Drug interactions
Diclofenac + Ramipril
Severity: Moderate
Diclofenac 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
Diclofenac can blunt the blood pressure lowering effect of ramipril. Together they can also impair kidney function, particularly in older adults, volume-depleted patients or those with existing renal impairment. Hyperkalemia may also occur.
What this interaction means in plain words
Diclofenac 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.
Diclofenac belongs to Musculoskeletal; Ramipril belongs to Cardiovascular.
Why it happens
NSAID inhibition of cyclooxygenase reduces vasodilatory renal prostaglandins, opposing ACE inhibitor effects and lowering glomerular filtration pressure.
What to do
Monitor blood pressure, serum creatinine and potassium after starting or changing the NSAID, and keep the patient well hydrated. Use the lowest effective NSAID dose for the shortest time or choose a non-NSAID analgesic.
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 Diclofenac
- Diclofenac + Ketorolac Contraindicated
- Diclofenac + Ketorolac intranasal Contraindicated
- Aceclofenac + Diclofenac Major
- Acemetacin + Diclofenac Major
- Alteplase + Diclofenac Major
- Amiloride + Diclofenac 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 Diclofenac with Ramipril?
MediHelp rates the interaction as moderate. Diclofenac 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. Diclofenac can blunt the blood pressure lowering effect of ramipril. Together they can also impair kidney function, particularly in older adults, volume-depleted patients or those with existing renal impairment. Hyperkalemia may also occur.
How serious is the interaction between Diclofenac 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 after starting or changing the NSAID, and keep the patient well hydrated. Use the lowest effective NSAID dose for the shortest time or choose a non-NSAID analgesic.
What other medicines interact with Diclofenac?
MediHelp also lists interactions of Diclofenac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Diclofenac page.
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