Drug interactions
Parecoxib + Ramipril
Severity: Moderate
Parecoxib 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
Parecoxib, a COX-2 inhibitor prodrug of valdecoxib, can blunt the antihypertensive effect of ramipril. In volume-depleted, elderly or renally impaired patients the combination can also precipitate acute kidney injury and raise potassium.
What this interaction means in plain words
Parecoxib 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.
Why it happens
Inhibition of renal prostaglandin synthesis reduces vasodilation and sodium excretion and impairs glomerular perfusion when ACE inhibition removes angiotensin II efferent tone.
What to do
Keep parecoxib to the shortest course, ensure adequate hydration, and monitor blood pressure, serum creatinine and potassium. Avoid in patients who are dehydrated or have renal impairment.
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 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 Parecoxib with Ramipril?
MediHelp rates the interaction as moderate. Parecoxib 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. Parecoxib, a COX-2 inhibitor prodrug of valdecoxib, can blunt the antihypertensive effect of ramipril. In volume-depleted, elderly or renally impaired patients the combination can also precipitate acute kidney injury and raise potassium.
How serious is the interaction between Parecoxib 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: Keep parecoxib to the shortest course, ensure adequate hydration, and monitor blood pressure, serum creatinine and potassium. Avoid in patients who are dehydrated or have renal impairment.
What other medicines interact with Ramipril?
MediHelp also lists interactions of Ramipril with, for example, Aliskiren, Protein a column, Sacubitril / valsartan. The full list is on the Ramipril page.
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