Atenolol and Clonixin: 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
Clonixin
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.
You're taking atenolol to help control your blood pressure, and clonixin is an anti-inflammatory pain reliever (an NSAID). When these are used together, the clonixin can make the atenolol work a little less well, so your blood pressure may not stay as low as it should.
This happens because NSAIDs like clonixin reduce certain natural substances in your kidneys (prostaglandins) that help keep blood pressure down. The good news is this is very manageable. Your care team can simply keep a closer eye on your blood pressure and adjust things if needed. Please don't stop either medicine on your own, just check in with your pharmacist or doctor.
Effect: NSAIDs such as clonixin may attenuate the antihypertensive efficacy of atenolol, a beta-blocker.
Mechanism: NSAID inhibition of renal prostaglandin synthesis promotes sodium/water retention and reduced vasodilation, blunting BP control (PD interaction, not PK). Neither agent is a prodrug in this context.
- Direction: reduced antihypertensive effect
- Onset: delayed
- Evidence: probable (class effect documented for other NSAIDs; sulindac may spare this effect)
- Severity: moderate
Management: Monitor blood pressure when coadministration is required; antihypertensive regimen may need individualized adjustment by the care team.
What happens
Reduced antihypertensive effect
Interaction Deep Dive
Using NSAIDs together with beta-adrenergic blockers can raise blood pressure and disrupt blood pressure management94. This has been documented with flurbiprofen (400 mg per day), ibuprofen (in doses exceeding 400 mg daily), indomethacin (at more than 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 concurrently, blood pressure should be monitored14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
This interaction is manageable with a few simple steps:
- Keep taking both medicines as prescribed unless your doctor or pharmacist tells you otherwise.
- Expect closer blood pressure monitoring. Your care team may check your blood pressure more often, especially in the first weeks after starting clonixin, since the effect can build gradually.
- Your blood pressure treatment may be adjusted and individualized by your team if your readings rise.
Let your pharmacist or prescriber know if you notice higher home blood pressure readings, headaches, or swelling. Ask whether an alternative pain reliever might suit you better.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Hypertensive patients maintained on their usual medications received ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. When the 3-week trial concluded, patients who received ibuprofen demonstrated rises of roughly 6 mmHg across several blood pressure measurements. No measurable blood pressure effect was seen with acetaminophen. 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. Findings from this 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) but left diastolic blood pressure unchanged. 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 combination of the two agents, suppressed plasma renin activity. With the two drugs administered together, blood pressure fell (systolic: -5.9 mmHg; diastolic: -4 mmHg; mean: -4.6 mmHg), but these blood pressure changes were diminished by approximately 50% relative to those observed during the oxprenolol-alone period 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 managed with oral propranolol at 10 mg to 240 mg daily. Serum propranolol concentrations were not measured, and patients with pre-existing renal disease, heart failure, or cirrhosis were not included in the study 8.
Common questions
Can I take Atenolol and Clonixin together?
Clonixin (an NSAID) can weaken how well atenolol controls your blood pressure, so have your blood pressure monitored and check with your care team rather than changing anything yourself. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Clonixin 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 Clonixin interaction managed?
This interaction is manageable with a few simple steps: Keep taking both medicines as prescribed unless your doctor or pharmacist tells you otherwise. Expect closer blood pressure monitoring. Your care team may check your blood pressure more often, especially in the first weeks after starting clonixin, since the effect can build gradually. Your blood pressure treatment may be adjusted and individu… 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 Clonixin 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 Clonixin
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