Atenolol and Celecoxib: 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
Celecoxib
Atenolol
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.
Celecoxib (Celebrex) can make atenolol (Tenormin) work a little less well at controlling your blood pressure. Atenolol lowers your blood pressure, and celecoxib is an anti-inflammatory pain reliever. NSAIDs like celecoxib can cause your body to hold onto extra fluid and slow down natural substances in your kidneys that help keep blood pressure down. The result is that your blood pressure may creep up a bit.
This usually happens gradually, not all at once. The good news is that this is easy to keep an eye on. Keep taking both medications as prescribed, and your care team can check your blood pressure and adjust things if needed.
Effect: Reduced antihypertensive efficacy of atenolol when combined with celecoxib.
Mechanism: NSAID-mediated inhibition of renal prostaglandin synthesis (COX-2 selective for celecoxib), promoting sodium/fluid retention and attenuating beta-blocker BP control. Neither drug is a prodrug; this is a pharmacodynamic, not metabolic, interaction.
- Direction: Decreased atenolol antihypertensive effect (blood pressure may rise).
- Onset: Delayed.
- Evidence: Probable; documented across several NSAIDs.
- Severity: Moderate.
Management: Monitor blood pressure during concomitant use; individualize antihypertensive therapy as needed. Sulindac may cause less antagonism if an alternative NSAID is considered.
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 daily), ibuprofen (in doses exceeding 400 mg daily), indomethacin (in doses above 50 mg daily), naproxen (1000 mg daily), and piroxicam6510. In contrast, sulindac may not counteract the antihypertensive action of beta-blockers1110. Blood pressure should be monitored whenever NSAIDs and beta blockers must be taken together14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
This interaction is manageable with routine monitoring.
- Keep taking both celecoxib and atenolol as prescribed unless your prescriber tells you otherwise.
- Your care team will likely monitor your blood pressure more closely while you take both, especially in the first weeks and with ongoing NSAID use.
- Your atenolol dose or overall blood pressure plan may be adjusted and individualized by your team if your readings rise.
- Ask your pharmacist or doctor before starting or stopping any over-the-counter pain reliever, and mention if you notice higher home readings, swelling, or headaches.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Hypertensive patients continuing their usual therapy were given ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. After the 3-week trial concluded, those receiving ibuprofen exhibited rises of about 6 mmHg across various blood pressure measurements. Acetaminophen produced no detectable effect on blood pressure. The 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 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 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 affect either blood pressure measure 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. When the two agents were administered in combination, 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% in comparison with those seen during 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 had no effect on blood pressure control in patients with mild to moderate hypertension managed with oral propranolol 10 mg to 240 mg daily. Serum propranolol concentrations 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 Celecoxib together?
Celecoxib can slightly weaken how well atenolol controls your blood pressure, so keep taking both as prescribed and let your care team monitor your blood pressure and adjust if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Celecoxib 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 Celecoxib interaction managed?
This interaction is manageable with routine monitoring. Keep taking both celecoxib and atenolol as prescribed unless your prescriber tells you otherwise. Your care team will likely monitor your blood pressure more closely while you take both, especially in the first weeks and with ongoing NSAID use. Your atenolol dose or overall blood pressure plan may be adjusted and individualized by your team i… 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 Celecoxib 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 Celecoxib
Keep reading about Atenolol
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