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Atenolol, Oral Tablet

Highlights

Highlights

  1. Atenolol is used to treat high blood pressure and chest pain. It can also help prevent heart attack or heart damage after a heart attack.
  2. This drug comes as a tablet you take by mouth.
  3. Atenolol is available as the brand-name drug Tenormin. It’s also available as a generic drug.
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Warnings

Atenolol warnings

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.

What Is Atenolol?

What Is Atenolol?

Atenolol is a prescription drug. It comes as a tablet you take by mouth. It’s also available in an intravenous (IV) form, which is only given by a healthcare provider.

Atenolol is available as the brand-name drug Tenormin. It’s 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.

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.

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.

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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Side Effects

Side Effects

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.

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.  
  • a large, red rash; swelling of the hands, feet, and ankles; or fever and 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.

Common Side Effects

The following common side effects may occur, but don’t usually require emergency care. Talk with your doctor or healthcare provider if these side effects continue or if they bother you:

  • 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 tiredness:  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

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.

Interactions

Atenolol may interact with other medications

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.

Other Warnings

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.

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.

Pregnant women: Atenolol is a category D pregnancy drug. That means two things:

Studies show a risk of adverse effects to the fetus when the mother takes the drug.

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

  • Can grapefruit affect how atenolol works?
  • Grapefruit does not directly affect how atenolol works. However, taking atenolol with food in your stomach can slow down the absorption of the drug. This means that the drug moves more slowly from your digestive tract into your blood stream. If your body absorbs the drug more slowly, more of it leaves your body as waste than enters your blood. You have to have enough of the drug in your blood for it to work right. You can help this drug work better by taking it on an empty stomach at the same time every day. Take it either a half hour before you eat or two hours after you eat. Taking it at bedtime, at least two hours after your last meal of the day, can help you to avoid lightheadedness from the drug.

    - Healthline Pharmacist Review Team

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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Dosage

How to take atenolol

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

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 and forms. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

For high blood pressure

Brand: Tenormin
Form: Oral tablet
Strengths: 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.

For angina (chest pain)

Brand: Tenormin
Form: Oral tablet
Strengths: 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
Strengths: 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.

Pharmacist's Advice

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, and 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.

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Considerations

Important considerations for taking this drug

You can cut or crush the tablet

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.

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.

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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Pregnancy and Breastfeeding

Atenolol use during pregnancy and breastfeeding

Chronic (long-term) high blood pressure isn’t common in pregnancy. Only about three to five percent of pregnant women have chronic high blood pressure. However, that number is increasing for many reasons. For example, more women are waiting to get pregnant until they’re older.

Chronic high blood pressure is associated with:

  • premature birth
  • impaired fetal growth
  • separation of the placenta from the womb
  • cesarean delivery

However, some blood pressure drugs also have adverse effects for the fetus. It isn’t clear whether treating chronic high blood pressure during pregnancy is worth the risks it poses to the fetus. Atenolol is a category D pregnancy drug. That means two things:

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

Atenolol use in the second trimester of pregnancy has been associated with birth of babies who are smaller than normal. Also, newborns of mothers who took atenolol at the time of birth may be at risk of hypoglycemia (lower than normal blood sugar levels) and bradycardia (slower than normal heartbeat).

Atenolol passes into breast milk, as well. Newborns who breastfeed from mothers who take atenolol are also at risk of hypoglycemia and bradycardia. However, infants who are older than 3 months seem to be at little risk of the effects of atenolol in breastmilk.

If you take atenolol and are considering having a baby, or if you are pregnant, talk to your doctor right away. Atenolol is not the only medication that treats high blood pressure. Other drugs have fewer adverse effects during pregnancy and breastfeeding. Your doctor will be able to tell you if a different drug or a dose adjustment is an option for you.

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.

Cost

Costs associated with atenolol

Atenolol is one of the lesser expensive beta-blockers. The brand-name version of atenolol is much more expensive than generic atenolol. Most health insurance policies will require that you use generic atenolol.

If you have to use atenolol for long-term therapy, your cost for this drug can add up. Shopping around can help you to save some money, even if it is just a little bit. For a specific prices for atenolol visit the web site GoodRx.

There are also many programs such as prescription assistance programs and co-pay assistance programs that may be able to help you with the cost of your drugs. Some of these programs are sponsored by your local government or local nonprofit organizations. Some of these programs are even sponsored by the companies that make the drugs. Your doctor or your doctor’s patient advocate can help direct you to these programs.

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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Professional

Atenolol professional information

Indications for use

Atenolol is indicated for the treatment of hypertension. It can be used alone or in combination with other agents.

Atenolol is approved for long term management of patients with angina pectoris.

Atenolol is indicated in the management of hemodynamically stable patients with definite or suspected myocardial infarction to reduce cardiovascular mortality.

Contraindications

Patients with sinus bradycardia, cardiogenic shock, overt cardiac failure, heart block greater than first degree. Also contraindicated in patients with hypersensitivity to atenolol or any of its components.

Warnings/precautions

BLACK BOX WARNING: Do not abruptly stop atenolol in patients with coronary artery disease. It can result in myocardial infarction or ventricular arrhythmias.

Beta-blockade carries the potential hazard of further depressing myocardial contractility and precipitating more severe failure. In patients who have congestive heart failure controlled by digitalis and/or diuretics, atenolol should be administered cautiously. Both digitalis and atenolol slow AV conduction. In patients with acute myocardial infarction, cardiac failure which is not promptly and effectively controlled by 80 mg of intravenous furosemide or equivalent therapy is a contraindication to beta-blocker treatment.

