Atenolol | Side Effects, Dosage, Uses & More

Generic Name:

atenolol, Oral tablet

All Brands

  • Tenormin
SECTION 1 of 5

Highlights for atenolol

Oral tablet
1

Atenolol treats high blood pressure and chest pain. It can also help to prevent heart attack or heart damage after a heart attack.

2

Stopping the drug suddenly increases your risk of heart attack. You may need to stop it by slowly reducing the dose over a period of days or weeks with your doctor’s supervision.

3

Atenolol can cover up or worsen symptoms in people with asthma, diabetes, or poor circulation. Tell your healthcare provider if you have one of these conditions.

4

Atenolol dosage depends on a person’s body and condition. Your doctor may adjust your dose as you go.

5

Atenolol has possible serious side effects, including swelling of the hands, feet, and ankles. It may also cause symptoms associated with an allergic reaction, such as fever, rash, or difficulty breathing.

IMPORTANT INFORMATION

FDA Warning

Atenolol has a black box warning. This is the most serious warning from the U.S. Food and Drug Administration (FDA). Though the medication can still be sold and used, a black box warning alerts doctors and patients to potentially dangerous problems.

Warning: Don’t stop taking atenolol suddenly. If you do, you may experience worse chest pain, a jump in blood pressure, or even have a heart attack.

Stopping atenolol is not recommended. If you need to stop taking the drug, first talk to your doctor. Your dose should be gradually decreased under a doctor's supervision.

Asthma/chronic obstructive pulmonary disease (COPD)

At higher doses, atenolol can block different types of beta receptors found in breathing passages. Blocking these receptors can lead to narrowing of breathing passages, making asthma or COPD worse.

Diabetes

Atenolol may mask important signs of low blood sugar, including shaking and increased heart rate. Without these signals, it becomes more difficult to recognize dangerously low blood sugar levels. 

Poor Circulation

If you have poor circulation in your feet and hands, you may have worse symptoms when taking atenolol. Atenolol reduces blood pressure, so you might not get as much blood to your hands and feet.

Drug Features

Atenolol is a prescription drug. It is available in these forms: oral tablet and intravenous (IV), which is only given by a healthcare provider.

Atenolol is available in its generic form. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

Why It's Used

Atenolol is used to:

  • lower high blood pressure
  • reduce chest pain
  • after a heart attack, the drug reduces the amount of work your heart muscle has to do to push blood through your body.

How It Works

Atenolol belongs to a class of drugs called beta blockers. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

More Details

How It Works

Atenolol belongs to a class of drugs called beta blockers. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Beta receptors are found on cells in the heart. When adrenaline activates a beta receptor, blood pressure and heart rate go up. Beta blockers prevent adrenaline from affecting beta receptors in blood vessels and the heart. This causes blood vessels to relax. By relaxing the vessels, beta blockers help to lower blood pressure and reduce chest pain.

Blood pressure is often raised because blood vessels are tightened. That puts a strain on the heart. It also increases the body's need for oxygen. Beta blockers help to lower heart rate and the heart's demand for oxygen.

Beta blockers don’t permanently change blood pressure and chest pain. Instead, they help to manage the symptoms.

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SECTION 2 of 5

atenolol Side Effects

Oral tablet

Most Common Side Effects

MOST COMMON SIDE EFFECTS

(to see Serious Side Effects click here or keep scrolling)

The following side effects may occur, but do not usually represent an emergency. Discuss with your doctor or healthcare professional if they continue or are bothersome.

Image

Cold hands and feet
Atenolol can slow your heart rate. This is because it blocks the effects of the hormone adrenaline on your heart. When your heart slows down, your blood pressure lowers. Less blood is then pumped through your blood vessels all the way to your hands and feet. With less blood to warm them, your hands and feet get cold.

Constipation
Atenolol blocks the signals sent from your brain to your intestines. This can make your intestines relax when they're supposed to be pushing food through your system. When food doesn't get pushed along fast enough, it can cause constipation.

Diarrhea
Atenolol blocks the signals from your brain to your intestines. This can make your intestines relax when they're supposed to be digesting your food. Sometimes the food slides through too fast and the intestines don't pull enough water from it. This results in diarrhea.

