Atenolol and Floctafenine: 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
Floctafenine
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) helps lower your blood pressure. Floctafenine is an anti-inflammatory pain reliever (an NSAID). When these are taken together, the pain medicine can make your blood pressure medicine work a little less well, so your blood pressure may creep up. This happens because NSAIDs affect natural substances in your kidneys that help control blood pressure and fluid.
The good news is this is easy to keep an eye on. If you take both, your care team can simply check your blood pressure and adjust things if needed. Don't stop either medicine on your own. Just mention to your pharmacist or doctor that you're using both.
Effect: Reduced antihypertensive efficacy of atenolol when combined with floctafenine (an NSAID).
Mechanism: NSAID inhibition of renal prostaglandin synthesis promotes sodium/fluid retention and reduced vasodilation, blunting beta-blocker BP control. This is a PD interaction; neither agent is a prodrug.
- Direction: Attenuated BP-lowering effect (possible BP elevation)
- Onset: Delayed
- Evidence: Probable (class effect documented for several NSAIDs)
- Severity: Moderate
Management: Monitor blood pressure during concomitant use; antihypertensive regimen may need individualized adjustment. Some NSAIDs (e.g., sulindac) show less antagonism if an alternative is considered.
What happens
Reduced antihypertensive effect
Interaction Deep Dive
Using NSAIDs together with beta-adrenergic blockers can raise blood pressure and disrupt blood pressure management94. This has been documented with flurbiprofen (400 mg daily), ibuprofen (in doses exceeding 400 mg daily), indomethacin (in doses exceeding 50 mg daily), naproxen (1000 mg daily), and piroxicam6510. In contrast, sulindac may not oppose the antihypertensive action of beta-blockers1110. When NSAIDs and beta blockers must be used concurrently, monitor blood pressure14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
This interaction is manageable, and you should keep taking both medicines as prescribed unless your care team tells you otherwise.
- Monitor your blood pressure more closely, especially after starting the pain medicine, since the effect can build up over time.
- Your blood pressure treatment may need to be adjusted and individualized by your care team if readings rise.
- Ask your pharmacist or doctor whether a different pain reliever might be a better fit if you need something long term.
Report any consistently higher blood pressure readings or new symptoms to your prescriber.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Hypertensive patients on their usual medications received ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. After the 3-week trial concluded, those given ibuprofen exhibited rises of about 6 mmHg across various blood pressure measurements. No measurable blood pressure effect was seen with acetaminophen. The proposed mechanism may involve diminished 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) Blood pressure response to naproxen and sulindac was investigated in 28 patients with mild to moderate essential hypertension that was well controlled with atenolol. Findings from this 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 left diastolic blood pressure unchanged. One week of sulindac 200 mg twice daily changed neither blood pressure measure 6.
c) Indomethacin was assessed in 16 patients with essential hypertension who were being treated with oxprenolol. Indomethacin, oxprenolol, and the combination of the two all 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 changes were roughly 50% smaller than those observed during the oxprenolol-alone phase 7.
d) In a single-blind study, adding 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. 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 Floctafenine together?
Floctafenine (an NSAID) can weaken atenolol's blood pressure control, so have your blood pressure checked when using both and talk with your care team about adjustments. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Floctafenine 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 Floctafenine interaction managed?
This interaction is manageable, and you should keep taking both medicines as prescribed unless your care team tells you otherwise. Monitor your blood pressure more closely, especially after starting the pain medicine, since the effect can build up over time. Your blood pressure treatment may need to be adjusted and individualized by your care team if readings rise. Ask your pharmacist or doctor wh… 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 Floctafenine 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 Floctafenine
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