What is the interaction between ACE inhibitors and NSAIDs?

The interaction between ACE inhibitors and NSAIDs is well-documented, particularly concerning their effects on kidney function. When NSAIDs are used alongside ACE inhibitors, there is a potential for the NSAIDs to mitigate the antihypertensive effects of ACE inhibitors. This occurs because NSAIDs can reduce the production of renal prostaglandins, which are necessary for maintaining renal blood flow, especially in states of volume depletion or compromised renal perfusion. This action can lead to an increase in blood pressure, counteracting the intended effect of ACE inhibitors.

Moreover, the combination raises the risk of renal damage. The renal protective effect that ACE inhibitors provide might be undermined by NSAIDs, leading to acute kidney injury, particularly in individuals with existing renal impairment, dehydration, or other risk factors.

Understanding this interaction is crucial for managing patients who are prescribed both ACE inhibitors for hypertension and NSAIDs for pain or inflammation, as it involves careful monitoring and adjustments to therapy to prevent adverse effects.