Dizziness
Atenolol blocks the signals from your brain to your heart and veins. This can slow your heart rate. When this happens, your blood doesn't travel fast enough to your brain. Standing up or moving your head quickly can slow blood flow to your brain even more. This can make you feel dizzy.

Headache
Atenolol blocks the signals from your brain to your veins. This can make your veins relax, and sometimes make them swell. When the veins in your brain swell, they can put some pressure on your brain. This can cause a headache.

Reduced sex drive and impotence
In men, atenolol can interfere with the brain's signals that are needed to get and maintain an erection. This can cause erectile dysfunction (impotence). In both men and women, atenolol can cause reduced sex drive and trouble having an orgasm. Why this occurs isn't fully understood.

Shortness of breath
Atenolol can block signals from your brain to the muscles in your lungs. This can cause these muscles to tighten, which narrows the airways in your lungs. This leads to shortness of breath and wheezing.

Unexplained fatigue
Atenolol can slow your heart rate and relax your blood vessels. This slows down blood circulation throughout your body and reduces the amount of oxygen that's available to muscle cells, which can make you feel tired.

Leg pain
This occurs most often at night, in the form of muscle cramps. Leg pain may be related to high levels of a substance called creatine phosphokinase, which has been found in the blood of people taking atenolol. Levels of this substance are increased when your muscles are stressed or injured. However, it isn't known if atenolol causes this stress or injury. Another way atenolol may cause leg pain is by narrowing the arteries of your legs. This decreases blood flow to the legs, which can cause leg pain.

Blood pressure that's lower than usual
Atenolol blocks the effects of the hormone adrenaline on the heart. This can slow down your heart rate, which lowers your blood pressure. If you're too sensitive to atenolol, or if you take too much of this drug, dangerously low blood pressure can result.

SERIOUS SIDE EFFECTS

The following are severe side effects that require emergency care. Contact your doctor or healthcare provider right away if you experience any of these side effects:

Depression
Atenolol use has been linked with depression. However, it's not known if this drug directly causes depression. This is because people with heart disease have depression more often than other people. Depression is always serious, so talk to your doctor right away if you notice symptoms of depression while taking this drug.

Allergic reaction
  1. A large, red rash
  2. Swelling of the hands, feet, and ankles
  3. Fever
  4. Trouble breathing
These side effects can all be caused by an allergy to atenolol. If you have any of these symptoms, especially if they happen suddenly or all together, stop taking this drug right away. Call 9-1-1 or go to the nearest emergency room.

Unusual weight gain
Some people have gained weight after using this drug for a long time, typically six months or longer. Usually, the weight gain is only about 4 pounds. This weight gain may be caused by the drug slowing down your metabolism (the process by which your body converts food into energy). Or it may be due to fluid retention (your body holding onto more water than usual). This can cause swelling of the feet, ankles, or arms.

MOST COMMON SIDE EFFECTS

The following side effects may occur, but do not usually represent an emergency. Discuss with your doctor or healthcare professional if they continue or are bothersome.

Image Cold hands and feet

Atenolol can slow your heart rate. This is because it blocks the effects of the hormone adrenaline on your heart. When your heart slows down, your blood pressure lowers. Less blood is then pumped through your blood vessels all the way to your hands and feet. With less blood to warm them, your hands and feet get cold.

Image
Image Constipation

Atenolol blocks the signals sent from your brain to your intestines. This can make your intestines relax when they're supposed to be pushing food through your system. When food doesn't get pushed along fast enough, it can cause constipation.

Image
Image Diarrhea

Atenolol blocks the signals from your brain to your intestines. This can make your intestines relax when they're supposed to be digesting your food. Sometimes the food slides through too fast and the intestines don't pull enough water from it. This results in diarrhea.

Image
Image Dizziness

Atenolol blocks the signals from your brain to your heart and veins. This can slow your heart rate. When this happens, your blood doesn't travel fast enough to your brain. Standing up or moving your head quickly can slow blood flow to your brain even more. This can make you feel dizzy.

Image
Image Headache

Atenolol blocks the signals from your brain to your veins. This can make your veins relax, and sometimes make them swell. When the veins in your brain swell, they can put some pressure on your brain. This can cause a headache.

Image
Image Reduced sex drive

In men, atenolol can interfere with the brain's signals that are needed to get and maintain an erection. This can cause erectile dysfunction (impotence). In both men and women, atenolol can cause reduced sex drive and trouble having an orgasm. Why this occurs isn't fully understood.

Image
Image Shortness of breath

Atenolol can block signals from your brain to the muscles in your lungs. This can cause these muscles to tighten, which narrows the airways in your lungs. This leads to shortness of breath and wheezing.

Image
Image Unexplained fatigue

Atenolol can slow your heart rate and relax your blood vessels. This slows down blood circulation throughout your body and reduces the amount of oxygen that's available to muscle cells, which can make you feel tired.

Image
Image Leg pain

This occurs most often at night, in the form of muscle cramps. Leg pain may be related to high levels of a substance called creatine phosphokinase, which has been found in the blood of people taking atenolol. Levels of this substance are increased when your muscles are stressed or injured. However, it isn't known if atenolol causes this stress or injury. Another way atenolol may cause leg pain is by narrowing the arteries of your legs. This decreases blood flow to the legs, which can cause leg pain.

Image
Image Low blood pressure

Atenolol blocks the effects of the hormone adrenaline on the heart. This can slow down your heart rate, which lowers your blood pressure. If you're too sensitive to atenolol, or if you take too much of this drug, dangerously low blood pressure can result.

Image

SERIOUS SIDE EFFECTS

The following are severe and emergent side effects of these medications. Contact your medical provider immediately if you experience the following:

Image Depression

Atenolol use has been linked with depression. However, it's not known if this drug directly causes depression.This is because people with heartdisease have depression more often than other people. Depression is always serious, so talk to your doctor right away if you notice symptoms of depression while taking this drug.

Image
Image Allergic reaction
  1. A large, red rash
  2. Swelling of the hands, feet, and ankles
  3. Fever
  4. Trouble breathing

These side effects can all be caused by an allergy to atenolol. If you have any of these symptoms, especially if they happen suddenly or all together, stop taking this drug right away. Call 9-1-1 or go to the nearest emergency room.

Image
Image Unusual weight gain

Atenolol blocks the effects of the hormone adrenaline on the heart. This can slow down your heart rate, which lowers your blood pressure. If you're too sensitive to atenolol, or if you take too much of this drug, dangerously low blood pressure can result.

Image

Serious Side Effects

Pharmacist's Advice
Healthline Pharmacist Editorial Team

To reduce the likelihood of having side effects, take atenolol exactly as prescribed at a regularly scheduled time each day.

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 May Interact with Other Medications

Oral tablet

Atenolol can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Medications That Might Interact with This Drug

Mental Health Drugs

Reserpine and monamine oxidase (MAO) inhibitors may increase or add to the effects of atenolol. They may also increase light-headedness or slow your heart rate more. MAO inhibitors can continue to interact with atenolol for up to 14 days after taking them.

MAO inhibitors include:

  • isocarboxazid (Marplan)
  • phenelzine (Nardil)
  • selegiline (Emsam)
  • tranylcypromine (Parnate)

Heart Rhythm Drugs

These drugs can also interact with atenolol. If you use them with atenolol, they could slow down your heart rate too much. They include:

  • digitalis (Lanoxin)
  • amiodarone
  • disopyramide

Calcium Channel Blockers

Like atenolol, these drugs are used for hypertension and several other heart problems. If combined with atenolol, they may reduce the contraction of your heart and slow it down more. Doctors sometimes use this combination under close supervision.

These drugs include:

  • amlodipine (Norvasc)
  • diltiazem (Cardizem, Dilacor, Taztia, Tiazac)
  • felodipine
  • celvidipine
  • flunaraizine
  • isradipine
  • nicardipine
  • nifedipine
  • nimodipine
  • nisoldipine
  • verapamil

Alpha Blockers

Alpha blockers also lower blood pressure. They may decrease blood pressure too much when combined with atenolol.

Types include:

  • guanethidine
  • betanidine
  • reserpine
  • alpha-methyldopa
  • clonidine
  • prazosin

Clonidine must be carefully managed if it's combined with atenolol. Suddenly stopping the drug while also taking atenolol can cause a big jump in blood pressure.

Indomethacin

Indomethacin can reduce the blood pressure lowering effects of atenolol.

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.

People with asthma/chronic obstructive pulmonary disease (COPD)

Generally, people with asthma or COPD shouldn’t take atenolol. A doctor may still prescribe it, but only in small doses with careful monitoring. Atenolol works to block beta receptors on cells in the heart. But at higher doses, atenolol can block different types of beta receptors found in breathing passages. Blocking these receptors can lead to narrowing of breathing passages, making asthma or COPD worse.

People with diabetes

Atenolol may mask important signs of low blood sugar, including shaking and increased heart rate. Without these signals, it becomes more difficult to recognize dangerously low blood sugar levels. 

People with poor circulation

If you have poor circulation in your feet and hands, you may have worse symptoms when taking atenolol. Atenolol reduces blood pressure, so you might not get as much blood to your hands and feet.

Pregnant women

Atenolol 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 atenolol during pregnancy may outweigh the potential risks in certain cases.

If you’re pregnant and have high blood pressure, speak with your healthcare provider about your treatment options during pregnancy.

Women who are nursing

Atenolol is absorbed into the mother’s breast milk and could be passed to the infant. Talk to your healthcare provider before breastfeeding.

SECTION 4 of 5

How to Take atenolol (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it 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

Brand: Tenormin

Form: Oral Tablet
Strength: 25 mg, 50 mg, 100 mg
Adult Dosage (ages 18-64 years)

Atenolol is often started at 50 mg once a day. It’s gradually adjusted if needed.

Child Dosage (ages 0-17 years)

This medicine has not been studied in children and should not be used in children under the age of 18 years.

Senior Dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you’re a senior, you may need a lower dose or you may need a different schedule.

Special considerations

Seniors: Seniors may need a smaller dose of atenolol at first because they can be more sensitive to the way medications act in their body. Also, as people age, they sometimes have a harder time clearing drugs from their body. After a small first dose, their dose may then increase gradually.

Kidney Disease: Kidney disease can make it more difficult for you to clear the drug from your body. Having kidney disease may affect your dose. Speak with your healthcare provider.

Angina (chest pain)

Brand: Tenormin

Form: Oral Tablet
Strength: 25 mg, 50 mg, 100 mg
Adult Dosage (ages 18-64 years)

Atenolol is often started at 50 mg once a day. It’s gradually adjusted if needed.

Child Dosage (ages 0-17 years)

This medicine has not been studied in children and should not be used in children under the age of 18 years.

Senior Dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you’re a senior, you may need a lower dose or you may need a different schedule.

Special considerations

Seniors: Seniors may need a smaller dose of atenolol at first because they can be more sensitive to the way medications act in their body. Also, as people age, they sometimes have a harder time clearing drugs from their body. After a small first dose, their dose may then increase gradually.

Kidney Disease: Kidney disease can make it more difficult for you to clear the drug from your body. Having kidney disease may affect your dose. Speak with your healthcare provider.

After a heart attack

Brand: Tenormin

Form: Oral Tablet
Strength: 25 mg, 50 mg, 100 mg
Adult Dosage (ages 18-64 years)

After heart attack, the dose is highly individual. It depends on the cause and the effects of the heart attack. Your doctor will monitor your blood pressure and how your heart is responding and may adjust the dose. The drug is often started in the hospital.

Atenolol is often dosed at 100 mg per day given once a day or in two divided doses. It’s gradually adjusted if needed.

Child Dosage (ages 0-17 years)

This medicine has not been studied in children and should not be used in children under the age of 18 years.

Senior Dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you’re a senior, you may need a lower dose or you may need a different schedule.

Special considerations

Seniors: Seniors may need a smaller dose of atenolol at first because they can be more sensitive to the way medications act in their body. Also, as people age, they sometimes have a harder time clearing drugs from their body. After a small first dose, their dose may then increase gradually.

