Drug interactions
Enalapril + Parecoxib
Severity: Moderate
Enalapril and Parecoxib: 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
Parecoxib, a COX-2 selective NSAID prodrug, can reduce the blood pressure lowering effect of enalapril. Combined use raises the risk of renal impairment and hyperkalemia, particularly in dehydrated or older patients.
What this interaction means in plain words
Enalapril and Parecoxib 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.
Why it happens
Inhibition of renal prostaglandin synthesis causes sodium and water retention and reduced renal perfusion, counteracting ACE inhibition.
What to do
Ensure adequate hydration and monitor blood pressure, creatinine and potassium. Limit parecoxib to the shortest duration needed.
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 Enalapril
- Aliskiren + Enalapril Contraindicated
- Enalapril + Protein a column Contraindicated
- Enalapril + Sacubitril / valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Amifostine + Enalapril Major
- Amiloride + Enalapril Major
Frequently asked questions
Can I take Enalapril with Parecoxib?
MediHelp rates the interaction as moderate. Enalapril and Parecoxib 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. Parecoxib, a COX-2 selective NSAID prodrug, can reduce the blood pressure lowering effect of enalapril. Combined use raises the risk of renal impairment and hyperkalemia, particularly in dehydrated or older patients.
How serious is the interaction between Enalapril and Parecoxib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Ensure adequate hydration and monitor blood pressure, creatinine and potassium. Limit parecoxib to the shortest duration needed.
What other medicines interact with Enalapril?
MediHelp also lists interactions of Enalapril with, for example, Aliskiren, Protein a column, Sacubitril / valsartan. The full list is on the Enalapril page.
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