Atenolol/chlorthalidone | Side Effects, Dosage, Uses & More
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Generic Name:

atenolol-chlorthalidone, Oral tablet

All Brands

  • Tenoretic
SECTION 1 of 5

Highlights for atenolol-chlorthalidone

Oral tablet
1

Atenolol/chlorthalidone is used to lower your blood pressure. It is used when other blood pressure drugs have not worked for you.

2

This medication comes in the form of a tablet you take by mouth. It is a combination of two medications in one: atenolol and chlorthalidone.

3

This medication is available as a brand-name drug called Tenoretic. It is also available in its generic form.

4

Common side effects include nausea, diarrhea, increased urination, and headache. They also include dizziness, drowsiness, and muscle weakness.

5

Don’t take this medication if you have certain heart conditions, such as heart failure. This drug may make these conditions worse.

IMPORTANT INFORMATION

Heart failure and heart disease

Use of this medication may cause heart failure or may worsen heart failure if you already have it. If you have heart disease, suddenly stopping this drug can cause chest pain (angina) or heart attack.

Kidney problems

This medication is removed from your body by your kidneys. If your kidneys don’t work well, the medication may build up in your system. This puts you at risk of serious side effects. These include azotemia and uremia. Symptoms of these conditions include tiredness, confusion, urinating less, pale and dry skin, dry mouth, or thirst.

Thyroid disease (hyperthyroidism)

This drug can mask symptoms of an overactive thyroid (hyperthyroidism). These symptoms include an increased heart rate. In patients with hyperthyroidism, suddenly stopping this drug can cause a thyroid storm. This is a life-threatening medical emergency.

What is atenolol/chlorthalidone?

This drug is a prescription drug. It comes in the form of a tablet you take by mouth once each day. This medication is a combination of two drugs in a single form. It is important to know about all the drugs in the combination because each drug may affect you in a different way.

This drug is available as a brand-name drug called Tenoretic. It is also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. Talk to your doctor to see if the generic version will work for you.

This medication may be used as part of a combination therapy. This means that you may need to take it with other drugs.

Why it's used

This medication is used to treat high blood pressure (hypertension).

How it works

This medication belongs to a class of drugs called antihypertensives.

More Details

How it works

This medication belongs to a class of drugs called antihypertensives. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

This medication is a combination of two drugs that both work to lower blood pressure:

  • Atenolol. This drug works by relaxing blood vessels and slowing the heart rate. This helps to improve blood flow and decrease blood pressure.
  • Chlorthalidone. This drug works by making your kidneys move unneeded water and salt out of your body through your urine. This helps to relax the walls of the blood vessels, which lowers blood pressure.
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atenolol-chlorthalidone Side Effects

Oral tablet

Most Common Side Effects

The more common side effects that occur with use of atenolol/chlorthalidone include:

  • nausea

  • vomiting

  • diarrhea

  • stomach pain or cramps

  • loss of appetite

  • lightheadedness

  • dizziness

  • tiredness

  • headache

  • depression

  • hair loss

  • increased urination

  • thirst

  • muscle weakness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Heart failure. Symptoms can include:

    • shortness of breath
    • chronic coughing or wheezing
    • swelling of the legs, ankles, feet, or abdomen (stomach area)
    • tiredness
    • feeling lightheaded
    • nausea
    • lack of appetite
    • confusion or impaired thinking
    • fast heart rate
  • Breathing problems. Symptoms can include:

    • shortness of breath
    • trouble breathing
  • Severe allergic reaction. Symptoms can include:

    • trouble breathing
    • swelling of your throat or tongue
    • hives
    • rash
    • swelling of the hands, feet, ankles, or lower legs
  • Skin problems. Symptoms can include:

    • severe rash with peeling skin
    • flat red or purple spots that may turn into blisters
    • sores in your mouth or nose, or around your eyes or genitals
  • Blood disorders (problems with platelets, and red and white blood cells). Symptoms can include:

    • nosebleeds
    • bleeding from the gums
    • prolonged bleeding from cuts or wounds
    • unexplained bruising
    • tiredness
    • dizziness
    • paler skin
    • frequent infections, or infections that won’t go away. Symptoms can include sore throat or fever.
  • Central nervous system problems. Symptoms can include:

    • fainting
    • dizziness
    • lightheadedness
    • vertigo (dizziness and loss of balance)
    • tiredness
    • depression
  • Unexpected weight gain

  • Problems with electrolytes (minerals that help control the fluid balance in your body and help with other important functions). Symptoms can include:

    • dry mouth
    • increased thirst
    • weakness
    • tiredness
    • restlessness
    • muscle pain or cramps
    • muscle weakness
    • urinating smaller amounts
    • faster heart rate
    • nausea
    • vomiting
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug may cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

atenolol-chlorthalidone May Interact with Other Medications

Oral tablet

Atenolol/chlorthalidone can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Allergy drugs

Epinephrine may not work as well if used along with atenolol/chlorthalidone.

