MajorSelective COX-2 inhibitor (coxib)×Angiotensin-converting enzyme inhibitors (ACEi)
Updated · Methodology
Mechanism
NSAIDs reduce renal blood flow via prostaglandin blockade. The ACE-I (enalapril) dilates glomerular efferent arterioles. The combination causes acute kidney injury, especially in older patients, chronic kidney disease, and dehydration.
Symptoms
Reduced urine output, rising creatinine and potassium, oedema. Symptoms appear earlier in older patients and in chronic kidney disease.
Management
For prolonged celecoxib therapy, check creatinine 2–4 weeks after start, then every 3 months. In older patients and chronic kidney disease, paracetamol is preferable.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Vasotec section 7 (2017)– ; DailyMed setid 39631f1f-5d19-43c1-b504-bf56d991ed97
- AEMPS: Ficha técnica: Celecoxib (nº registro 78687), sección 4.5 (2024)– AEMPS, CIMA, nº registro 78687, revisión 07/2024, sección 4.5
- AEMPS: Ficha técnica: Enalapril (nº registro 63355), sección 4.5 (2025)– AEMPS, CIMA, nº registro 63355, revisión 08/2025, sección 4.5