Indometacin Enalapril

Potassium-rich foods (e.g. bananas) can cause hyperkalaemia if the medication(s) used also tend to cause hyperkalaemia, for example potassiumsparing diuretics (triamterene, spironolactone), ACE inhibitors (captopril, enalapril, etc,), angiotensin receptor blockers and indometacin,... 

The manufacturer of spirapril briefly noted in a review that there was no relevant pharmacokinetic interaction between spirapril and diclofenac. Oxaprozin 1.2 g daily for 3 weeks did not affect the pharmacokinetics of enalapril 10 to 40 mg daily in 29 patients with hypertension. A brief mention is made in a review that, in healthy subjects, the pharmacokinetics of ramipril were unaffected by indometacin [dosage not stated] given for 3 days. ... 

The interaction between indometacin and ACE inhibitors is well established, with several studies showing that indometacin can reduce the blood pressure-lowering effect ofa number of ACE inhibitors. The interaction may not occur in all patients. If indometacin is required in a patient taking any ACE inhibitor, it would be prudent to monitor blood pressure. In a few small comparative studies, indometacin has been shown to have less effect on the calcium-channel blockers amlodipine, felodipine, and nifedipine, than on enalapril. See also, Calcium-channel blockers -i-Aspirin or NSAIDs , p.861. Therefore, a calcium-channel blocker may sometimes be an alternative to an ACE inhibitor in a patient requiring indometacin. 

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