Do not use in heart failure patients as it can worsen heart failure. It should be stopped immediately if someone develops new heart failure.

Do not use with calcium channel blockers: can cause bradycardia and heart block. In addition, left ventricular end diastolic pressure can rise when beta blockers are administered with verapamil or diltiazem. Patients with preexisting conduction abnormalities or left ventricular dysfunction are particularly susceptible.

PATIENTS WITH BRONCHOSPASTIC DISEASE SHOULD, IN GENERAL, NOT RECEIVE BETA-BLOCKERS. Because of its relative beta selectivity, however, atenolol may be used with caution in patients with bronchospastic disease that do not respond to, or cannot tolerate, other antihypertensive treatment. Since beta selectivity is not absolute, the lowest possible dose of atenolol should be used with therapy initiated at 50 mg and a beta-stimulating agent (bronchodilator) should be made available. If dosage must be increased, dividing the dose should be considered in order to achieve lower peak blood levels.

It is not advisable to withdraw beta-adrenoreceptor blocking drugs prior to surgery in the majority of patients. However, care should be taken when using anesthetic agents such as those which may depress the myocardium.

Atenolol should be used with caution in diabetic patients if a beta-blocking agent is required. Beta-blockers may mask tachycardia occurring with hypoglycemia, but other manifestations such as dizziness and sweating may not be significantly affected.

Beta-adrenergic blockade may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism. Abrupt withdrawal of beta-blockade might precipitate a thyroid storm; therefore, patients suspected of developing thyrotoxicosis from which atenolol therapy is to be withdrawn should be monitored closely.

Atenolol should not be given to patients with untreated pheochromocytoma.

Atenolol can cause fetal harm when administered to a pregnant woman. Atenolol crosses the placental barrier and appears in cord blood. Administration of atenolol starting in the second trimester of pregnancy has been associated with the birth of infants that are small for gestational age. No studies have been performed on the use of atenolol in the first trimester, and the possibility of fetal injury cannot be excluded. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.

Mechanism of action

Atenolol is a beta-selective (cardioselective), beta-adrenergic receptor-blocking agent without membrane-stabilizing or intrinsic sympathomimetic (partial agonist) activities. This preferential effect is not absolute, however, and at higher doses, atenolol inhibits beta-adrenoreceptors, chiefly located in the bronchial and vascular musculature.

Dosing in adults

Hypertension

The initial dose of atenolol is 50 mg given as one tablet per day either alone or added to diuretic therapy. The full effect of this dose will usually be seen within one to two weeks. If an optimal response is not achieved, the dosage should be increased to atenolol 100 mg given as one tablet a day. Increasing the dosage beyond 100 mg per day is unlikely to produce any further benefit.

Angina pectoris

The initial dose of atenolol is 50 mg given as one tablet per day. If an optimal response is not achieved within one week, the dosage should be increased to atenolol 100 mg given as one tablet per day. Some patients may require a dosage of 200 mg once per day for optimal effect.

Acute myocardial infarction

Treatment is initiated in the hospital with intravenous atenolol.

In patients who tolerate the full intravenous dose (10 mg), atenolol 50 mg should be initiated 10 minutes after the last intravenous dose followed by another 50 mg oral dose 12 hours later.

Thereafter, atenolol can be given orally either 100 mg once daily or 50 mg twice per day for a further six to nine days or until discharge from the hospital. If bradycardia or hypotension requiring treatment or any other untoward effects occur, atenolol should be discontinued.

Dosing in children

(no information)

Dosing in elderly

In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Dosing in renal impairment

Normal doses of atenolol can be given until the CrCl falls to 35 mL/min/1.73m2.

In patients with CrCl between 15-35 mL/min/1.73m2: Maximum daily dose is 50 mg.

In patients with CrCl below15 mL/min/1.73m2: Maximum daily dose is 25 mg.

Dosing in hepatic impairment

Not applicable

Drug interactions

Catecholamine-depleting drugs (e.g., reserpine) may have an additive effect when given with beta-blocking agents. Closely observe for evidence of hypotension and/or marked bradycardia which may produce vertigo, syncope, or postural hypotension.

Calcium channel blockers: additive effect when given with atenolol.

Beta-blockers may exacerbate the rebound hypertension that can follow the withdrawal of clonidine. If the two drugs are coadministered, the beta-blocker should be withdrawn several days before the gradual withdrawal of clonidine. If replacing clonidine by beta-blocker therapy, the introduction of beta-blockers should be delayed for several days after clonidine administration has stopped.

Concomitant use of prostaglandin synthase inhibiting drugs (e.g., indomethacin) may decrease the hypotensive effects of beta-blockers.

While taking beta-blockers, patients with a history of anaphylactic reaction to a variety of allergens may have a more severe reaction on repeated challenge, either accidental, diagnostic or therapeutic. Such patients may be unresponsive to the usual doses of epinephrine used to treat the allergic reaction.

Adverse drug reactions

Bradycardia, hypotension, dizziness, vertigo, fatigue, lethargy, nausea, diarrhea, depression, rash.

Monitoring parameters

Monitor blood pressure for effectiveness.

Monitor the patient for signs and symptoms of lethargy, slowed breathing, wheezing, sinus pause and bradycardia.

Pregnancy risk factor

Pregnancy Category D.

Atenolol can cause fetal harm when administered to a pregnant woman. Atenolol crosses the placental barrier and appears in cord blood. Administration of atenolol starting in the second trimester of pregnancy, has been associated with the birth of infants that are small for gestational age. No studies have been performed on the use of atenolol in the first trimester, and the possibility of fetal injury cannot be excluded. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.

Preparation of suspension

NA

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.

Article resources
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