Atenolol and Ceritinib: 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
Ceritinib
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.
Both of these medicines can slow your heart rate. Atenolol is a beta-blocker, which is designed to slow the heart and lower blood pressure. Ceritinib, a cancer medicine, has also been linked to a slower heart rate. When you take them together, those effects can add up and your heart could beat too slowly (called bradycardia). You might feel tired, dizzy, lightheaded, or even faint.
The good news is that this is very manageable. Keep taking both exactly as prescribed and let your care team know if you feel dizzy or notice a slow pulse. Your team can watch your heart rate and blood pressure and adjust things if needed.
Effect: Additive risk of bradycardia when ceritinib is combined with atenolol.
Mechanism: Pharmacodynamic (additive), not PK-mediated. Atenolol slows AV nodal conduction and heart rate via beta-1 blockade; ceritinib is independently associated with bradycardia. Neither is a prodrug here, so effects simply stack.
- Direction: Increased bradycardic effect.
- Onset: Unspecified.
- Evidence: Theoretical.
- Management: Avoid concomitant use where feasible. Monitor heart rate and blood pressure regularly. Per prescribing information, based on severity, withhold ceritinib and resume at a reduced dose upon resolution, or discontinue. Any beta-blocker changes are physician-directed.
What happens
Increased risk of bradycardia
Interaction Deep Dive
Bradycardia has been reported with ceritinib. When feasible, refrain from giving ceritinib together with other agents recognized to produce bradycardia (for example, beta-blockers, nondihydropyridine calcium channel blockers, clonidine, and digoxin). Blood pressure and heart rate should be checked on a regular basis. Depending on how severe the adverse reaction is, either hold ceritinib and restart it at a lowered dose once the bradycardia has resolved, or stop it permanently1.
Why it happens (mechanism)
Additive bradycardic effects
How to manage this interaction
This is manageable with monitoring and dose tailoring by your care team. Continue taking both medicines as prescribed unless your prescriber tells you otherwise.
- Your team will likely check your heart rate and blood pressure regularly.
- If bradycardia develops, your oncologist may adjust the ceritinib dose (holding it and restarting at a lower dose once resolved, or in some cases stopping it). These decisions are individualized by your care team.
- Report symptoms like dizziness, unusual tiredness, fainting, or a very slow pulse to your pharmacist or doctor.
- Do not start or stop either drug on your own.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Atenolol and Ceritinib together?
Atenolol and ceritinib can both slow the heart, so together they raise the risk of bradycardia; keep taking both as prescribed and let your care team monitor your heart rate and adjust doses if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Ceritinib interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Atenolol and Ceritinib interaction managed?
This is manageable with monitoring and dose tailoring by your care team. Continue taking both medicines as prescribed unless your prescriber tells you otherwise. Your team will likely check your heart rate and blood pressure regularly. If bradycardia develops, your oncologist may adjust the ceritinib dose (holding it and restarting at a lower dose once resolved, or in some cases stopping it). Thes… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Atenolol or Ceritinib 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 a safer alternative to one of these medications for me?
References (1)
- Product Information: ZYKADIA(R) oral capsules, oral tablets, ceritinib oral capsules, oral tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2019. DailyMed
Keep reading about Ceritinib
Keep reading about Atenolol
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