Aceclofenac and Atenolol: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 15, 2026 · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Atenolol
Aceclofenac
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Here's what's going on. Atenolol (Tenormin) is a beta-blocker that helps lower your blood pressure. Aceclofenac is an anti-inflammatory pain reliever (an NSAID). When you take an NSAID regularly, it can make your body hold onto a bit more fluid and can blunt how well your blood pressure medicine works. So your atenolol may not control your blood pressure quite as well as usual.
The good news is this is easy to keep an eye on. If you use both, your doctor or pharmacist can check your blood pressure and adjust things if needed. Don't stop either medicine on your own, just bring it up at your next visit.
Effect: Reduced antihypertensive efficacy of atenolol when combined with aceclofenac (an NSAID).
Mechanism: NSAID inhibition of cyclooxygenase decreases renal prostaglandin synthesis, promoting sodium/fluid retention and attenuating beta-blocker blood-pressure control. This is a PD interaction; neither agent's clearance is the issue.
- Direction: Diminished BP lowering (possible loss of control).
- Onset: Delayed (develops over days of regular NSAID use).
- Evidence: Probable; documented for several NSAIDs. Sulindac may be less antagonistic.
- Management: Monitor blood pressure during concomitant use; dose may need individualizing by the care team; use lowest effective NSAID dose/duration.
What happens
Reduced antihypertensive effect
Interaction Deep Dive
When NSAIDs are used together with beta-adrenergic blockers, blood pressure may rise and control of blood pressure may be compromised94. Such an effect has been documented with flurbiprofen (400 mg per day), ibuprofen (in excess of 400 mg per day), indomethacin (above 50 mg per day), naproxen (1000 mg per day), and piroxicam6510. In contrast, sulindac may not oppose the antihypertensive action of beta-blockers1110. Blood pressure should be monitored whenever NSAIDs and beta blockers must be taken concurrently14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
Keep taking both as prescribed unless your prescriber tells you otherwise. This interaction is manageable with monitoring.
- Your care team will likely check your blood pressure more closely while you use both drugs, especially during regular or longer NSAID use.
- Your blood pressure medicine dose may be adjusted and individualized by your team if readings creep up.
- Using the aceclofenac at the lowest effective dose for the shortest time helps.
- Ask your pharmacist or doctor whether a different pain option might suit you if you need frequent pain relief.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Hypertensive patients taking their usual medications were given ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. After the 3-week trial concluded, those receiving ibuprofen exhibited increases of about 6 mmHg across various blood pressure measurements. Acetaminophen produced no detectable effect on blood pressure. The mechanism may involve a lessening of antihypertensive drug effectiveness due to interference with the production of vasodilator and natriuretic prostaglandins that are stimulated by antihypertensive agents. A decrease in sodium excretion may have contributed to worsening the hypertension 5.
b) The impact of naproxen and sulindac on blood pressure response was investigated in 28 patients with mild to moderate essential hypertension well controlled with atenolol. The findings of this 5-week, double-blind, placebo-controlled trial showed that 1 week of naproxen 500 mg twice daily significantly raised systolic blood pressure (mean 4 mmHg) but did not change diastolic blood pressure. Sulindac 200 mg twice daily for 1 week did not modify either blood pressure parameter 6.
c) The effects of indomethacin were assessed in 16 patients with essential hypertension who were treated with oxprenolol. Indomethacin and oxprenolol individually, and the combination of the two drugs, all suppressed plasma renin activity. When the two drugs were administered together, blood pressure fell (systolic: -5.9 mmHg; diastolic: -4 mmHg; mean: -4.6 mmHg), but the blood pressure changes produced were reduced by roughly 50% compared with those during the oxprenolol-alone period 7.
d) Simultaneous administration of oral naproxen 500 mg twice daily or oral sulindac 200 mg twice daily produced no effect on blood pressure control in patients with mild to moderate hypertension controlled with oral propranolol 10 mg to 240 mg daily in a single-blind study. Serum propranolol levels were not measured, and patients with preexisting renal disease, heart failure, or cirrhosis were not included 8.
Common questions
Can I take Aceclofenac and Atenolol together?
Aceclofenac can make atenolol control your blood pressure a bit less well, so have your blood pressure checked while using both and let your care team adjust things if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Aceclofenac and Atenolol interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How is the Aceclofenac and Atenolol interaction managed?
Keep taking both as prescribed unless your prescriber tells you otherwise. This interaction is manageable with monitoring. Your care team will likely check your blood pressure more closely while you use both drugs, especially during regular or longer NSAID use. Your blood pressure medicine dose may be adjusted and individualized by your team if readings creep up. Using the aceclofenac at the lowes… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Aceclofenac or Atenolol need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (11)
- Product Information: ZORVOLEX(R) oral capsules, diclofenac oral capsules. Iroko Pharmaceuticals, LLC (per FDA), Philadelphia, PA, 2016. DailyMed
- Product Information: ANAPROX(R) DS oral tablets, naproxen sodium oral tablets. Canton Laboratories, LLC (per FDA), Alpharetta, GA, 2016. DailyMed
- Product Information: CALDOLOR(R) intravenous injection, ibuprofen intravenous injection. Cumberland Pharmaceuticals Inc. (per FDA), Nashville, TN, 2016. DailyMed
- Product Information: COMBOGESIC(R) oral tablets, acetaminophen ibuprofen oral tablets. AFT Pharmaceuticals Inc (per FDA), Highland, MD, 2023. DailyMed
- 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 1987; 107:628-635. PubMed
- Abate MA, Layne RD, Neely JL, et al: Effect of naproxen and sulindac on blood pressure response to atenolol. Drug Intell Clin Pharm 1990; 24:810-813. DOI
- Salvetti A, Arzilli F, Pedrinelli R, et al: Interaction between oxprenolol and indomethacin on blood pressure in essential hypertensive patients. Eur J Clin Pharmacol 1982; 22:197-201. DOI
- Schuna AA, Vejraska BD, Hiatt JG, et al: Lack of interaction between sulindac or naproxen and propranolol in hypertensive patients. J Clin Pharmacol 1989; 29:524-528. PubMed
- Product Information: VIMOVO(TM) delayed release oral tablets, naproxen and esomeprazole magnesium delayed release oral tablets. AstraZeneca LPW, Wilmington, DE, 2010. DailyMed
- Salvetti A, Pedrinelli R, Alberici P, et al: The influence of indomethacin and sulindac on some pharmacological actions of atenolol in hypertensive patients. Br J Clin Pharmacol 1984; 17(suppl):108S-111S. PubMed
- Abate MA, Neely JL, Layne RD, et al: Interaction of indomethacin and sulindac with labetolol. Br J Clin Pharmacol 1991; 31:363-366.
Keep reading about Atenolol
Keep reading about Aceclofenac
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