Can you take Atenolol with Cimetidine?
1 drug interaction and 31 additional warnings found for the following 2 drugs:
- atenolol
- cimetidine
Drug interactions
Moderate drug interactions
Moderate:
atenolol cimetidine
Applies to: atenolol and cimetidine
Using atenolol together with cimetidine can increase the effects of atenolol. This can lower your blood pressure and slow your heart rate. This can cause a slow heartbeat, headaches, dizziness, or feeling like you might pass out. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or need your blood pressure checked more often if you take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
atenolol Food/Lifestyle
Applies to: atenolol
You may take atenolol with or without food, but take it the same way every time. Avoid consumption of large amounts of orange juice to prevent any changes in your atenolol levels. Orange juice could decrease the effectiveness of atenolol.
Moderate:
atenolol Alcohol (Ethanol)
Applies to: atenolol
Ethanol and atenolol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, or changes in pulse or heart rate, especially when treatment is started, the dose is changed, or treatment is restarted. Tell your doctor promptly if these symptoms occur and seek urgent medical help if you faint or have severe dizziness. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate:
atenolol multivitamins with minerals
Applies to: atenolol
Using atenolol together with multivitamins with minerals may decrease the effects of atenolol. Separate the administration times of atenolol and multivitamins with minerals by at least 2 hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Minor food/lifestyle interactions
Minor:
cimetidine Alcohol (Ethanol)
Applies to: cimetidine
Information for this minor interaction is available on the professional version.
Minor:
cimetidine Caffeine
Applies to: cimetidine
Information for this minor interaction is available on the professional version.
Minor:
cimetidine Nicotine
Applies to: cimetidine
Information for this minor interaction is available on the professional version.
Disease interactions
25 potential interactions Applies to: 23 conditions, including High Cholesterol, Allergies, Heart Failure, Asthma, and COPD.
Allergies
Major:
atenolol
Atenolol has a major potential interaction with Allergies.
The use of beta-adrenergic receptor blocking agents (aka beta-blockers) in patients with a history of allergic reactions or anaphylaxis may be associated with heightened reactivity to culprit allergens. The frequency and/or severity of attacks may be increased during beta-blocker therapy. In addition, these patients may be refractory to the usual doses of epinephrine used to treat acute hypersensitivity reactions and may require a beta-agonist such as isoproterenol.
Asthma
Moderate:
atenolol
Atenolol has a moderate potential interaction with Asthma.
Patients with bronchospastic disease, should, in general, not receive beta blockers, including cardioselective beta-blockers. Because of the relative beta-1 selectivity, cardioselective beta-blockers may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. Because beta-1 selectivity is not absolute, the lowest possible dose of these agents should be used. Consider administering in smaller doses to avoid the higher plasma levels associated with the longer dosing intervals. If dosage must be increased, dividing the dose should be considered to achieve lower peak blood levels. It is recommended to have bronchodilators, including beta-2 agonists, readily available or administered concomitantly if necessary.
Cardiogenic Shock
Major:
atenolol
Atenolol has a major potential interaction with Cardiogenic Shock.
The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with hypotension or cardiogenic shock. Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to further depress cardiac output and blood pressure, which can be detrimental in these patients.
Cerebrovascular Insufficiency
Moderate:
atenolol
Atenolol has a moderate potential interaction with Cerebrovascular Insufficiency.
Beta-adrenergic blocking agents (beta-blockers), should be used with caution in patients with cerebrovascular insufficiency because of their potential effects relative to blood pressure and pulse. If signs or symptoms suggesting reduced cerebral blood flow are observed, consideration should be given to discontinuing these agents.
COPD
Moderate:
atenolol
Atenolol has a moderate potential interaction with COPD.
Patients with bronchospastic disease, should, in general, not receive beta blockers, including cardioselective beta-blockers. Because of the relative beta-1 selectivity, cardioselective beta-blockers may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. Because beta-1 selectivity is not absolute, the lowest possible dose of these agents should be used. Consider administering in smaller doses to avoid the higher plasma levels associated with the longer dosing intervals. If dosage must be increased, dividing the dose should be considered to achieve lower peak blood levels. It is recommended to have bronchodilators, including beta-2 agonists, readily available or administered concomitantly if necessary.
Diabetes Mellitus
Major:
atenolol
Atenolol has a major potential interaction with Diabetes Mellitus.
Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask symptoms of hypoglycemia such as tremors, tachycardia and blood pressure changes. In addition, the nonselective beta-blockers (e.g., propranolol, pindolol, timolol) may inhibit catecholamine-mediated glycogenolysis, thereby potentiating insulin-induced hypoglycemia and delaying the recovery of normal blood glucose levels. Since cardioselectivity is not absolute, larger doses of beta-1 selective agents may demonstrate these effects as well. Therapy with beta-blockers should be administered cautiously in patients with diabetes or predisposed to spontaneous hypoglycemia.
