Is it safe to take ibuprofen with benazepril?
No, it's generally not safe. Ibuprofen, an NSAID, can reduce the blood pressure-lowering effect of benazepril, an ACE inhibitor used for hypertension. More critically, this combination raises the risk of acute kidney injury, especially in people with dehydration, heart failure, diabetes, or pre-existing kidney issues. Studies show up to a 30-80% increased risk of hospitalization for kidney problems with NSAID-ACE inhibitor use.[1][2]
Why does this interaction happen?
Benazepril relaxes blood vessels and helps kidneys filter blood by inhibiting angiotensin-converting enzyme. Ibuprofen inhibits prostaglandins, which normally protect kidney blood flow during blood pressure treatment. Together, they can cut kidney perfusion by 30-50%, leading to reduced glomerular filtration rate.[3]
Who is most at risk?
- Older adults (over 65): Kidney function declines naturally, amplifying damage.
- Those with chronic kidney disease, diabetes, or heart failure: Baseline risks compound.
- Dehydrated patients or those on diuretics: Fluid loss worsens the effect.
Short-term use in healthy, hydrated people might carry lower risk, but guidelines advise against it.[1][4]
What do doctors recommend instead?
Avoid the combo if possible. For pain, switch to acetaminophen (Tylenol), which lacks this interaction. If NSAIDs are needed, use the lowest dose for shortest time, with close kidney function monitoring (e.g., serum creatinine tests). Hydrate well and inform your doctor.[2][4]
How common are problems, and what are the signs?
Real-world data from over 1 million patients links this pair to 1.3 extra kidney injury cases per 100 person-years. Watch for fatigue, swelling, reduced urine output, nausea, or confusion—seek immediate care.[1][3]
Can you take them occasionally?
Even occasional use (e.g., one ibuprofen dose) carries risk, per FDA warnings on both drugs' labels. No "safe" threshold exists for everyone; consult a pharmacist or doctor for your case.[2]
[1]: FDA Label: Benazepril (Lotensin)
[2]: FDA Label: Ibuprofen (Motrin)
[3]: Lapi F et al. BMJ 2013; "Concurrent Use of Diuretics, ACE Inhibitors, and NSAIDs and Risk of Acute Kidney Injury" (doi:10.1136/bmj.f8525)
[4]: American College of Cardiology Guidelines on NSAID-ACEI Interactions