Lornoxicam 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
Lornoxicam
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.
You're taking atenolol to help control your blood pressure, and lornoxicam is an anti-inflammatory pain reliever (an NSAID). When taken together, the NSAID can make your blood pressure medicine work a little less well, so your blood pressure may creep up over time.
This happens because NSAIDs reduce certain substances in your kidneys that help keep blood pressure down. The good news is this is easy to manage. Don't stop either medicine on your own. Just let your doctor or pharmacist know you take both, and they can keep an eye on your blood pressure and adjust things if needed.
Effect: Lornoxicam (NSAID) may blunt the antihypertensive efficacy of atenolol, potentially raising blood pressure.
Mechanism: NSAID-mediated inhibition of renal prostaglandin synthesis reduces vasodilation and promotes sodium/fluid retention, antagonizing beta-blocker BP control. Neither agent is a prodrug; this is a pharmacodynamic interaction.
- Direction: reduced atenolol antihypertensive effect
- Onset: delayed
- Evidence: probable (class effect documented for several NSAIDs; sulindac may be less antagonistic)
- Management: Monitor BP when coadministered; dose may need individualization by the care team. Consider limiting NSAID duration/dose.
What happens
Reduced antihypertensive effect
Interaction Deep Dive
The concurrent use of NSAIDs alongside beta-adrenergic blockers can raise blood pressure and hinder its control94. 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 fail to counteract the antihypertensive action of beta-blockers1110. Blood pressure should be monitored whenever NSAIDs and beta blockers must be taken together14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
This interaction is manageable with a little attention from your care team.
- Keep taking both medicines as prescribed unless your doctor or pharmacist tells you otherwise.
- Your team may monitor your blood pressure more closely, especially after you start or change the NSAID dose.
- Because the effect builds gradually, home blood pressure checks can help spot any upward trend.
- Your blood pressure medicine dose may need to be adjusted and individualized by your care team if readings rise.
- Tell your pharmacist or prescriber that you take both, and ask before adding any other pain relievers.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Hypertensive patients who continued their usual medications were assigned to receive ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo. After the 3-week study concluded, patients who received ibuprofen exhibited rises of about 6 mmHg across various blood pressure measurements. Acetaminophen produced no measurable change in blood pressure. The underlying mechanism may involve a lessening of antihypertensive drug effectiveness resulting from interference with the production of vasodilator and natriuretic prostaglandins that antihypertensive agents stimulate. A decrease in sodium excretion may have contributed to worsening the hypertension 5.
b) The influence of naproxen and sulindac on blood pressure response was investigated 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 did not alter either blood pressure measure 6.
c) The effects of indomethacin were assessed in 16 patients with essential hypertension being treated with oxprenolol. Indomethacin and oxprenolol individually, as well as both drugs used 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 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 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. Propranolol serum levels were not measured, and patients with existing renal disease, heart failure, or cirrhosis were not included in the study 8.
Common questions
Can I take Lornoxicam and Atenolol together?
Lornoxicam can make atenolol slightly less effective at controlling blood pressure over time, so keep taking both as prescribed and have your blood pressure monitored. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lornoxicam 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 Lornoxicam and Atenolol interaction managed?
This interaction is manageable with a little attention from your care team. Keep taking both medicines as prescribed unless your doctor or pharmacist tells you otherwise. Your team may monitor your blood pressure more closely, especially after you start or change the NSAID dose. Because the effect builds gradually, home blood pressure checks can help spot any upward trend. Your blood pressure medi… 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 Lornoxicam 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 Lornoxicam
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