Atenolol and Lixisenatide: 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
Lixisenatide
No brand names on recordAtenolol
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 lixisenatide (a diabetes medicine that lowers blood sugar) along with atenolol (a beta-blocker for the heart or blood pressure). These two can affect each other in a couple of ways. Your blood sugar may run a little lower or higher than expected. Just as important, atenolol can hide one of the usual warning signs of low blood sugar, a fast or pounding heartbeat.
The good news is that other warning signs like sweating and dizziness usually still show up. Please keep taking both medicines as prescribed. Your care team can manage this easily by checking your sugar a bit more often and adjusting doses if needed. Talk with your pharmacist or doctor about how best to watch your levels.
Effect: Beta-blockade plus a GLP-1 agonist may alter glycemic control (hypo- or hyperglycemia) and may blunt the adrenergic warning signs of hypoglycemia.
- Direction: Variable glucose effect; masking of tachycardia as a hypoglycemia cue. Sweating and dizziness are generally preserved.
- Mechanism: Altered glucose metabolism combined with beta-adrenergic blockade. Atenolol is cardioselective, so risk is somewhat lower than with nonselective agents.
- Onset: Delayed. Evidence: Probable.
- Management: Increase frequency of glucose monitoring; individualize antidiabetic dosing as needed. If atenolol is discontinued, watch for loss of glycemic control.
What happens
Hypoglycemia or hyperglycemia; decreased symptoms of hypoglycemia
Interaction Deep Dive
Using antidiabetic medications together with beta-blockers can produce either hypoglycemia or hyperglycemia, and may mask the warning signs of low blood sugar23. Among hypoglycemic symptoms, tachycardia may be blunted, whereas others such as dizziness and sweating are not affected1. Insulin-induced hypoglycemia can be intensified by nonselective beta-blockers, which may also impede the return of serum glucose to normal levels. In individuals with both heart failure and diabetes, hyperglycemia may become worse7. More frequent glucose monitoring, or a change in the dose of the antidiabetic drug, may be necessary23. When these agents are given together, watch carefully for signs and symptoms of hypoglycemia, and should the beta-blocker be discontinued, monitor for a loss of glycemic control4.
Why it happens (mechanism)
Altered glucose metabolism and beta blockade
How to manage this interaction
Keep taking both medications as prescribed. This is a manageable interaction that your care team handles routinely.
- Your team may check your blood glucose more often, and your diabetes medicine dose may be adjusted and individualized as needed.
- Learn the low-sugar signs that atenolol does not hide, such as sweating and dizziness, since a racing heartbeat may be less noticeable.
- If atenolol is ever stopped, expect your team to watch for your blood sugar drifting higher.
- Raise any episodes of low or high blood sugar with your pharmacist or prescriber so they can fine-tune your plan.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
2 reports — tap to read
a) In elderly diabetic patients receiving either insulin or sulfonylureas, the particular antihypertensive agent selected had little influence on hypoglycemia risk; however, once other risk factors were accounted for, cardioselective beta blockers carried the lowest risk and non-cardioselective beta blockers the highest, while the remaining antihypertensive agents fell in between (N=13,559) 5.
b) In patients with hypertension and non-insulin dependent diabetes, beta blockers, though not alpha blockade or ACE inhibitors, produced a worsening of long-term glycemic control. Certain unfavorable changes in the lipid profile were also seen with beta blockade. These effects were particularly evident with propranolol. Using an alpha blocker together with the beta blocker prevented the worsening attributable to beta blockade 6.
Common questions
Can I take Atenolol and Lixisenatide together?
Taking lixisenatide with atenolol can shift your blood sugar either way and can mask a fast heartbeat that normally warns of low sugar, so monitor more closely and let your care team adjust as needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Lixisenatide 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 Lixisenatide interaction managed?
Keep taking both medications as prescribed. This is a manageable interaction that your care team handles routinely. Your team may check your blood glucose more often, and your diabetes medicine dose may be adjusted and individualized as needed. Learn the low-sugar signs that atenolol does not hide, such as sweating and dizziness, since a racing heartbeat may be less noticeable. If atenolol is ever… 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 Lixisenatide 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 (7)
- Product Information: TENORMIN(R) oral tablets, atenolol oral tablets. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2012. DailyMed
- Product Information: TOUJEO(R) subcutaneous injection, insulin glargine subcutaneous injection. sanofi-aventis (per manufacturer), Bridgewater, NJ, 2015. DailyMed
- Product Information: AMARYL(R) oral tablets, glimepiride oral tablets. Sanofi-Aventis U.S. LLC (per FDA), Bridgewater, NJ, 2013. DailyMed
- Product Information: Glynase(R) PresTab(R) oral micronized tablets, glyburide oral micronized tablets. Pharmacia & Upjohn Co (per FDA), New York, NY, 2013. DailyMed
- Shorr RI, Ray WA, Daugherty JR, et al: Antihypertensives and the risk of serious hypoglycemia in older persons using insulin or sulfonylureas. JAMA 1997; 278:40-43. DOI
- Whitcroft IA, Thomas JM, Rawsthorne A, et al: Effects of alpha and beta adrenoceptor blocking drugs and ACE inhibitors on long term glucose and lipid control in hypertensive non-insulin dependent diabetics. Horm Metab Res Suppl 1990; 22:42-46.
- Product Information: COREG CR(R) extended-release oral capsules, carvedilol phosphate extended-release oral capsules. GlaxoSmithKline, Research Triangle Park, NC, 2011. DailyMed
Keep reading about Lixisenatide
Keep reading about Atenolol
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