Rofecoxib Benazepril

This effect is more prominent in patients with low renin concentrations. The interaction of COX-2 inhibitors with ACE inhibitors has been much less well investigated. In a review of Phase II/III studies of COX-2 inhibitors, it was reported that the co-administration of rofecoxib 25 mg/day and benazepril 10-40 mg/day for 4 weeks was associated with an average increase in mean arterial pressure of about 3 mmHg compared with ACE inhibitor monotherapy (121). 

Two studies that compared the interaction of celecoxib with ACE inhibitors found no difference in blood pressure effects compared to placebo [58, 59]. In one study (n=359), the blood pressure (systohc and diastolic) effects of celecoxib 200 mg BID and nabumetone 1 g BID were found to be similar to placebo, but significantly different from ibuprofen 800 mg IID [58]. In the second study (n=178), the effects of celecoxib 400 mg daily and placebo on 24-hour blood pressure in hypertensive patients controlled on hsinopiil 10-40 mg daily was evaluated [59]. No difference between groups was observed in 24-hour ambulatory SBP. The difference between groups in 24-hour diastolic BP was only 1.4 mm Hg. The change from baseline in 24-hour blood pressure (1.8 mm Hg/1.4mm Hg) is less than what has been the effect of NSAIDs on the SBP (defined as an increase >20 mm Hg with an absolute value of >140 mm Hg) reported for traditional NSAIDs in ACE inhibitor-treated patients. On the other hand, co-ad-ministration of rofecoxib 25 mg daily with benazepril 10-40 mg for 4 weeks in patients with mild to moderate... 

The manufacturer of rofecoxib noted that in patients with mild-to-moder-ate hypertension, rofecoxib 25 mg daily, taken with benazepril 10 to 40 mg daily, for four weeks, was associated with a small attenuation of the antihypertensive effect (average increase in mean arterial pressure of 2.8 mmHg). Similarly, a case report describes a patient taking lisinopril 10 mg daily whose blood pressure rose from 127/78 to 143/89 mmHg when he was given rofecoxib 25 mg daily. His blood pressure was controlled by increasing the dose of lisinopril to 20 mg daily. ... 

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See also in sourсe #XX -- [ ]

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