Drug General Information (ID: DDIFC1IPH9)
Drug Name			Rofecoxib		Drug Info		Captopril		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiinflammatory Agents				Antihypertensive Agents
Structure

Mechanism of Rofecoxib-Captopril Interaction (Severity Level: Moderate)
Antagonize the effect of antihypertensive agents Click to Show/Hide Mechanism Graph
Drug Name		Rofecoxib				Captopril
Mechanism 1		Hypertensive effects				Antihypertensive agent
Key Mechanism Factor 1
		Factor Name		Antihypertensive agents
		Factor Description		The hypotensive effect of antihypertensive agents may be reduced, leading to higher blood pressure, increased blood pressure fluctuations, and possible cardiovascular damage.
Mechanism Description		Antagonize the effect of Captopril when combined with Rofecoxib
Mechanism 2		Hypertensive effects				Hypotensive effects
Key Mechanism Factor 2
		Factor Name		Antihypertensive agents
		Factor Description		The hypotensive effect of antihypertensive agents may be reduced, leading to higher blood pressure, increased blood pressure fluctuations, and possible cardiovascular damage.
Mechanism Description		Antagonize the effect of Captopril when combined with Rofecoxib

Recommended Action
Management		Patients receiving ACE inhibitors who require prolonged (greater than 1 week) concomitant therapy with an NSAID should have blood pressure monitored more closely following initiation, discontinuation, or change of dosage of the NSAID. Renal function should also be evaluated periodically during prolonged coadministration. The interaction is not expected to occur with low doses (e.g., low-dose aspirin) or intermittent short-term administration of NSAIDs.

References
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6	Product Information. Celebrex (celecoxib). Searle, Chicago, IL.
7	Product Information. Daypro (oxaprozin). Searle, Skokie, IL.
8	Product Information. Toradol (ketorolac). Roche Laboratories, Nutley, NJ.
9	Radack KL, Deck CC, Bloomfield SS "Ibuprofen interferes with the efficacy of antihypertensive drugs: a randomized, double-blind, placebo-controlled trial of ibuprofen compared with acetaminophen." Ann Intern Med 107 (1987): 628-35. [PMID: 2889416]
10	Seto S, Aoi W, Iwami K, et al "Effect of propranolol and indomethacin on the depressor action of captopril in patients with essential hypertension." Clin Exp Hypertens 9 (1987): 623-7. [PMID: 3301085]
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12	Townend JN, Doran J, Lote CJ, Davies MK "Peripheral haemodynamic effects of inhibition of prostaglandin synthesis in congestive heart failure and interactions with captopril." Br Heart J 73 (1995): 434-41. [PMID: 7786658]
13	Polonia J, Boaventura I, Gama G, Camoes I, Bernardo F, Andrade P, Nunes JP, Brandao F, Cerqueiragomes M "Influence of non-steroidal anti-inflammatory drugs on renal function and 24h ambulatory blood pressure-reducing effects of enalapril and nifedipine gastrointestinal therapeutic system in hypertensive patients." J Hypertens 13 (1995): 925-31. [PMID: 8557971]