NutriStack
Atenolol and L-Arginine, a caution.
L-Arginine modestly lowers blood pressure through nitric oxide-mediated vasodilation. Stacked with atenolol's beta1 blockade, the combined drop can produce symptomatic hypotension, especially in older adults or those already well-controlled.
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At a glance
- Substances
- Atenolol and L-Arginine
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. L-Arginine modestly lowers blood pressure through nitric oxide-mediated vasodilation. Stacked with atenolol's beta1 blockade, the combined drop can produce symptomatic hypotension, especially in older adults or those already well-controlled.
Mechanism. L-Arginine is the substrate for eNOS; supplementation raises NO production and vasodilation. This adds to atenolol's reduction in cardiac output via beta1 blockade.
Recommendation. If you take atenolol, start L-arginine at lower doses (1-3 g/day) and monitor your blood pressure for 1-2 weeks. Reduce or stop if you develop dizziness, fatigue, or readings below your usual range.
Sources (2)
- Dong JY, Qin LQ, Zhang Z, et al. Effect of oral L-arginine supplementation on blood pressure: a meta-analysis of randomized, double-blind, placebo-controlled trials. Am Heart J. 2011;162(6):959-65. PMID 22137067
- Khalaf D, Krüger M, Wehland M, Infanger M, Grimm D. The Effects of Oral l-Arginine and l-Citrulline Supplementation on Blood Pressure. Nutrients. 2019;11(7):1679. PMID 31336573
Stack Score
How this pair moves the number.
Effect on the composite score
If both Atenolol and L-Arginine are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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