Drug Interaction Report

Atenolol and Droxicam: Interaction Details

A pharmacist-reviewed analysis of the Atenolol and Droxicam interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

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

Tenormin Tenormin®
+

Droxicam

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Jul 11, 2026
Editorial policy · Data sources
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
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.

Of 202 documented Atenolol interactions, 158 are rated moderate — including this one.
At a glance + Effects may be weaker
The Bottom Line
Taking the NSAID droxicam with atenolol may weaken atenolol's blood-pressure control over time, so keep taking both as prescribed and have your care team monitor your blood pressure.

Here's what's going on. Atenolol (Tenormin) is a beta-blocker that helps lower your blood pressure. Droxicam is an anti-inflammatory pain medicine (an NSAID). When you take an NSAID like this regularly, it can cause your body to hold on to more fluid and can make atenolol work a little less well, so your blood pressure may not stay as low as your doctor wants.

This doesn't happen instantly, and it's very manageable. The main thing is to keep taking both medicines as prescribed and let your care team check your blood pressure. If it creeps up, they can adjust things. Please talk with your pharmacist or doctor about the best plan for you.

Interaction: NSAID (droxicam) may blunt the antihypertensive efficacy of atenolol.

  • Mechanism: NSAID inhibition of COX reduces renal prostaglandin synthesis, promoting sodium/fluid retention and attenuating the beta-blocker's BP-lowering effect (PD antagonism, not CYP-mediated).
  • Direction: reduced atenolol antihypertensive effect.
  • Onset: delayed.
  • Evidence: probable; class effect documented for several NSAIDs (flurbiprofen, ibuprofen, indomethacin, naproxen, piroxicam). Sulindac may antagonize less.
  • Management: Monitor blood pressure during concomitant use; the antihypertensive regimen may need to be adjusted and individualized. Consider shortest effective NSAID course.
Onset
delayed
Evidence
probable
Severity
Moderate

What happens

Reduced antihypertensive effect

Interaction Deep Dive

Using NSAIDs together with beta-adrenergic blockers can raise blood pressure and hinder its control94. Such an effect has been documented with flurbiprofen (400 mg per day), ibuprofen (in excess of 400 mg per day), indomethacin (more than 50 mg per day), naproxen (1000 mg per day), and piroxicam6510. In contrast, sulindac may not counteract the blood pressure lowering 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

The good news: your care team can manage this by keeping an eye on your blood pressure.

  • Keep taking both atenolol and droxicam exactly as prescribed unless your prescriber tells you otherwise.
  • Expect blood pressure checks during the time you take both, since the effect builds up gradually.
  • If your blood pressure rises, your team may adjust and individualize your blood pressure medicine or reconsider the pain medicine.
  • Raise with your pharmacist or doctor: how long you'll need the NSAID, whether a different pain option fits you, and how often to monitor.

Management is individual — confirm any change with your pharmacist or prescriber.

Literature reports

4 reports — tap to read

a) Hypertensive patients who continued their standard medications were assigned to ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. At the conclusion of the 3-week study, those receiving ibuprofen exhibited rises of about 6 mmHg across several blood pressure measurements. Acetaminophen produced no measurable change in blood pressure. The underlying mechanism may involve reduced effectiveness of antihypertensive drugs due to interference with the generation of vasodilator and natriuretic prostaglandins that these agents stimulate. Decreased sodium excretion may have contributed to worsening of the hypertension 5.

b) The impact of naproxen and sulindac on blood pressure response was investigated in 28 patients with mild to moderate essential hypertension that was well managed with atenolol. Findings from the 5-week, double-blind, placebo-controlled study showed that 1 week of naproxen 500 mg twice daily significantly raised systolic blood pressure (mean 4 mmHg) but produced no change in diastolic blood pressure. Sulindac 200 mg twice daily for 1 week did not affect either blood pressure measurement 6.

c) The influence of indomethacin was assessed in 16 patients with essential hypertension 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 reductions were diminished by roughly 50% relative to those observed during the oxprenolol-alone phase 7.

d) Coadministration of oral naproxen 500 mg twice daily or oral sulindac 200 mg twice daily produced 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 preexisting renal disease, heart failure, or cirrhosis were not included in the study 8.

Common questions

Can I take Atenolol and Droxicam together?

Taking the NSAID droxicam with atenolol may weaken atenolol's blood-pressure control over time, so keep taking both as prescribed and have your care team monitor your blood pressure. Always confirm with your pharmacist or prescriber before making any change.

How serious is the Atenolol and Droxicam 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 Droxicam interaction managed?

The good news: your care team can manage this by keeping an eye on your blood pressure. Keep taking both atenolol and droxicam exactly as prescribed unless your prescriber tells you otherwise. Expect blood pressure checks during the time you take both, since the effect builds up gradually. If your blood pressure rises, your team may adjust and individualize your blood pressure medicine or reconsid… 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 Droxicam 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)

  1. Product Information: ZORVOLEX(R) oral capsules, diclofenac oral capsules. Iroko Pharmaceuticals, LLC (per FDA), Philadelphia, PA, 2016. DailyMed
  2. Product Information: ANAPROX(R) DS oral tablets, naproxen sodium oral tablets. Canton Laboratories, LLC (per FDA), Alpharetta, GA, 2016. DailyMed
  3. Product Information: CALDOLOR(R) intravenous injection, ibuprofen intravenous injection. Cumberland Pharmaceuticals Inc. (per FDA), Nashville, TN, 2016. DailyMed
  4. Product Information: COMBOGESIC(R) oral tablets, acetaminophen ibuprofen oral tablets. AFT Pharmaceuticals Inc (per FDA), Highland, MD, 2023. DailyMed
  5. 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
  6. 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
  7. 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
  8. 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
  9. Product Information: VIMOVO(TM) delayed release oral tablets, naproxen and esomeprazole magnesium delayed release oral tablets. AstraZeneca LPW, Wilmington, DE, 2010. DailyMed
  10. 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
  11. Abate MA, Neely JL, Layne RD, et al: Interaction of indomethacin and sulindac with labetolol. Br J Clin Pharmacol 1991; 31:363-366.
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