Nonsteroidal Anti-inflammatory Drugs/Beta-Blockers
Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
The cause of the interaction is not known.
What might happen:
The beneficial effects of your beta-blocker may decrease and cause an increase in your blood pressure.
What you should do about this interaction:
If you experience headache, dizziness, or blurred vision, contact your doctor. It may be necessary to check your blood pressure more often. The dose of your beta-blocker may need adjusting.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Durao V, Prata MM, Goncalves LM. Modification of antihypertensive effect of beta-adrenoceptor-blocking agents by inhibition of endogenous prostaglandin synthesis. Lancet 1977 Nov 12;2(8046):1005-7.
2.Lopez-Ovejero JA, Weber MA, Drayer JIM, Sealey JE, Laragh JH. Effects of indomethacin alone and during diuretic or B-adrenoreceptor-blockade therapy on blood pressure and the renin system in essential hypertension. Clin Sci Mol Med 1978;55:203s-5s.
3.Watkins J, Abbott EC, Hensby CN, Webster J, Dollery CT. Attenuation of hypotensive effect of propranolol and thiazide diuretics by indomethacin. Br Med J 1980 Sep 13;281(6242):702-5.
4.Salvetti A, Arzilli F, Pedrinelli R, Beggi P, Motolese M. Interaction between oxprenolol and indomethacin on blood pressure in essential hypertensive patients. Eur J Clin Pharmacol 1982;22(3):197-201.
5.Salvetti A, Pedrinelli R, Alberici P, Magagna A, Abdel-Haq B. The influence of indomethacin and sulindac on some pharmacological actions of atenolol in hypertensive patients. Br J Clin Pharmacol 1984;17 Suppl 1:108S-111S.
6.Rodriquez Alvarez C, Baez MA, Weidler DJ. Effect of sulindac and piroxicam administration on the antihypertensive effect of propranolol. J Clin Pharmacol 1986;26:544.
7.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 Nov; 107(5):628-35.
8.Schoenfeld A, Freedman S, Hod M, Ovadia Y. Antagonism of antihypertensive drug therapy in pregnancy by indomethacin?. Am J Obstet Gynecol 1989 Nov; 161(5):1204-5.
9.Abate MA, Layne RD, Neely JL, D'Alessandri R. Effect of naproxen and sulindac on blood pressure response to atenolol. DICP 1990 Sep; 24(9):810-3.
10.Abate MA, Neely JL, Layne RD, D'Alessandri R. Interaction of indomethacin and sulindac with labetalol. Br J Clin Pharmacol 1991 Mar;31(3):363-6.
11.Pope JE, Anderson JJ, Felson DT. A meta-analysis of the effects of nonsteroidal anti-inflammatory drugs on blood pressure. Arch Intern Med 1993 Feb 22;153(4):477-84.
12.Phansalkar S, van der Sijs H, Tucker AD, Desai AA, Bell DS, Teich JM, Middleton B, Bates DW. Drug-drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records. J Am Med Inform Assoc 2012 Sep 25.