Drug interactions
Celecoxib + Ramipril
Severity: Moderate
Celecoxib and Ramipril: moderate interaction.
Last updated
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
Celecoxib can reduce the antihypertensive effect of ramipril. In elderly, volume-depleted or renally impaired patients, the combination may lead to acute kidney injury and hyperkalemia.
What this interaction means in plain words
Celecoxib and Ramipril can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Celecoxib belongs to Musculoskeletal; Ramipril belongs to Cardiovascular.
Why it happens
Inhibition of vasodilatory renal prostaglandin synthesis by the NSAID opposes ACE inhibitor effects and reduces glomerular perfusion.
What to do
Monitor blood pressure, serum creatinine and potassium at initiation and periodically thereafter, and keep patients hydrated. Prefer paracetamol or the lowest NSAID dose for the shortest duration in high-risk patients.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Celecoxib
- Celecoxib + Ketorolac Contraindicated
- Celecoxib + Ketorolac intranasal Contraindicated
- Aceclofenac + Celecoxib Major
- Acemetacin + Celecoxib Major
- Amiloride + Celecoxib Major
- Apixaban + Celecoxib Major
Other interactions of Ramipril
- Aliskiren + Ramipril Contraindicated
- Protein a column + Ramipril Contraindicated
- Ramipril + Sacubitril / valsartan Contraindicated
- Ramipril + Sacubitril-valsartan Contraindicated
- Amifostine + Ramipril Major
- Amiloride + Ramipril Major
Frequently asked questions
Can I take Celecoxib with Ramipril?
MediHelp rates the interaction as moderate. Celecoxib and Ramipril can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Celecoxib can reduce the antihypertensive effect of ramipril. In elderly, volume-depleted or renally impaired patients, the combination may lead to acute kidney injury and hyperkalemia.
How serious is the interaction between Celecoxib and Ramipril?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure, serum creatinine and potassium at initiation and periodically thereafter, and keep patients hydrated. Prefer paracetamol or the lowest NSAID dose for the shortest duration in high-risk patients.
What other medicines interact with Celecoxib?
MediHelp also lists interactions of Celecoxib with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Celecoxib page.
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