Drug Interaction Report

Dipyrone and Bisoprolol: Interaction Details

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

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Dipyrone

No brand names on record
+

Bisoprolol

Zebeta®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 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.
Onset
delayed
Evidence
probable
Severity
Moderate

What happens

Reduced antihypertensive effect

Interaction Deep Dive

Coadministration of NSAIDs and beta-adrenergic blockers may increase blood pressure and interfere with blood pressure control94. This effect was reported for flurbiprofen (400 mg daily), ibuprofen (more than 400 mg daily), indomethacin (more than 50 mg daily), naproxen (1000 mg daily), and piroxicam 6510. Sulindac may not antagonize the antihypertensive effects of beta-blockers 1110. Monitor blood pressure when concomitant use of NSAIDs and beta blockers is required 14.

Why it happens (mechanism)

Decreased production of renal prostaglandins

Literature reports

4 reports — tap to read

a) Ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo was given to hypertensive patients receiving their usual medications. At the end of the 3-week trial, patients given ibuprofen showed increases of approximately 6 mmHg in various blood pressure measures. Acetaminophen had no demonstrable effect on blood pressure. The mechanism may involve attenuation of the effectiveness of antihypertensive agents secondary to interference with production of vasodilator and natriuretic prostaglandins that are stimulated by antihypertensive agents. A reduction in sodium excretion may have been involved in exacerbating hypertension 5.

b) The effect of naproxen and sulindac on blood pressure response was studied in 28 patients with mild to moderate essential hypertension well controlled by atenolol. The results of the 5-week, double-blind, placebo-controlled trial indicated that 1 week of therapy with naproxen 500 mg twice daily significantly increased systolic blood pressure (mean 4 mmHg), but did not alter diastolic blood pressure. Sulindac 200 mg twice daily for 1 week did not alter either blood pressure parameter 6.

c) The effects of indomethacin in 16 patients with essential hypertension treated with oxprenolol have been examined. Both indomethacin and oxprenolol, as well as the 2 drugs combined, inhibited plasma renin activity. When the 2 drugs were given in combination, blood pressure decreased (systolic: -5.9 mmHg; diastolic: -4 mmHg; mean: -4.6 mmHg), but the changes induced in blood pressure were reduced by about 50% when compared with those in the oxprenolol-alone period 7.

d) Concomitant administration of oral naproxen 500 mg twice daily or oral sulindac 200 mg twice daily resulted in no effect on blood pressure control in patients with mild to moderate hypertension controlled with oral propranolol 10 mg to 240 mg daily in a single-blind study. The serum levels of propranolol were not determined and patients with preexisting renal disease, heart failure, or cirrhosis were not studied 8.

Common questions

Can I take Dipyrone and Bisoprolol together?

Reduced antihypertensive effect Always confirm with your pharmacist or prescriber before making any change.

How serious is the Dipyrone and Bisoprolol 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 strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Dipyrone or Bisoprolol 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. PubMed
  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. DOI
  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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Dipyrone

Keep reading about Dipyrone

All Dipyrone interactions (116)
Also serious with: Ketorolac Nasal Spray Ketorolac Injection Ketorolac Ophthalmic Ketorolac
Bisoprolol

Keep reading about Bisoprolol

All Bisoprolol interactions (189) Bisoprolol drug information
Also serious with: Albuterol Oral Inhalation Albuterol Olodaterol Oral Inhalation Vilanterol
Beyond drug–drug

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:

Bisoprolol + Activated Charcoal American Hellebore American Mistletoe Indian Snakeroot Tyramine 1,3-dmaa Acacia Rigidula Active Hexose Correlated Compound (ahcc) + 175 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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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.