Propyphenazone 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
Propyphenazone
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.
Here's what's going on. Atenolol (Tenormin) is a beta-blocker that helps lower your blood pressure. Propyphenazone is an anti-inflammatory pain reliever in the NSAID family. When you take an NSAID with a beta-blocker, the NSAID can reduce natural chemicals in your kidneys (called prostaglandins) that help keep blood pressure down. The result is that your atenolol may not control your blood pressure quite as well, so it can creep up a bit.
This usually builds up over time rather than all at once. The good news is your care team can easily handle it by checking your blood pressure and adjusting things if needed. Please don't stop either medicine on your own, just talk with your pharmacist or doctor.
Effect: Reduced antihypertensive efficacy of atenolol when combined with propyphenazone (an NSAID/pyrazolone analgesic).
- Mechanism: NSAID-mediated inhibition of renal prostaglandin synthesis, promoting sodium/fluid retention and increased vascular tone, attenuating beta-blocker BP control. This is a pharmacodynamic interaction; neither agent requires bioactivation.
- Direction: Diminished blood-pressure-lowering effect.
- Onset: Delayed. Evidence: Probable (documented for other NSAIDs; class effect assumed). Severity: Moderate.
- Management: Monitor blood pressure during concomitant use; individualize antihypertensive therapy. Sulindac may be less likely to antagonize beta-blocker effects.
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 (above 50 mg per day), naproxen (1000 mg per day), and piroxicam6510. In contrast, sulindac may not oppose the antihypertensive action of beta-blockers1110. When NSAIDs and beta blockers must be taken concurrently, blood pressure should be monitored14.
Why it happens (mechanism)
Decreased production of renal prostaglandins
How to manage this interaction
How your care team typically handles this:
- They will likely monitor your blood pressure more closely while you use both medicines together.
- If your blood pressure rises, your atenolol dose (or overall blood pressure plan) may need to be adjusted and individualized by your care team.
- Sometimes a different pain option may be considered, but that is your prescriber's call.
What you should do: Keep taking both exactly as prescribed. Mention to your pharmacist or doctor that you're using them together, especially if you use the pain reliever regularly rather than just occasionally, and report any home blood pressure readings that seem high.
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 trial concluded, those given ibuprofen exhibited rises of about 6 mmHg across several blood pressure measurements. Acetaminophen produced no observable effect on blood pressure. The proposed mechanism may involve a lessening of the effectiveness of antihypertensive drugs due to interference with the production of vasodilator and natriuretic prostaglandins that these 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 evaluated in 28 patients whose mild to moderate essential hypertension was well controlled with atenolol. Findings from this 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) without changing diastolic blood pressure. Sulindac 200 mg twice daily for 1 week changed neither blood pressure parameter 6.
c) The effects of indomethacin were 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. When the two drugs were administered 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% compared with the period of oxprenolol 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 had no effect on blood pressure control in patients whose mild to moderate hypertension was controlled with 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 8.
Common questions
Can I take Propyphenazone and Atenolol together?
Taking propyphenazone (an NSAID) with atenolol can blunt its blood-pressure-lowering effect, so have your blood pressure watched and keep both medicines going unless your doctor says otherwise. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Propyphenazone 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 Propyphenazone and Atenolol interaction managed?
How your care team typically handles this: They will likely monitor your blood pressure more closely while you use both medicines together. If your blood pressure rises, your atenolol dose (or overall blood pressure plan) may need to be adjusted and individualized by your care team. Sometimes a different pain option may be considered, but that is your prescriber's call. What you should do: Keep ta… 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 Propyphenazone 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 Propyphenazone
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