Atenolol | Side Effects, Dosage, Uses & More
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Atenolol

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.

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.

OTHER WARNINGS

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 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.

Atenolol Side Effects

More common side effects

Most people don’t experience many side effects when taking atenolol.

The most common side effects include:

  • lower-than-normal blood pressure
  • cold hands
  • diarrhea
  • dizziness
  • headache
  • reduced sex drive
  • shortness of breath
  • unexplained fatigue
  • leg pain

Serious side effects

  • depression
  • a large, red rash
  • swelling of the hands, feet, and ankles
  • symptoms associated with severe allergic reaction, such as fever and difficulty breathing
  • unusual weight gain
Pharmacist's Advice
To reduce the likelihood of having side effects, take atenolol exactly as prescribed at a regularly scheduled time each day.

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.


AMLODIPINE 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:

  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 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.

Atenolol and grapefruit

You Asked, We Answered

  • 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 the drug leaves your body as waste than gets into 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 for you by taking it on an empty stomach at the same time every day. Take it either one half hour before you eat or 2 hours after you eat. Taking it at bedtime, at least 2 hours after your last meal of the day, can help you to avoid lightheadedness from the drug.

    - Healthline Pharmacist Review Team

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.

What are you taking this medication 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.

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.

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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