Atenolol and Dexketoprofen: 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
Dexketoprofen
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.
What's going on: Atenolol (Tenormin) is a beta-blocker that helps lower your blood pressure. Dexketoprofen is an anti-inflammatory pain reliever (an NSAID), similar to ibuprofen or naproxen. When taken together over time, the NSAID can make your body hold onto more fluid and can partly block how well the atenolol lowers your blood pressure.
The good news is this is manageable. If you and your doctor decide you need both, your care team can simply keep an 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: Reduced antihypertensive efficacy of atenolol with concomitant dexketoprofen.
Mechanism: NSAID inhibition of renal prostaglandin synthesis (COX), causing sodium/fluid retention and blunting of beta-blocker BP control. This is a PD interaction, not CYP-mediated; neither agent is a prodrug in a way that alters direction.
- Direction: Attenuated blood-pressure lowering.
- Onset: Delayed (develops over days of continued use).
- Evidence: Probable; documented for other NSAIDs (ibuprofen, naproxen, indomethacin, piroxicam), reasonably extrapolated to dexketoprofen.
- Management: Monitor BP when co-use is required; antihypertensive regimen may need individualized adjustment.
What happens
Reduced antihypertensive effect
Interaction Deep Dive
Using NSAIDs together with beta-adrenergic blockers can raise blood pressure and disrupt blood pressure control94. Such an effect has been documented with flurbiprofen (400 mg per day), ibuprofen (greater than 400 mg per day), indomethacin (greater than 50 mg per day), naproxen (1000 mg per day), and piroxicam6510. In contrast, sulindac may not counteract the antihypertensive action of beta-blockers1110. When NSAIDs and beta blockers must be given concurrently, monitor blood pressure14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
Keep taking both as prescribed unless your prescriber tells you otherwise. This interaction is usually handled with closer monitoring.
- Expect your care team to monitor your blood pressure more closely, especially when you first combine these or use the NSAID regularly.
- Your blood pressure medicine dose may need to be adjusted and individualized by your care team if readings rise.
- Tell your pharmacist or doctor if you notice higher readings, swelling in your legs, or new shortness of breath.
- Ask whether a different pain option or the lowest effective NSAID dose for the shortest time makes sense for you.
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 ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. After the 3-week study concluded, those receiving ibuprofen exhibited rises 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 efficacy of antihypertensive drugs due to interference with the production of vasodilator and natriuretic prostaglandins that these agents stimulate. Decreased sodium excretion may have contributed to worsening the hypertension 5.
b) The influence of naproxen and sulindac on blood pressure response was evaluated in 28 patients with mild to moderate essential hypertension that was well controlled with atenolol. Findings from this 5-week, double-blind, placebo-controlled study 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 did not change either 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 given together, suppressed plasma renin activity. With the two drugs administered in combination, blood pressure fell (systolic: -5.9 mmHg; diastolic: -4 mmHg; mean: -4.6 mmHg), but these blood pressure changes were diminished by roughly 50% relative to those seen during the oxprenolol-alone phase 7.
d) 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 in a single-blind study. Serum propranolol concentrations were not measured, and patients with existing renal disease, heart failure, or cirrhosis were not included 8.
Common questions
Can I take Atenolol and Dexketoprofen together?
Dexketoprofen can partly reduce how well atenolol controls your blood pressure, especially with regular use. Keep taking both as prescribed and have your blood pressure monitored so your team can adjust if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Dexketoprofen 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 Dexketoprofen interaction managed?
Keep taking both as prescribed unless your prescriber tells you otherwise. This interaction is usually handled with closer monitoring. Expect your care team to monitor your blood pressure more closely, especially when you first combine these or use the NSAID regularly. Your blood pressure medicine dose may need to be adjusted and individualized by your care team if readings rise. Tell your pharmac… 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 Dexketoprofen 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 Dexketoprofen
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