Enalapril NSAIDs

Diclofenac is a non-steroidal anti-inflammatory drug. NSAIDs interact with both angiotensin-converting enzyme inhibitors, such as enalapril, and beta-adrenoceptor blockers, such as atenolol, resulting in antagonism to the hypotensive reaction, leading to a hypertensive reaction. NSAIDs interact with... 

ACE INHIBITORS, ANGIOTENSIN II RECEPTOR ANTAGONISTS ASPIRIN t risk of renal impairment. 1 efficacy of captopril and enalapril with high-dose (>100mg/day) aspirin Aspirin and NSAIDs can cause elevation of BP. Prostaglandin inhibition leads to sodium and water retention and poor renal function in those with impaired renal blood flow Monitor renal function every 3-6 months watch for poor response to ACE inhibitors when >100mg/day aspirin is given... 

Slc22a7) Drugs NSAIDs, AZT, MTX, zalcitabine Drugs p-lactam antibiotics, NSAIDs, bumetanide, enalapril, glibenclamide, rifampicin, verapamil... 

Clinically important, potentially hazardous interactions with ACE inhibitors, alcohol, amiloride, barbiturates, benazepril, captopril, cyclosporine, enalapril, fosinopril, juniper, lisinopril, mitotane, moexipril, narcotics, NSAIDs, potassium chloride, potassium iodide, quinapril, ramipril, trandolapril, triamterene, zofenopril... 

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. 

Nitrendipine. A post-hoc analysis of the Syst-Eur trial of nitrendipine-based antihypertensive treatment found no difference in cardiovascular outcome between 861 patients who were also using long-term aspirin (700 patients) and/or other NSAIDs (161) and 2882 patients who had never taken aspirin or NSAIDs. Patients in this trial were randomised to receive nitrendipine, which could be combined or replaced by enalapril, hydrochlorothiazide, or both. ... 

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