Can You Take Aspirin And Lisinopril Together?

In our latest question and answer, the pharmacist the interaction between aspirin and lisinopril.

Jan 28, 2018

Cindy asked

I am supposed to start lisinopril and just read you can't take aspirin with it? My Dr knows I take an aspirin a day and never said anything. I also take Excedrin migraine does this mean I have to suffer and not take what works for my headaches or ask for different BP med?

Answer

There is a minor interaction between aspirin and lisinopril (an ACE-Inhibitor medication). However, this interaction does not preclude the use of both together.

Aspirin - Lisinopril Interaction

Studies indicate that aspirin can reduce the vasodilatory effects of all ACE-inhibitors (which includes lisinopril). Lisinopril works to reduce blood pressure and the risk of cardiovascular disease via many mechanisms. One such mechanism is that it decreases the breakdown of bradykinin. Bradykinin is a strong vasodilator and increases the formation of vasodilatory prostaglandins.  

Aspirin (and many other medications) work by inhibiting the enzyme cyclooxygenase (i.e. COX) , which decreases the production of the prostaglandins. This inhibition can attenuate (i.e. decrease) the effects of ACE-Inhibitors, such as lisinopril.  However, in most patients, studies have shown significant benefits in using aspirin in addition to an ACE inhibitor in patients with specific disease states such as ischemic heart disease and left ventricular dysfunction. 

Overall, it appears most patients receive additional benefit using aspirin and ACE-Inhibitors (such as lisinopril) together. The interaction certainly exists, but the benefits of the combination outweigh the negative impact of the interaction in most situations. Generally speaking, your doctor should monitor how you're responding to therapy and adjust doses as needed for optimal effect.

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