Etofenamate and Atenolol: 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
Etofenamate
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.
What's going on: Atenolol (Tenormin) is a beta-blocker that helps lower your blood pressure. Etofenamate is an anti-inflammatory medicine (an NSAID) used for pain and swelling. When taken together, the NSAID can make your beta-blocker work a little less well, so your blood pressure may not stay as low as it should.
This happens because NSAIDs affect natural substances in your kidneys that help control blood pressure. The good news is this is easy to keep an eye on. Don't stop either medicine on your own. Just let your pharmacist or doctor know you take both, and they can check your blood pressure and adjust things if needed.
Interaction: Etofenamate (NSAID) may reduce the antihypertensive efficacy of atenolol (beta-blocker).
Mechanism: NSAID inhibition of renal prostaglandin synthesis promotes sodium/fluid retention and reduced vasodilation, antagonizing blood-pressure control. Neither agent's activity depends on prodrug conversion here; this is a pharmacodynamic interaction.
- Direction: reduced beta-blocker antihypertensive effect
- Onset: delayed
- Evidence: probable (documented for other NSAIDs; class effect assumed)
- Management: Monitor blood pressure during concomitant use. Antihypertensive regimen may need to be individualized. Sulindac may antagonize less if an alternative NSAID is considered by the prescriber.
What happens
Reduced antihypertensive effect
Interaction Deep Dive
Using NSAIDs together with beta-adrenergic blockers can raise blood pressure and disrupt blood pressure management94. Such an effect has been documented with flurbiprofen (400 mg per day), ibuprofen (in excess of 400 mg per day), indomethacin (in excess of 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 given concurrently, blood pressure should be monitored14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
What your care team may do:
- Check your blood pressure more closely while you use both medicines.
- Adjust and individualize your blood pressure treatment if readings creep up.
- Consider whether a different anti-inflammatory option is appropriate for you.
What you can do:
- Keep taking both medicines as prescribed unless told otherwise.
- Tell your pharmacist or doctor that you take atenolol and etofenamate together.
- Report symptoms like headaches, swelling, or higher home blood pressure readings.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Hypertensive patients taking their usual medications were assigned to receive ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. After the 3-week trial concluded, patients who received ibuprofen exhibited rises of about 6 mmHg across several blood pressure measurements. Acetaminophen produced no detectable effect on blood pressure. The underlying mechanism may involve a diminished effectiveness of antihypertensive drugs due to interference with the production of vasodilator and natriuretic prostaglandins that these antihypertensive agents stimulate. A decrease in sodium excretion may have contributed to the worsening of hypertension 5.
b) The influence of naproxen and sulindac on blood pressure response was examined in 28 patients with mild to moderate essential hypertension that was well controlled with atenolol. Findings from the 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 did not change diastolic blood pressure. Sulindac 200 mg twice daily for 1 week changed neither blood pressure measure 6.
c) The effects of indomethacin were assessed in 16 patients with essential hypertension who were treated with oxprenolol. Indomethacin and oxprenolol individually, as well as both drugs together, suppressed plasma renin activity. When the two drugs were administered in combination, 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 observed during the oxprenolol-alone period 7.
d) In a single-blind study, giving oral naproxen 500 mg twice daily or oral sulindac 200 mg twice daily at the same time had no effect on blood pressure control in patients with mild to moderate hypertension controlled by 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 Etofenamate and Atenolol together?
Etofenamate can blunt how well atenolol controls your blood pressure, so have your blood pressure monitored and keep both medicines going unless your prescriber says otherwise. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Etofenamate 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 Etofenamate and Atenolol interaction managed?
What your care team may do: Check your blood pressure more closely while you use both medicines. Adjust and individualize your blood pressure treatment if readings creep up. Consider whether a different anti-inflammatory option is appropriate for you. What you can do: Keep taking both medicines as prescribed unless told otherwise. Tell your pharmacist or doctor that you take atenolol and etofenama… 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 Etofenamate 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)
- 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 Etofenamate
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