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Can you take Advil® / Motrin® with Prinivil®/Zestril®?

Evidence-based interaction check between Advil® / Motrin® and Prinivil®/Zestril®

MajorEditorially reviewed · last updated April 15, 2025

High risk — avoid this combination unless there is no good alternative.

Acute kidney injury (rising creatinine), reduced blood-pressure-lowering benefit from lisinopril, and elevated potassium. The risk roughly triples when an ACE inhibitor, a diuretic, and an NSAID are taken together — the so-called 'triple whammy'.

Why this happens (mechanism)

ACE inhibitors lower blood pressure partly by widening the blood vessels in the kidney; NSAIDs do the opposite by blocking prostaglandins that keep those vessels open. Combining the two can drop kidney blood flow sharply, especially in people already volume-depleted (older adults, diuretic users, hot weather).

What to monitor

  • Serum creatinine and potassium 1-2 weeks after starting/changing regular NSAID use
  • Blood pressure check; note if previously well-controlled BP rises
  • Daily fluid intake and signs of dehydration (dark urine, dizziness)
  • Urine output drop or new leg swelling

Dose adjustment

No dose change to lisinopril; reduce or stop the NSAID. If chronic NSAID use is medically necessary, hydrate well, recheck labs at 1-2 weeks, and reassess the combination at every visit.

Safer alternatives to consider

Acetaminophen (Tylenol)

No renal vasoconstriction effect; preferred analgesic in patients on ACE inhibitors.

Topical NSAID (diclofenac gel)

Much lower systemic exposure for localized musculoskeletal pain.

Always discuss alternatives with your prescriber before making any change. The right choice depends on your other medications, conditions, and what is working for you today.

Evidence and sources

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Check another pair

2 interactions found

Major

Kidney failure, reduced BP control

Moderate

NSAIDs blunt blood pressure reduction and increase acute kidney injury risk, especially problematic in elderly or dehydrated patients.

View Advil® / Motrin® View Prinivil®/Zestril®

What this means

This summary is based on published interaction data from FDA prescribing information and clinical literature. It does not account for individual health factors, dosages, or other medications you may be taking. Always consult a qualified healthcare provider before making changes to your medication regimen.

Frequently Asked Questions

Is it safe to take Advil® / Motrin® with Prinivil®/Zestril®?

High risk — avoid this combination unless there is no good alternative. Acute kidney injury (rising creatinine), reduced blood-pressure-lowering benefit from lisinopril, and elevated potassium. The risk roughly triples when an ACE inhibitor, a diuretic, and an NSAID are taken together — the so-called 'triple whammy'. Always discuss your full medication list with your prescriber.

What happens if you take Advil® / Motrin® and Prinivil®/Zestril® together?

ACE inhibitors lower blood pressure partly by widening the blood vessels in the kidney; NSAIDs do the opposite by blocking prostaglandins that keep those vessels open. Combining the two can drop kidney blood flow sharply, especially in people already volume-depleted (older adults, diuretic users, hot weather).

What should I monitor if I take both?

Serum creatinine and potassium 1-2 weeks after starting/changing regular NSAID use. Blood pressure check; note if previously well-controlled BP rises. Daily fluid intake and signs of dehydration (dark urine, dizziness). Urine output drop or new leg swelling.