for the shortest time, ensure hydration, and monitor blood pressure, creatinine and potassium.
What other medicines interact with Enalapril-hydrochlorothiazide?
MediHelp also lists interactions of Enalapril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Protein a column. The full list is on the Enalapril-hydrochlorothiazide page.
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