Drug & supplement interaction

Apple + Atenolol, Chlortalidone

Atenolol, Chlortalidone brand names: AtenixCo, Totaretic, Tenoret 50.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Atenolol, Chlortalidone falls into 2 drug categories that Apple can interact with; the most serious is rated moderate. Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Apple and Atenolol, Chlortalidone

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Apple interacts with whole categories of medication. Atenolol, Chlortalidone falls into 2 of those categories, so it can interact with Apple in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTIHYPERTENSIVE DRUGS

1 of 2

Why this applies to Atenolol, Chlortalidone

Atenolol, Chlortalidone falls under ANTIHYPERTENSIVE DRUGS — the group Apple interacts with.

Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Some clinical evidence suggests that consuming apple and cherry juice can increase blood pressure in elderly patients.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: your combo pill pairs atenolol (a beta-blocker that slows the heart and eases blood pressure) with chlortalidone (a water pill). Some lower-quality research found that drinking apple juice, especially in older folks, nudged blood pressure back up a bit. That could work against what this medicine is trying to do, possibly leaving your numbers higher than expected.

This is about juice, not the occasional whole apple, and the evidence is modest, so don't panic. Still, if you regularly drink large amounts of apple juice or use concentrated apple extracts, mention it to your pharmacist or doctor. They may want to check your blood pressure and make sure your treatment is still doing its job. Don't change anything on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Visvanathan, R., Chen, R., Horowitz, M., and Chapman, I. Blood pressure responses in healthy older people to 50 g carbohydrate drinks with differing glycaemic effects. Br J Nutr 2004;92(2):335-340. PubMed
Moderate

ATENOLOL (Tenormin)

2 of 2
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of atenolol.
Pharmacokinetic research shows that coadministration of apple juice 600-1200 mL decreases levels of atenolol by 58% to 82% in a dose-dependent manner. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Your combo pill pairs atenolol (a beta blocker for blood pressure and heart rate) with chlortalidone (a water pill). The piece that matters here is the atenolol. Studies found that drinking a fair amount of apple juice (about 600 to 1200 mL, roughly 2.5 to 5 cups) can block a gut transporter called OATP that helps pull atenolol into your body. The result is that less atenolol gets absorbed, sometimes a lot less.

In plain terms, your atenolol could end up working less well, so your blood pressure or heart rate might not be as well controlled. A regular apple as a snack is very unlikely to cause this. To be safe, separate any larger amounts of apple juice from your dose by at least 4 hours, and check with your pharmacist before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
  2. Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
  3. Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
  4. Jeon H, Jang IJ, Lee S, et al. Apple juice greatly reduces systemic exposure to atenolol. Br J Clin Pharmacol 2012 May 11. doi: 10.1111/j.1365-2125.2012.04324.x. [Epub ahead of print]. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Apple Also Interacts With Other Medications

Apple has 47 major, 252 moderate known drug interactions in our database — the Atenolol, Chlortalidone one above is among them. If you take anything else, check it against the full list below.

Major 47 Moderate 252 No known interaction 2,531 (incl. Atenolol, Chlortalidone)
Taking anything else?

Check Another of Your Medications Against Apple

Covers the 2,830 medications we’ve checked against Apple. Pick one to open its full report.

From our Q&A

Questions About Apple or Atenolol, Chlortalidone

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Apple or Atenolol, Chlortalidone, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Atenolol, Chlortalidone

This page covers Apple only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Atenolol, Chlortalidone page lists 229 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Dolomite (major) and Indian Snakeroot (major).

By severity: 9 major · 197 moderate · 23 minor.

Open the Atenolol, Chlortalidone interaction page

One more smart check

Taking Apple as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2,841 real supplement products containing Apple, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Apple. Your product may carry other ingredients that interact with Atenolol, Chlortalidone too, on top of Apple — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Apple and Atenolol, Chlortalidone Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Apple
Top 10%

#107 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Atenolol, Chlortalidone
Steady interest

#2,081 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Apple

What is Apple?

Apple
  • General nutrition and fiber intake
  • Heart and cholesterol health
  • Blood sugar and weight management
  • Digestive regularity
  • Antioxidant support

Apples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy diet. While research suggests apples may support heart and digestive health, most claims about concentrated apple supplements or extracts are not strongly proven, so enjoy apples as food and talk with your pharmacist before using high-dose products.

Read the full Apple monograph & all interactions
Keep checking

Other Drugs & Apple

Browse every other medication we’ve checked against Apple — both the ones with a known interaction and the ones without. Select any drug for the full detail.

47Major
252Moderate
0Minor
2,530No known interaction
47 Major 252 Moderate 2,530 No interaction
Major

47 interactions

Moderate

252 interactions

Showing 60 of 252 moderate interactions — see all 252 on the Apple page.

No interaction 2,530 drugs checked — show the list

We also checked Apple against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,530 medications checked with no known interaction — see the full Apple list.

See the full Apple interactions page
See every supplement checked against Atenolol, Chlortalidone, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Apple monograph › Uses, safety, and every drug interaction in one place Atenolol, Chlortalidone supplement interactions › Every supplement checked against Atenolol, Chlortalidone, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Apple and Atenolol, Chlortalidone Together: Common Questions

Can you take Apple with Atenolol, Chlortalidone?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Apple and Atenolol, Chlortalidone?
Atenolol, Chlortalidone belongs to more than one drug category, and Apple interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Apple and Atenolol, Chlortalidone interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Atenolol, Chlortalidone and Apple?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.