Anesthesia

Your risk of complications from anesthesia used during surgery may increase if you take atenolol/chlorthalidone. Talk to your doctor if you take this medication and will be having surgery. Do not stop taking it before your procedure unless that is what your doctor tells you.

Antiarrhythmic and heart failure drugs

Some of these drugs can slow down the heart. Taking these drugs with atenolol/chlorthalidone raises your risk of having a heart rate that is too slow (bradycardia). These drugs include:

  • amiodarone
  • digoxin
  • diltiazem
  • disopyramide
  • flecainide
  • propafenone
  • verapamil

Blood pressure drugs

Some blood pressure drugs can increase your risk of very low blood pressure. This can lead to vertigo and fainting. The risk is increased when you stand up after sitting or lying down. These drugs include:

  • clonidine
  • doxazosin
  • nifedipine
  • prazosin
  • reserpine
  • terazosin

Mental health drugs

Taking lithium with atenolol/chlorthalidone can result in higher levels of lithium in your body. This can raise your risk of side effects from lithium. If you take these drug together, your doctor will likely monitor your lithium levels more closely and adjust your dose as needed.

Pain and inflammation drugs

Some NSAIDs (non-steroidal anti-inflammatory drugs) can decrease the effect of atenolol/chlorthalidone. These NSAIDs can prevent the drug from working well. They include:

  • ibuprofen
  • indomethacin
  • naproxen
  • piroxicam

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
heart failure
People with heart failure and heart disease

Use of this medication may cause heart failure, or may make it worse if you already have it. Do not stop taking this drug suddenly. This would increase your risk of chest pain and heart attack.

breathing problems
People with breathing problems

Talk to your doctor if you have breathing problems such as asthma or COPD. There is a small risk that this drug could cause trouble breathing, or keep some breathing medications from working well. Your doctor may tell you to take this medication only if you cannot tolerate other drugs, or if other blood pressure medications don’t work for you.

diabetes
People with diabetes

Talk to your doctor before using this medication. It may prevent symptoms of low blood sugar, such as an increased heart rate. This can keep you from treating your low blood sugar. If you have excessive sweating and dizziness even without an increased heart rate while taking this medication, you may still have low blood sugar.

kidney problems
People with kidney problems

This medication is removed from your body by your kidneys. If your kidneys don’t work well, the medication may build up in your system. This puts you at risk of serious side effects. These include azotemia and uremia. Symptoms of these conditions include tiredness, confusion, urinating less, pale and dry skin, dry mouth, or thirst. If your kidney disease gets worse while you’re on this medication, your doctor will likely stop the medication.

liver problems
People with liver problems

Talk to your doctor before using this medication. This drug removes extra water and salt from your body. If you have liver disease, these changes in your body’s fluid and salt levels can cause serious complications. These include coma (a state of being unconscious from which you can’t be awakened). This risk is increased if you are dehydrated or having diarrhea or vomiting.

overactive thyroid
People with an overactive thyroid (hyperthyroidism)

Use of this medication may prevent signs of hyperthyroidism, such as an increased heart rate. If you use this medication and plan to stop, your doctor should monitor you closely for these symptoms.

Do not suddenly stop taking this drug. Doing so can cause a condition called thyroid storm. This is a life-threatening medical emergency.

gout
People with gout

Use of this medication may increase your levels of uric acid and the risk of gout flare-ups.

pheochromocytoma
People with untreated pheochromocytoma

Do not use this medication. It can mask the symptoms of your condition. (Pheochromocytoma is a type of tumor that can cause very high blood pressure.)

pregnant women
Pregnant women

This drug is a category D pregnancy drug. That means two things:

  1. Studies show a risk of adverse effects to the fetus when the mother takes the drug.
  2. The benefits of taking the drug during pregnancy may outweigh the potential risks in certain cases.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

This drug may pass into breast milk and cause serious side effects in a breastfed child.

