Atenolol and Felbinac: 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
Felbinac
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 felbinac is an anti-inflammatory pain reliever (an NSAID). When these are used together, the felbinac can make your atenolol work a little less well, so your blood pressure may not stay as low as your doctor wants.
This happens because NSAIDs like felbinac can affect the way your kidneys handle salt and water and how your blood vessels relax, which can nudge blood pressure up. The good news is this is easy to keep an eye on. Please don't stop either medicine on your own. Just let your pharmacist or doctor know you're using both, and they can check your blood pressure and adjust things if needed.
Effect: NSAIDs such as felbinac may blunt the antihypertensive efficacy of atenolol, potentially raising blood pressure.
Mechanism: NSAID inhibition of renal prostaglandin synthesis promotes sodium and water retention and reduces vasodilation, opposing beta-blocker BP control.
- Direction: reduced atenolol antihypertensive effect (PD interaction, not prodrug-related)
- Onset: delayed
- Evidence: probable; documented for several NSAIDs (flurbiprofen, ibuprofen, indomethacin, naproxen, piroxicam)
- Magnitude: variable; sulindac may spare BP control
Management: Monitor blood pressure with concurrent use; individualize antihypertensive therapy as needed.
What happens
Reduced antihypertensive effect
Interaction Deep Dive
Taking 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 daily), ibuprofen (in excess of 400 mg daily), indomethacin (in excess of 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 used together, monitor blood pressure14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
This interaction is manageable with awareness and monitoring.
- Keep taking both medicines as prescribed unless your care team tells you otherwise.
- Blood pressure checks: your team may monitor your blood pressure more closely while you use both, especially in the first weeks.
- Dose: if your blood pressure creeps up, your atenolol or other blood pressure treatment may need to be adjusted and individualized by your care team.
- Tell your pharmacist or doctor about any regular or long-term NSAID use, and mention headaches or higher home readings.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Hypertensive patients continuing their usual medications received ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. After the 3-week trial concluded, 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 a reduction in the efficacy of antihypertensive drugs due to interference with the synthesis of vasodilator and natriuretic prostaglandins that 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 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 produced a significant rise in systolic blood pressure (mean 4 mmHg) but did not change diastolic blood pressure. 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 being treated with oxprenolol. Indomethacin and oxprenolol individually, as well as the two agents together, suppressed plasma renin activity. With the 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 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 with mild to moderate hypertension managed with oral propranolol 10 mg to 240 mg daily. Serum propranolol concentrations were not measured, and patients with preexisting renal disease, heart failure, or cirrhosis were not included 8.
Common questions
Can I take Atenolol and Felbinac together?
Felbinac (an NSAID) can make atenolol less effective at controlling blood pressure, so have your blood pressure monitored while using both and talk to your pharmacist or doctor before changing anything. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Felbinac 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 Felbinac interaction managed?
This interaction is manageable with awareness and monitoring. Keep taking both medicines as prescribed unless your care team tells you otherwise. Blood pressure checks: your team may monitor your blood pressure more closely while you use both, especially in the first weeks. Dose: if your blood pressure creeps up, your atenolol or other blood pressure treatment may need to be adjusted and individua… 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 Felbinac 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 Felbinac
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist