Moderate
Bisoprolol × naproxen
Selective beta-adrenergic blockers×NSAID, propionic acid derivative
Mechanism
NSAIDs weaken the antihypertensive effect of beta-blockers via renal prostaglandin suppression.
Symptoms
Gradual blood pressure rise 1–2 weeks after starting the NSAID. In chronic kidney disease: risk of fluid retention and oedema.
Management
For short naproxen courses (5–7 days), monitor blood pressure. For chronic analgesia: switch to paracetamol or celecoxib (with PPI cover).
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.