Gastrointestinal Hemorrhage
Major:
cimetidine
Cimetidine has a major potential interaction with Gastrointestinal Hemorrhage.
Histamine H2 receptor antagonists should not be used in the presence of vomit with blood, or bloody or black stools. These might be serious conditions and the diagnosis needs to be ruled out.
Glaucoma/Intraocular Hypertension
Moderate:
atenolol
Atenolol has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Systemic beta-adrenergic receptor blocking agents (aka beta-blockers) may lower intraocular pressure. Therefore, patients with glaucoma or intraocular hypertension may require adjustments in their ophthalmic regimen following a dosing change or discontinuation of beta-blocker therapy.
Heart Block
Major:
atenolol
Atenolol has a major potential interaction with Heart Block.
The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to exacerbate these conditions.
Heart Failure
Major:
atenolol
Atenolol has a major potential interaction with Heart Failure.
Beta-adrenergic receptor blocking agents (aka beta-blockers) in general should not be used in patients with overt congestive heart failure (CHF). Sympathetic stimulation may be important in maintaining the hemodynamic function in these patients, thus beta-blockade can worsen the heart failure. However, therapy with beta-blockers may be beneficial and can be administered cautiously in some CHF patients provided they are well compensated and receiving digitalis, diuretics, an ACE inhibitor, and/or nitrates. Carvedilol, specifically, is indicated for use with these agents in the treatment of mild to severe heart failure of ischemic or cardiomyopathic origin. There is also increasing evidence that the addition of a beta-blocker to standard therapy can improve morbidity and mortality in patients with advanced heart failure, although it is uncertain whether effectiveness varies significantly with the different agents. Data from one meta-analysis study suggest a greater reduction of mortality risk for nonselective beta-blockers than for beta-1 selective agents.
Hemodialysis
Major:
atenolol
Atenolol has a major potential interaction with Hemodialysis.
Atenolol is moderately removed by conventional hemodialysis. Patients on hemodialysis should receive a dose of atenolol following each dialysis session when they are hemodynamically stable to avoid marked falls in blood pressure. The hemodynamic status should be closely monitored before and after the dose.
Moderate:
cimetidine
Cimetidine has a moderate potential interaction with Hemodialysis.
Cimetidine is partially removed by hemodialysis and should be administered after dialysis.
High Cholesterol
Moderate:
atenolol
Atenolol has a moderate potential interaction with High Cholesterol.
Beta-adrenergic receptor blocking agents (aka beta-blockers) may alter serum lipid profiles. Increases in serum VLDL and LDL cholesterol and triglycerides, as well as decreases in HDL cholesterol, have been reported with some beta-blockers. Patients with preexisting hyperlipidemia may require closer monitoring during beta-blocker therapy, and adjustments made accordingly in their lipid-lowering regimen.
Hyperthyroidism
Moderate:
atenolol
Atenolol has a moderate potential interaction with Hyperthyroidism.
When beta-adrenergic receptor blocking agents (aka beta-blockers) are used to alleviate symptoms of hyperthyroidism such as tachycardia, anxiety, tremor and heat intolerance, abrupt withdrawal can exacerbate thyrotoxicosis or precipitate a thyroid storm. To minimize this risk, cessation of beta-blocker therapy, when necessary, should occur gradually with incrementally reduced dosages over a period of 1 to 2 weeks. Patients should be advised not to discontinue treatment without first consulting with the physician. Close monitoring is recommended during and after therapy withdrawal.
Hypotension
Major:
atenolol
Atenolol has a major potential interaction with Hypotension.
The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with hypotension or cardiogenic shock. Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to further depress cardiac output and blood pressure, which can be detrimental in these patients.
Ischemic Heart Disease
Major:
atenolol
Atenolol has a major potential interaction with Ischemic Heart Disease.
Heightened sensitivity to catecholamines may occur after prolonged use of beta-adrenergic receptor blocking agents (aka beta-blockers). Exacerbation of angina, myocardial infarction and ventricular arrhythmias have been reported in patients with coronary artery disease following abrupt withdrawal of therapy. Cessation of beta-blocker therapy, whenever necessary, should occur gradually with incrementally reduced dosages over a period of 1 to 2 weeks in patients with coronary insufficiency. Patients should be advised not to discontinue treatment without first consulting with the physician. In patients who experience an exacerbation of angina following discontinuation of beta-blocker therapy, the medication should generally be reinstituted, at least temporarily, along with other clinically appropriate measures.
Liver Disease
Major:
cimetidine
Cimetidine has a major potential interaction with Liver Disease.
Cimetidine is partially metabolized by the liver, and to a greater extent when administered orally than when given intravenously. Although dosage reductions are generally not necessary, therapy with cimetidine should be administered cautiously in patients with liver disease. Hepatotoxicity has been associated with cimetidine use. In addition, liver disease appears to be a risk factor for cimetidine-related central nervous system toxicity, which may include mental confusion, agitation, psychosis, depression, anxiety, hallucinations, and disorientation. These effects are usually reversible within 3 to 4 days after discontinuation of therapy.
Myasthenia Gravis
Moderate:
atenolol
Atenolol has a moderate potential interaction with Myasthenia Gravis.
Beta-adrenergic receptor blocking agents (aka beta-blockers) may potentiate muscle weakness consistent with certain myasthenic symptoms such as diplopia, ptosis, and generalized weakness. Several beta-blockers have been associated rarely with aggravation of muscle weakness in patients with preexisting myasthenia gravis or myasthenic symptoms. Use cautiously in patients with myasthenia gravis.
Peripheral Arterial Disease
Major:
atenolol
Atenolol has a major potential interaction with Peripheral Arterial Disease.
Due to their negative inotropic and chronotropic effects on the heart, beta-adrenergic receptor blocking agents (aka beta-blockers) reduce cardiac output and may precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. In addition, the nonselective beta-blockers (e.g., propranolol, pindolol, timolol) may attenuate catecholamine-mediated vasodilation during exercise by blocking beta-2 receptors in peripheral vessels. Therapy with beta-blockers should be administered cautiously in patients with peripheral vascular disease. Close monitoring for progression of arterial obstruction is advised.
Pheochromocytoma
Moderate:
atenolol
Atenolol has a moderate potential interaction with Pheochromocytoma.
Administration of beta-blockers alone in the setting of pheochromocytoma has been associated with a paradoxical increase in blood pressure due to the attenuation of beta receptor-mediated vasodilatation in skeletal muscle. In patients with pheochromocytoma, an alpha-blocking agent should be initiated prior to the use of any beta-blocking agent. Caution should be taken in the administration of these agents to patients suspected of having pheochromocytoma.
Psoriasis
Moderate:
atenolol
Atenolol has a moderate potential interaction with Psoriasis.
The use of beta-blockers in psoriatic patients should be carefully weighed since the use of these agents may cause an aggravation in psoriasis.
Renal Dysfunction
Major:
atenolol
Atenolol has a major potential interaction with Renal Dysfunction.
Atenolol is eliminated by the kidney. Significant accumulation of the drug occurs in patients with a creatinine clearance below 35 mL/min/1.73 m2. Dosage adjustments are recommended for these patients.
Moderate:
cimetidine
Cimetidine has a moderate potential interaction with Renal Dysfunction.
Cimetidine and its metabolites are primarily eliminated by the kidney. The daily dosage should initially be reduced in patients with moderate to severe renal impairment (CrCl < 50 mL/min). If necessary, the daily dosage may be increased with caution. Renal dysfunction also appears to be a risk factor for cimetidine-related central nervous system toxicity, which may include mental confusion, agitation, psychosis, depression, anxiety, hallucinations, and disorientation. These effects are generally reversible within 3 to 4 days after discontinuation of therapy.
Sinus Node Dysfunction
Major:
atenolol
Atenolol has a major potential interaction with Sinus Node Dysfunction.
The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to exacerbate these conditions.
Tachyarrhythmia
Moderate:
atenolol
Atenolol has a moderate potential interaction with Tachyarrhythmia.
Beta-adrenergic blockade in patients with Wolff-Parkinson-White syndrome and tachycardia has been associated with severe bradycardia requiring treatment with a pacemaker. In one case, this result was reported after an initial dose of 5 mg propranolol. The use of beta-adrenergic receptor blocking agents (aka beta-blockers) should be administered cautiously in these patients.
More resources
atenolol
A total of 504 drugs are known to interact with atenolol.
- Atenolol is in the drug class cardioselective beta blockers.
-
Atenolol is used to treat the following conditions:
- Alcohol Withdrawal (off-label)
- Angina
- Angina Pectoris Prophylaxis
- Anxiety (off-label)
- Esophageal Variceal Hemorrhage Prophylaxis (off-label)
- Heart Attack
- High Blood Pressure
- Migraine Prevention (off-label)
- Mitral Valve Prolapse (off-label)
- Supraventricular Tachycardia (off-label)
- Ventricular Tachycardia (off-label)
cimetidine
A total of 494 drugs are known to interact with cimetidine.
- Cimetidine is in the drug class H2 antagonists.
-
Cimetidine is used to treat the following conditions:
- Bronchogenic Carcinoma (off-label)
- Cutaneous Mastocytosis
- Duodenal Ulcer
- Duodenal Ulcer Prophylaxis
- Erosive Esophagitis
- GERD
- Human Papilloma Virus
- Indigestion
- Laryngopharyngeal Reflux (off-label)
- Stomach Ulcer
- Stress Ulcer Prophylaxis
- Upper GI Hemorrhage
- Weight Loss (off-label)
- Zollinger-Ellison Syndrome
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.