Talk to your doctor if you breastfeed your baby. You should decide whether to stop breastfeeding or stop taking this medication.

allergies
Allergies

This drug can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives
  • rash

If you have a reaction, call your doctor right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you have ever had an allergic reaction to it before. Also avoid it if you’ve had an allergic reaction to any sulfur drugs, or any thiazide or thiazide-like diuretics before. Taking it a second time after any allergic reaction to it could be fatal (cause death).

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How to Take atenolol-chlorthalidone (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

High blood pressure (hypertension)

Brand: Tenoretic

Form: Oral tablet
Strengths:
  • 50 mg atenolol/25 mg chlorthalidone
  • 100 mg atenolol/25 mg chlorthalidone

Generic: atenolol/chlorthalidone

Form: Oral tablet
Strengths:
  • 50 mg atenolol/25 mg chlorthalidone
  • 100 mg atenolol/25 mg chlorthalidone
Adult dosage (ages 18–64 years)

Your initial dose will likely be one tablet per day of 50 mg atenolol/25 mg chlorthalidone. At a later time, your doctor may increase your dose to one tablet per day of 100 mg atenolol/25 mg chlorthalidone.

Child dosage (ages 0–17 years)

This medication has not been studied in children. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different schedule. This can help prevent levels of this drug from building up too much in your body.

Special considerations

Kidney disease: Your doctor will likely give you a lower dose of this medication. This depends on how well your kidneys are working. In some cases, the largest suggested dose is 50 mg atenolol/25 mg chlorthalidone once each day. In other cases, it is 50 mg atenolol/25 mg chlorthalidone once every other day.

Breathing problems: Your doctor will likely prescribe the lowest possible dose of this medication for you. If your doctor plans to increase your dose, they may divide the dose so that you take it twice a day. This can help decrease its effect on your breathing.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all

Your blood pressure may rise. If your blood pressure is high and not controlled for a long time, you can have serious complications. These include chest pain, heart failure, stroke, or heart attack.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. In order for this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. If you think you’ve taken too much of this drug, act right away. Call your doctor or local Poison Control Center, or go to the nearest emergency room.

What to do if you miss a dose

Take it as soon as you remember. But if you remember just a few hours before the time for your next dose, only take one dose. Never try to catch up by taking two tablets at once. This could result in dangerous side effects.

How to tell if the drug is working

Your blood pressure should be lowered.

This medication is a long-term drug treatment.

This drug must be stored at the right temperature

Store this medication at a temperature between 68°F (20°C) and 77°F (25°C). Keep it away from light, and do not freeze it.

Do not store this medication in moist or damp areas, such as bathrooms.

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Be sure to carry with you the prescription-labeled box your medication came in.
  • This medication needs to be refrigerated. You may need to use an insulated bag with a cold pack to maintain the drug’s temperature.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor may tell you that you should buy a home blood pressure monitor. This can help you to check your blood pressure in between doctor visits.

Clinical monitoring

Your and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Electrolyte levels. Blood tests can check the levels of electrolytes in your body. Electrolytes are chemicals that help your cells perform many important functions. Certain blood pressure drugs can disrupt the balance of electrolytes in your body.
  • Kidney function. Blood tests can check how well your kidneys are working. If your kidneys aren’t working well, your doctor may decide to lower your dose of this drug.
  • Liver function. Blood tests can check how well your liver is working. If your liver isn’t working well, your doctor may decide to lower your dose of this drug.
  • Blood pressure. Your doctor may suggest that you check your blood pressure each day using a home blood pressure monitor.

Sun sensitivity

This drug can make your skin more sensitive to the sun. This increases your risk of sunburn. Avoid the sun if you can. If you can’t, be sure to wear protective clothing and apply sunscreen.

Hidden costs

To help manage your blood pressure, you may need to have certain tests done. You may also need to purchase certain equipment.

  • Blood tests. These can help check your kidney and liver function, and the levels of electrolytes in your body.
  • Home blood pressure monitor. This device can help you check your blood pressure each day.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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How Much Does atenolol-chlorthalidone Cost?

Oral tablet

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These prices represent the lowest priced national pharmacies for atenolol-chlorthalidone on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on August 31, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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