Atenolol and Etoricoxib: 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
Etoricoxib
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.
Atenolol (Tenormin) is a beta blocker that helps lower your blood pressure. Etoricoxib is an anti-inflammatory drug used for pain and swelling. When you take them together, the etoricoxib can make the atenolol work a little less well, so your blood pressure may creep up.
This happens because anti-inflammatory drugs can change how your kidneys handle salt and fluid, which nudges blood pressure higher. The good news is this is easy to manage. 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 mention it to your pharmacist or doctor.
Effect: Reduced antihypertensive efficacy of atenolol when combined with etoricoxib (an NSAID/COX-2 inhibitor).
Mechanism: NSAID-mediated inhibition of renal prostaglandin synthesis promotes sodium and fluid retention and attenuates beta-blocker BP control. This is a PD interaction; neither drug's clearance is the driver.
- Direction: Diminished BP-lowering effect (possible BP rise).
- Onset: Delayed.
- Evidence: Probable (documented for several NSAIDs as a class effect).
- Management: Monitor blood pressure during concomitant use; individualize antihypertensive therapy as needed.
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 (in excess of 400 mg per day), indomethacin (in excess of 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 taken concurrently, monitor blood pressure14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
If you have been prescribed both, keep taking them as directed unless your prescriber tells you otherwise.
- Monitoring: Your care team will likely check your blood pressure more closely while you use both drugs together.
- Adjustment: If your blood pressure rises, your antihypertensive dose may need to be adjusted and individualized by your care team.
- What to raise: Tell your pharmacist or doctor you take both, and report home blood pressure readings that seem high. Ask whether a home BP monitor would help.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Hypertensive patients taking their usual medications were given ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. After the 3-week trial concluded, patients receiving ibuprofen exhibited rises of roughly 6 mmHg across several blood pressure measurements. Acetaminophen produced no measurable change in blood pressure. The underlying mechanism may involve a reduction in the effectiveness 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 investigated in 28 patients with mild to moderate essential hypertension that was well controlled with atenolol. Findings from the 5-week, double-blind, placebo-controlled trial 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 changed neither blood pressure measure 6.
c) Indomethacin was evaluated in 16 patients with essential hypertension who were being treated with oxprenolol. Indomethacin and oxprenolol individually, as well as the two combined, suppressed plasma renin activity. When both drugs were administered together, blood pressure fell (systolic: -5.9 mmHg; diastolic: -4 mmHg; mean: -4.6 mmHg), but these blood pressure changes were diminished by about 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 alongside treatment had no effect on blood pressure control in patients with mild to moderate hypertension managed with oral propranolol 10 mg to 240 mg daily. 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 Etoricoxib together?
Etoricoxib can blunt atenolol's blood-pressure-lowering effect, so have your blood pressure watched while you take both and keep taking them as prescribed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Etoricoxib 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 Etoricoxib interaction managed?
If you have been prescribed both, keep taking them as directed unless your prescriber tells you otherwise. Monitoring: Your care team will likely check your blood pressure more closely while you use both drugs together. Adjustment: If your blood pressure rises, your antihypertensive dose may need to be adjusted and individualized by your care team. What to raise: Tell your pharmacist or doctor you… 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 Etoricoxib 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 Etoricoxib
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