Atenolol and Saxagliptin: 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
Saxagliptin
Atenolol
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.
Taking Onglyza (saxagliptin) with Tenormin (atenolol)? Here is what to know. Saxagliptin helps lower your blood sugar, and atenolol is a beta-blocker for your heart or blood pressure. When used together, your blood sugar may run a little lower or a little higher than usual.
The trickier part is that atenolol can hide some warning signs of low blood sugar. Normally a fast heartbeat is one of the first clues, and atenolol can mute that. You will usually still feel sweating and dizziness. The good news is your care team can manage this easily by checking your sugar a bit more often and tailoring your doses. Do not stop either medicine on your own.
Effect: Combined DPP-4 inhibitor (saxagliptin) and beta-blocker (atenolol) use may alter glycemic control (hypo- or hyperglycemia) and can blunt adrenergic warning signs of hypoglycemia.
- Mechanism: Altered glucose metabolism plus beta blockade; atenolol masks tachycardia while diaphoresis and dizziness generally persist. Neither agent is metabolized as a prodrug relevant here.
- Direction/magnitude: Variable; unpredictable glycemic shift. Nonselective agents pose higher risk, but caution applies to atenolol too.
- Onset: Delayed. Evidence: Probable.
- Management: Increase glucose self-monitoring; individualize antidiabetic dosing. If atenolol is discontinued, watch for loss of glycemic control.
What happens
Hypoglycemia or hyperglycemia; decreased symptoms of hypoglycemia
Interaction Deep Dive
When antidiabetic medications are taken together with beta-blockers, the result may be hypoglycemia or hyperglycemia, and the symptoms of hypoglycemia may be masked23. Among hypoglycemic manifestations, tachycardia may be influenced, whereas others such as dizziness and sweating may not be 1. Insulin-induced hypoglycemia can be intensified by nonselective beta-blockers, which can also hinder the restoration of serum glucose levels. In individuals with both heart failure and diabetes, hyperglycemia may deteriorate 7. Dose modification of the antidiabetic drug or more frequent glucose monitoring may become necessary 23. During combined use, watch carefully for signs and symptoms of hypoglycemia, and should the beta-blocker be discontinued, monitor for a loss of glycemic control 4.
Why it happens (mechanism)
Altered glucose metabolism and beta blockade
How to manage this interaction
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. This combination is manageable with a few simple steps.
- Check your blood sugar more often, especially when starting, stopping, or changing either drug.
- Know that a racing heartbeat may be muffled, so pay attention to sweating, shakiness, and dizziness as low-sugar clues.
- Your antidiabetic dose may need to be adjusted and individualized by your care team.
- If your atenolol is ever stopped, watch for higher blood sugars and tell your team.
Bring your glucose logs to your pharmacist or doctor 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 selection of antihypertensive agent had minimal impact on hypoglycemia risk; however, once other risk factors were accounted for, the lowest risk was observed with cardioselective beta blockers and the highest with non-cardioselective beta blockers, while other antihypertensive agents fell somewhere in between (N=13,559) 5.
b) Beta blockers, though not alpha blockade or ACE inhibitors, led to a worsening of long-term glycemic control in patients who had hypertension and non-insulin dependent diabetes. Certain unfavorable effects on the lipid profile were also seen with beta blockade. These effects were most pronounced with propranolol. Using an alpha blocker together with the beta blocker prevented the worsening caused by beta blockade 6.
Common questions
Can I take Atenolol and Saxagliptin together?
Saxagliptin and atenolol can be used together, but your blood sugar may shift and atenolol can hide a fast heartbeat that normally warns of a low. Monitor glucose more closely and rely on sweating and dizziness as low-sugar signs. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Atenolol and Saxagliptin 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 Saxagliptin interaction managed?
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. This combination is manageable with a few simple steps. Check your blood sugar more often, especially when starting, stopping, or changing either drug. Know that a racing heartbeat may be muffled, so pay attention to sweating, shakiness, and dizziness as low-sugar clues. Your antidiabetic dose may need to be adjus… 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 Saxagliptin 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 Saxagliptin
Keep reading about Atenolol
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