Atenolol and Crizotinib: 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
Crizotinib
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.
What's going on: Both of these medicines can slow your heart rate. Crizotinib (Xalkori) is a cancer medicine that can lower heart rate on its own, and atenolol (Tenormin) is a beta-blocker whose whole job is to slow the heart and lower blood pressure. Taken together, those effects can add up, so your pulse could drop lower than intended.
You might notice things like feeling dizzy, lightheaded, unusually tired, or like your heart is beating slowly. The good news is this is very manageable. Your care team can check your heart rate and blood pressure and adjust things as needed. Please don't stop either medicine on your own, just talk with your doctor or pharmacist.
Mechanism: Additive pharmacodynamic bradycardia. Crizotinib is associated with bradycardia, and atenolol is a beta-1 selective antagonist that lowers heart rate; combined use can produce additive HR reduction. This is a PD interaction, not PK, and neither agent's metabolism drives it.
- Direction: Increased bradycardia risk (additive negative chronotropy).
- Severity/onset: Major; onset unspecified.
- Evidence: Theoretical.
Management: Avoid concurrent use when feasible. If coadministered, monitor HR and BP regularly. If bradycardia develops, reassess concomitant bradycardic agents and, per labeling, withhold, dose-reduce, or discontinue crizotinib as recommended. Individualize therapy with the oncology team.
What happens
An increased risk of bradycardia
Interaction Deep Dive
Do not use crizotinib together with medications that are recognized to produce bradycardia, such as beta-blockers, since the bradycardic effects may be additive. When such combined use cannot be avoided, check blood pressure and heart rate on a routine basis. Should bradycardia develop, reassess any concurrent medications known to induce bradycardia. Depending on the recommendations, crizotinib should be held, dose-reduced, or stopped permanently in cases of bradycardia1.
Why it happens (mechanism)
Additive bradycardia
How to manage this interaction
Keep taking both medicines as prescribed unless your care team tells you otherwise. Because both can slow the heart, teams usually manage this by watching you closely and adjusting as needed.
- Your team may check your heart rate and blood pressure regularly.
- Doses may be adjusted and individualized by your care team; sometimes an alternative to one drug is considered.
- Tell your prescriber or pharmacist if you feel dizzy, faint, very tired, or notice a slow pulse.
Don't start, stop, or change either medicine on your own, raise any concerns with your pharmacist or doctor first.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Atenolol and Crizotinib together?
Crizotinib and atenolol can both slow the heart, so together they may cause your pulse to drop too low. Keep taking both as prescribed, watch for dizziness or a slow heartbeat, and let your care team monitor and adjust as needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Crizotinib 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 Crizotinib interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. Because both can slow the heart, teams usually manage this by watching you closely and adjusting as needed. Your team may check your heart rate and blood pressure regularly. Doses may be adjusted and individualized by your care team; sometimes an alternative to one drug is considered. Tell your prescriber or pharma… 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 Crizotinib 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: XALKORI(R) oral pellets, oral capsules, crizotinib oral pellets, oral capsules. Pfizer Labs (per FDA), New York, NY, 2023. DailyMed
Keep reading about Crizotinib
Keep reading about Atenolol
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