Proglumetacin 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
Proglumetacin
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.
Atenolol (Tenormin) is a beta-blocker that helps lower your blood pressure. Proglumetacin is an anti-inflammatory drug (an NSAID) used for pain and swelling. When you take an NSAID with a blood pressure medicine, the NSAID can make your body hold onto more salt and water and can blunt how well the beta-blocker works. That means your blood pressure may not be controlled as well as usual.
The good news is this is easy to keep an eye on. Your care team can check your blood pressure and adjust things if needed. Please don't stop either medicine on your own, just let your pharmacist or doctor know you take both.
Effect: Reduced antihypertensive efficacy of atenolol when combined with the NSAID proglumetacin.
Mechanism: NSAID inhibition of cyclooxygenase decreases renal prostaglandin synthesis, promoting sodium/fluid retention and attenuating beta-blocker blood pressure lowering. This is a pharmacodynamic interaction; neither agent is a prodrug requiring activation here.
- Direction: Diminished BP control (reduced drug effect).
- Onset: Delayed.
- Evidence: Probable; class effect documented for several NSAIDs.
- Management: Monitor blood pressure during concomitant use; the antihypertensive regimen may be individualized/adjusted by the care team. Sulindac may be less likely to antagonize.
What happens
Reduced antihypertensive effect
Interaction Deep Dive
Using NSAIDs together with beta-adrenergic blockers can raise blood pressure and hinder its management94. Such an effect has been documented with flurbiprofen (400 mg per day), ibuprofen (in excess of 400 mg per day), indomethacin (over 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, blood pressure should be monitored14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
This interaction is manageable with monitoring. Here is what typically happens and what you can do:
- Keep taking both exactly as prescribed unless your prescriber tells you otherwise.
- Your care team may check your blood pressure more closely while you are on both drugs.
- Your blood pressure medicine dose may be adjusted and individualized by your team if needed.
- Tell your pharmacist or doctor that you take both, and mention any home blood pressure readings that seem high.
If you notice headaches, swelling, or higher-than-usual readings, let your care team know.
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 were given 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 several blood pressure measurements. Acetaminophen produced no measurable change in blood pressure. The underlying mechanism could involve reduced effectiveness of antihypertensive drugs due to interference with the generation of vasodilator and natriuretic prostaglandins that these agents stimulate. Diminished sodium excretion may have contributed to worsening the hypertension 5.
b) Naproxen and sulindac were investigated for their impact on blood pressure response in 28 patients with mild to moderate essential hypertension that was well controlled by atenolol. The findings of this 5-week, double-blind, placebo-controlled study showed that 1 week of naproxen 500 mg twice daily significantly raised systolic blood pressure (mean 4 mmHg), while leaving diastolic blood pressure unchanged. Sulindac 200 mg twice daily given for 1 week did not modify either blood pressure measurement 6.
c) 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 the two drugs, suppressed plasma renin activity. With the two agents administered together, blood pressure fell (systolic: -5.9 mmHg; diastolic: -4 mmHg; mean: -4.6 mmHg), however these blood pressure changes were roughly 50% smaller than those observed during the period with oxprenolol used alone 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 produced no effect on blood pressure control among patients with mild to moderate hypertension managed with oral propranolol 10 mg to 240 mg daily. Serum propranolol concentrations 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 Proglumetacin and Atenolol together?
The NSAID proglumetacin can weaken how well atenolol controls your blood pressure, so your care team should keep an eye on your readings and adjust treatment if needed. Keep taking both as prescribed and report high readings. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Proglumetacin 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 Proglumetacin and Atenolol interaction managed?
This interaction is manageable with monitoring. Here is what typically happens and what you can do: Keep taking both exactly as prescribed unless your prescriber tells you otherwise. Your care team may check your blood pressure more closely while you are on both drugs. Your blood pressure medicine dose may be adjusted and individualized by your team if needed. Tell your pharmacist or doctor that y… 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 Proglumetacin 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 Proglumetacin
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