Moderate
Bisoprolol × Ibuprofen
Selective beta-adrenergic blockers×Non-steroidal anti-inflammatory drugs (NSAIDs)
Mechanism
Similar to bisoprolol + ketorolac. Ibuprofen weakens the antihypertensive effect of the beta-blocker via renal prostaglandin blockade.
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 ibuprofen courses (5–7 days), monitor blood pressure. For chronic analgesia: switch to paracetamol, celecoxib (with PPI cover), or topical NSAIDs.
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.