Drug Interaction Report

Dipyrone and Atenolol: Interaction Details

A pharmacist-reviewed analysis of the Dipyrone and Atenolol interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · AI content regenerated Jul 15, 2026 · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Dipyrone

No brand names on record
+

Atenolol

Tenormin Tenormin®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Jul 11, 2026
Editorial policy · Data sources
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
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.

Of 116 documented Dipyrone interactions, 28 are rated moderate — including this one.
At a glance + Effects may be weaker
The Bottom Line
Dipyrone can slightly reduce how well atenolol controls your blood pressure, so your team may monitor your blood pressure and adjust treatment as needed. Keep taking both as prescribed and talk with your pharmacist or doctor.

Dipyrone is a pain and fever medicine that works like an NSAID, and atenolol (Tenormin) is a beta-blocker used to lower blood pressure. When taken together, the dipyrone can slightly weaken how well the atenolol controls your blood pressure. That happens because pain relievers like this can reduce certain natural substances in your kidneys (called prostaglandins) that help keep blood pressure down.

The good news is this is very manageable. Your care team may simply check your blood pressure a bit more often and adjust your treatment if needed. Please don't stop or change either medicine on your own, just mention it to your pharmacist or doctor.

Effect: Reduced antihypertensive efficacy of atenolol when combined with dipyrone (an NSAID-type analgesic).

Mechanism: NSAID-mediated inhibition of renal prostaglandin synthesis promotes sodium/water retention and attenuates beta-blocker BP lowering. Pharmacodynamic, not a prodrug interaction.

  • Direction: Diminished BP control (reduced drug effect).
  • Onset: Delayed.
  • Evidence: Probable; documented for several NSAIDs (ibuprofen, indomethacin, naproxen, piroxicam, flurbiprofen), class-extrapolated to dipyrone.
  • Severity: Moderate.

Management: Monitor blood pressure with concomitant use; adjust antihypertensive therapy as clinically indicated and individualize to the patient.

Onset
delayed
Evidence
probable
Severity
Moderate

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 (greater than 400 mg per day), indomethacin (greater than 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 used concurrently, monitor blood pressure14.

Why it happens (mechanism)

Decreased production of renal prostaglandins

How to manage this interaction

This interaction is manageable and does not usually mean you must avoid either drug.

  • Keep taking both as prescribed unless your prescriber tells you otherwise.
  • Your care team may check your blood pressure more closely when you use these together.
  • If your blood pressure runs higher, your treatment may be adjusted and individualized by your doctor.
  • Home blood pressure readings can help; share them with your team.

Ask your pharmacist or doctor before starting, stopping, or changing any dose, and mention any new or worsening symptoms like headaches or swelling.

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 either ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. After the 3-week study concluded, those who received ibuprofen exhibited rises of about 6 mmHg across various blood pressure measurements. Acetaminophen produced no detectable change in blood pressure. The underlying mechanism may involve a reduction in the efficacy 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) Naproxen and sulindac were evaluated for their impact on blood pressure response in 28 patients with mild to moderate essential hypertension that was well controlled by 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), while leaving diastolic blood pressure unchanged. Sulindac 200 mg twice daily for 1 week affected neither blood pressure measure 6.

c) The influence of indomethacin was assessed in 16 patients with essential hypertension who were being treated with oxprenolol. Indomethacin and oxprenolol individually, as well as the combination of both drugs, suppressed plasma renin activity. With the two drugs used together, 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 phase 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. Propranolol serum concentrations were not measured, and patients with existing renal disease, heart failure, or cirrhosis were not included 8.

Common questions

Can I take Dipyrone and Atenolol together?

Dipyrone can slightly reduce how well atenolol controls your blood pressure, so your team may monitor your blood pressure and adjust treatment as needed. Keep taking both as prescribed and talk with your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.

How serious is the Dipyrone and Atenolol 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 Dipyrone and Atenolol interaction managed?

This interaction is manageable and does not usually mean you must avoid either drug. Keep taking both as prescribed unless your prescriber tells you otherwise. Your care team may check your blood pressure more closely when you use these together. If your blood pressure runs higher, your treatment may be adjusted and individualized by your doctor. Home blood pressure readings can help; share them w… 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 Dipyrone or Atenolol 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)

  1. Product Information: ZORVOLEX(R) oral capsules, diclofenac oral capsules. Iroko Pharmaceuticals, LLC (per FDA), Philadelphia, PA, 2016. DailyMed
  2. Product Information: ANAPROX(R) DS oral tablets, naproxen sodium oral tablets. Canton Laboratories, LLC (per FDA), Alpharetta, GA, 2016. DailyMed
  3. Product Information: CALDOLOR(R) intravenous injection, ibuprofen intravenous injection. Cumberland Pharmaceuticals Inc. (per FDA), Nashville, TN, 2016. DailyMed
  4. Product Information: COMBOGESIC(R) oral tablets, acetaminophen ibuprofen oral tablets. AFT Pharmaceuticals Inc (per FDA), Highland, MD, 2023. DailyMed
  5. 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
  6. 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
  7. 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
  8. 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
  9. Product Information: VIMOVO(TM) delayed release oral tablets, naproxen and esomeprazole magnesium delayed release oral tablets. AstraZeneca LPW, Wilmington, DE, 2010. DailyMed
  10. 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
  11. Abate MA, Neely JL, Layne RD, et al: Interaction of indomethacin and sulindac with labetolol. Br J Clin Pharmacol 1991; 31:363-366.
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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.