Drug interactions
Naproxen + Ramipril
Severity: Major
Naproxen and Ramipril: major 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
Naproxen can weaken the antihypertensive effect of ramipril. The combination may also reduce renal function and cause acute kidney injury, mainly in older, dehydrated or renally impaired patients.
What this interaction means in plain words
Naproxen and Ramipril 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.
Naproxen belongs to Musculoskeletal; Ramipril belongs to Cardiovascular.
Why it happens
NSAID inhibition of vasodilatory renal prostaglandins opposes ACE inhibitor effects and, with reduced angiotensin II-mediated efferent tone, lowers glomerular filtration.
What to do
Prefer a non-NSAID analgesic. If co-use is necessary, ensure adequate hydration and monitor blood pressure, serum creatinine and potassium, particularly after starting or changing doses.
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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Other interactions of Naproxen
- Ketorolac intranasal + Naproxen Contraindicated
- Ketorolac + Naproxen Contraindicated
- Aceclofenac + Naproxen Major
- Acemetacin + Naproxen Major
- Acetylsalicylic acid + Naproxen Major
- Alteplase + Naproxen 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 Naproxen with Ramipril?
MediHelp rates the interaction as major. Naproxen and Ramipril 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. Naproxen can weaken the antihypertensive effect of ramipril. The combination may also reduce renal function and cause acute kidney injury, mainly in older, dehydrated or renally impaired patients.
How serious is the interaction between Naproxen and Ramipril?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-NSAID analgesic. If co-use is necessary, ensure adequate hydration and monitor blood pressure, serum creatinine and potassium, particularly after starting or changing doses.
What other medicines interact with Naproxen?
MediHelp also lists interactions of Naproxen with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Naproxen page.
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