Atenolol and Acemetacin: 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
Acemetacin
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.
Atenolol (Tenormin) is a beta-blocker that helps lower your blood pressure. Acemetacin is an anti-inflammatory painkiller (an NSAID). When you take an NSAID like this, it can make your blood pressure medicine work a little less well, so your numbers may creep up over time.
This doesn't happen overnight, and it doesn't mean you can't use both. The good news is your care team can keep an eye on your blood pressure and adjust things if needed. Please don't stop either medicine on your own. Just let your pharmacist or doctor know you're taking both so they can check your readings.
Effect: NSAIDs (including acemetacin) may reduce the antihypertensive efficacy of atenolol.
Mechanism: NSAID inhibition of cyclooxygenase decreases renal prostaglandin synthesis, promoting sodium/water retention and reduced vasodilation, which blunts beta-blocker BP control. This is a PD interaction; neither agent's clearance is the issue.
- Direction: reduced atenolol antihypertensive effect
- Onset: delayed
- Evidence: probable (class effect documented for several NSAIDs; sulindac may be less antagonistic)
- Magnitude: variable, dose-related
Management: Monitor blood pressure during concurrent use. Antihypertensive regimen may need to be individualized if BP control worsens.
What happens
Reduced antihypertensive effect
Interaction Deep Dive
Using NSAIDs together with beta-adrenergic blockers can raise blood pressure and disrupt blood pressure management94. Such an effect has been documented with flurbiprofen (400 mg per day), ibuprofen (over 400 mg per day), indomethacin (over 50 mg per day), naproxen (1000 mg per day), and piroxicam6510. In contrast, sulindac may not counteract the antihypertensive action of beta-blockers1110. When NSAIDs and beta blockers must be given concurrently, blood pressure should be monitored14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
This is a manageable combination. Here is what usually happens and what you can do:
- Keep taking both exactly as prescribed unless your doctor tells you otherwise.
- Your care team will likely monitor your blood pressure more closely while you use both, since the effect builds gradually.
- If your blood pressure rises, your team may adjust and individualize your dose or consider a different pain option.
- Home blood pressure checks (if you do them) are worth sharing at your next visit.
Raise with your pharmacist or prescriber: that you take both, and any new headaches, swelling, or higher readings.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Hypertensive patients who were maintained on their usual medications received either ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. After the 3-week study concluded, those who took ibuprofen exhibited rises of about 6 mmHg across several blood pressure measurements. No measurable effect on blood pressure was observed with acetaminophen. The underlying mechanism could involve a reduction in the efficacy of antihypertensive drugs due to interference with the generation of vasodilator and natriuretic prostaglandins that these antihypertensive agents stimulate. 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 assessed in 28 patients with mild to moderate essential hypertension that was well controlled with atenolol. Findings from the 5-week, double-blind, placebo-controlled trial showed that 1 week of naproxen 500 mg twice daily produced a significant rise in systolic blood pressure (mean 4 mmHg), while diastolic blood pressure was unchanged. Sulindac 200 mg twice daily for 1 week did not change either blood pressure measure 6.
c) The effects of indomethacin were evaluated in 16 patients with essential hypertension who were being treated with oxprenolol. Indomethacin and oxprenolol individually, as well as the combination of the two drugs, suppressed plasma renin activity. With the two drugs used together, blood pressure fell (systolic: -5.9 mmHg; diastolic: -4 mmHg; mean: -4.6 mmHg), but these blood pressure changes were diminished by roughly 50% compared with the period of oxprenolol alone 7.
d) In a single-blind study, giving oral naproxen 500 mg twice daily or oral sulindac 200 mg twice daily at the same time produced no effect on blood pressure control in patients with mild to moderate hypertension that was controlled with oral propranolol at 10 mg to 240 mg daily. Propranolol serum levels were not measured, and patients with preexisting renal disease, heart failure, or cirrhosis were not included in the study 8.
Common questions
Can I take Atenolol and Acemetacin together?
Acemetacin, like other NSAIDs, can gradually weaken atenolol's blood-pressure-lowering effect, so have your blood pressure monitored while using both and keep taking both as prescribed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Acemetacin 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 Atenolol and Acemetacin interaction managed?
This is a manageable combination. Here is what usually happens and what you can do: Keep taking both exactly as prescribed unless your doctor tells you otherwise. Your care team will likely monitor your blood pressure more closely while you use both, since the effect builds gradually. If your blood pressure rises, your team may adjust and individualize your dose or consider a different pain option… 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 Atenolol or Acemetacin 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 Acemetacin
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