Atenolol and Bromfenac: 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
Bromfenac
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) helps lower your blood pressure. Bromfenac is an anti-inflammatory drug (an NSAID). NSAIDs can cause your body to hold onto fluid and salt and can nudge your blood pressure up. This means bromfenac may work against your atenolol, so your blood pressure may not be controlled as well.
The good news is bromfenac is usually given as an eye drop, so very little enters the bloodstream, and this effect tends to build up slowly rather than all at once. The most important thing is simply to keep taking both as prescribed and let your care team check your blood pressure. They can easily manage this by watching your numbers and adjusting things if needed.
Effect: NSAIDs may blunt the antihypertensive efficacy of beta-blockers via inhibition of renal prostaglandin synthesis, causing sodium/fluid retention and reduced vasodilation.
- Direction: Reduced atenolol antihypertensive effect (PD interaction, not a prodrug issue).
- Onset: Delayed. Evidence: Probable; documented mainly with systemic NSAIDs (ibuprofen, naproxen, indomethacin, etc.).
- Note: Bromfenac is typically ophthalmic, so systemic absorption and clinical impact are expected to be minimal, but the mechanism still applies.
- Management: Monitor blood pressure during concomitant use; individualize antihypertensive therapy if BP rises.
What happens
Reduced antihypertensive effect
Interaction Deep Dive
Using NSAIDs together with beta-adrenergic blockers can raise blood pressure and hinder blood pressure management94. Such an effect has been documented with flurbiprofen (400 mg daily), ibuprofen (exceeding 400 mg daily), indomethacin (exceeding 50 mg daily), naproxen (1000 mg daily), and piroxicam6510. In contrast, sulindac may not counteract the antihypertensive action of beta-blockers1110. When NSAIDs and beta blockers must be taken together, blood pressure should be monitored14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
This interaction is manageable, and you should keep taking both medications as prescribed unless your prescriber tells you otherwise.
- Your care team will likely monitor your blood pressure during the time you are using both drugs.
- If your blood pressure creeps up, your atenolol dose or overall blood pressure plan may be adjusted and individualized by your team.
- Because bromfenac is usually an eye drop, the effect on blood pressure is often small, but it is still worth mentioning.
- Tell your pharmacist or doctor if you notice higher home readings, swelling, or unusual headaches.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Hypertensive patients on their standard therapy were given either ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. After the 3-week study period, those receiving ibuprofen had increases of about 6 mmHg across various blood pressure measurements. Acetaminophen produced no observable change in blood pressure. The proposed mechanism may involve a reduction in the effectiveness of antihypertensive drugs due to interference with the production 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 influence of naproxen and sulindac on blood pressure response was investigated in 28 patients whose mild to moderate essential hypertension was well controlled with atenolol. In this 5-week, double-blind, placebo-controlled study, 1 week of naproxen 500 mg twice daily produced a significant rise in systolic blood pressure (mean 4 mmHg) but had no effect on diastolic blood pressure. Sulindac 200 mg twice daily for 1 week changed neither blood pressure parameter 6.
c) The effects of indomethacin were assessed in 16 patients with essential hypertension who were being treated with oxprenolol. Indomethacin and oxprenolol individually, as well as the two drugs together, suppressed plasma renin activity. With the two agents given together, blood pressure fell (systolic: -5.9 mmHg; diastolic: -4 mmHg; mean: -4.6 mmHg), but these blood pressure changes were about 50% smaller than those seen during the oxprenolol-alone phase 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 had no effect on blood pressure control in patients whose mild to moderate hypertension was controlled with oral propranolol 10 mg to 240 mg daily. Serum propranolol concentrations were not measured, and patients with existing renal disease, heart failure, or cirrhosis were not included in the study 8.
Common questions
Can I take Atenolol and Bromfenac together?
Bromfenac (an NSAID) can slightly weaken atenolol's blood-pressure-lowering effect, so have your blood pressure monitored while using both. Keep taking both as prescribed and report any rise to your care team. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Bromfenac 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 Bromfenac interaction managed?
This interaction is manageable, and you should keep taking both medications as prescribed unless your prescriber tells you otherwise. Your care team will likely monitor your blood pressure during the time you are using both drugs. If your blood pressure creeps up, your atenolol dose or overall blood pressure plan may be adjusted and individualized by your team. Because bromfenac is usually an eye… 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 Bromfenac 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 Bromfenac
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