Moderate
Established
Deskripsi
Celecoxib, a selective COX-2 inhibitor, attenuates the antihypertensive effect of lisinopril and increases the risk of renal impairment.
Mekanisme
COX-2 is constitutively expressed in the kidney and contributes to prostaglandin-mediated renal vasodilation; COX-2 inhibition reduces renal blood flow and opposes ACE-inhibitor-induced vasodilation.
Signifikansi Klinis
The renal risk is lower than with non-selective NSAIDs but still clinically meaningful; blood pressure elevation of 3–5 mmHg has been documented.
Penatalaksanaan
Monitor blood pressure and renal function; avoid in patients with renal impairment or heart failure. Prefer non-NSAID analgesics.