Kidney Disease: Kidney disease can make it more difficult for you to clear the drug from your body. Having kidney disease may affect your dose. Speak with your healthcare provider.

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
Healthline Pharmacist Editorial Team

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

If You Don’t Take It

If you have high blood pressure or chest pain and don’t take your atenolol, you risk:

  • increasing your blood pressure
  • damaging your blood vessels or main organs, such as your lungs, heart, or liver
  • increasing your risk of a heart attack

If You Stop Taking It Suddenly

If you suddenly stop taking atenolol for high blood pressure, chest pain, or after a heart attack, you raise your risk of heart attack.

If You Don’t Take It on Schedule

Not taking atenolol every day, skipping days, or taking doses at different times of day also come with risks. Your blood pressure might fluctuate too often. That might increase your risk for a heart attack.

If You Miss a Dose

If you miss a dose, just take the next dose as planned. Don’t double your dose.

How Can I Tell if the Drug is Working?

You can tell that atenolol is working if it lowers your blood pressure. If you’re taking it for angina, you can tell it’s working if it reduces your chest pain.

Taking this medication as prescribed is important for it to be safe or effective

Pay extra attention to this drug’s timing instructions.

Storing atenolol in the right conditions is important to its effectiveness

Store at controlled room temperature: 68–77°F (20–25°C ). Keep the medication tightly closed and in a light-resistant container. Store it away from moisture.

Note: Be careful of moist environments, including bathrooms. To keep drugs away from moisture, store them somewhere other than your bathroom and any other damp location.

Self-Management

Because atenolol can lower blood pressure, your doctor may ask that you periodically check your blood pressure while taking it. Let your doctor know if you experience blood pressure readings that are either too high or too low while taking atenolol.

Your blood pressure has a systolic reading (the top number) and a diastolic reading (the bottom number). High blood pressure is when your systolic reading (the top number) is higher than 120 mm Hg or a diastolic reading (the bottom number) is higher than 80 mm Hg.

Low blood pressure is when you have a systolic reading (the top number) lower than 90 mm Hg or a diastolic reading (the bottom number) lower than 60 mm Hg. If either one of these numbers is low, your blood pressure would be considered lower than normal.

Are There Any Alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

What does the pill look like?

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SECTION 5 of 5

How Much Does atenolol Cost?

Oral tablet

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Show Sources

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  • Tenormin- atenolol tablet. (2012, October). Retrieved from http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fcfc9676-4edc-460e-6199-8161b824908f
  • Shrestha, R. K., Khan, G. M., Thapa, P., & Koju, R. (2013). Study of the side effects profile of different antihypertensive drugs among the hypertensive patient. Nepalese Heart Journal, 9(1), 25-29.
  • Shapiro, A. P., Muldoon, M. F., Jennings, J. R., & Manuck, S. B. (2013). 8 behavioral effects of antihypertensive medications: a preliminary report. Quality of Life in Behavioral Medicine Research, 115.
  • Kinrys, G., Simon, N. M., Farach, F. J., & Pollack, M. H. (2014). Management of antidepressant-induced side effects. Handbook of Chronic Depression: Diagnosis and Therapeutic Management, 411.
  • Ringoir, L., Pedersen, S. S., Widdershoven, J. W. M. G., Pouwer, F., Keyzer, J. M. L., Romeijnders, A., & Pop, V. J. M. (2014). Beta-blockers and depression in elderly hypertension patients in primary care. Clinical and Psychological Aspects of Cardiovascular Risk Management in Primary Care Hypertension Patients, 75.
  • Imai, Y., Watanabe, N., Hashimoto, J., Nishimaya, A., Sakuma, H., Sekino, H., Omata, K., & Abe, K. (1995). Muscle cramps and elevated serum creatine phosphokinase levels induced by β-adrenoceptor blockers. European journal of clinical pharmacology, 48(1), 29-34.
  • Kholeif, M., & Isles, C. (1989). Profound hypotension after atenolol in severe hypertension. BMJ, 298(6667), 161-162.
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Content developed in collaboration with Stacey Boudreaux, PharmD

Medically reviewed by Susan J. Bliss, RPh, MBA and Alan Carter, PharmD on January 23, 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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