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Why it's used

Atenolol is used for the management of high blood pressure. It is a prescription medicine. This medicine works by relaxing the blood vessels and slowing down the heart rate in order to improve blood flow and to decrease the high blood pressure conditions. Atenolol is also used for the long-term treatment of chest pain due to reduced blood flow to the heart (angina pectoris caused by coronary atherosclerosis). This medicine works by reducing the requirement of oxygen to the heart. It also helps in the reduction of heart rate and the ability of the heart muscle to contract (contractility) thereby making it effective in reducing the symptoms of chest pain. It is also used for the management of heart attack. This medicine works by increasing the requirement of oxygen to heart by increasing left ventricular fiber length and end diastolic pressure in patients who have heart failure. Atenolol is also used for the management of increased or decreased heartbeat.
Atenolol may also be taken in combination with other medicines to treat certain conditions as recommended by the doctor. Atenolol is used together with thiazide-diuretic, Hydralazine, Prazosin, or Alpha Methyldopa for the management of high blood pressure.
Beta-Adrenergic Blocker
Atenolol belongs to a class of medicines called Beta-Adrenergic Blocker. Beta adrenergic blockers are a class of medicines which are used to treat high blood pressure, chest pain, migraines and to manage abnormal heart rhythms. Beta blockers are also used after the first heart attack to prevent the heart from the second heart attack.

How to use

Follow directions on the product label, information guide, and provided by your doctor before using Atenolol. Use this medicine as per your doctor's instructions.
Atenolol is used without food. Atenolol should not be taken with food because the absorption (bioavailability) of Atenolol is altered.
The typical adult dose of Atenolol is 100 mg once a day or 50 mg twice daily for a period of 6-9 days or until the patient is discharged from the hospital and 5-10 mg given as an intravenous injection into the veins. The maximum dose for adults of Atenolol is 100 mg/day per day. Atenolol is typically used at the same time every day.
Atenolol is to be used for longer periods of time. Atenolol may be prescribed for long-term use typically in case of chest pain due to reduced supply of blood to the heart (angina pectoris). You should continue to use this medicine as directed by the doctor even if you feel well.
Tell your doctor if you develop new symptoms. Talk to your doctor if swelling of the face, lips, mouth, tongue or throat, yellow discoloration of the skin, and purple-colored spots on the skin. If you have any kidney disease, Atenolol is excreted by the kidneys and should be used with caution and adjustment of dose should be done in patients with severe kidney damage starting at a low dose of 25 mg per day. If you have issues with the health of your liver, dose selection of Atenolol should be cautious and should begin at a low dose. Consult with your doctor before stopping the use of Atenolol.
To see the impact of Atenolol on the body, your doctor may recommend a lower initial dose. Please follow your doctor's instructions carefully. A lower dose of Atenolol may be recommended to reduce the risk of side-effects. Older patients may see an increase in the risk of side-effects. Hence, a lower dose may be recommended.
When stopping this medicine, it is possible that you may experience withdrawal symptoms such as chest pain, heart attack, and irregular heartbeat. You may need to gradually decrease the dose of this medicine before stopping.
The safety and effectiveness of using this medicine in children has not been established. Atenolol is not for use in children since the safety and effectiveness data in such patients has not been studied.
Atenolol is intended for intravenous use into the veins only. The injection should be given carefully under controlled conditions such as monitoring of heart rate, blood pressure, and electrocardiogram.
Limit drinking alcohol with Atenolol.
Medicines may be given for uses other than those listed in the medicine guide. Do not use Atenolol for symptoms for which it was not prescribed. Do not give Atenolol to others who may have similar symptoms as you. Self-medication can cause harm.
Store Atenolol 20°C-25°C (68°F-77°F), away from moisture, and away from light. Keep this medicine away from children and pets.

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How to take Atenolol

Your dose and how often you take Atenolol will depend on the following factors:
  • age
  • weight
  • patient's health
  • the health of the patient's liver
  • the health of the patient's kidneys
  • medicines recommended by the doctor
  • any other medicines being used
  • herbal supplements in use
  • response to the medicine

Atenolol Dosage

Dosage for high blood pressure

Adult
  • Initial: 50 mg once daily
  • Maximum: 100 mg once daily and a dose of more than 100 mg a day is unlikely to produce further benefit.

Dosage for chest pain (angina pectoris)

Adult
  • Initial: 50 mg once a day
  • Maximum: 100 mg once a day or a dosage of 200 mg once a day for optimal effect.

Dosage for heart attack

Adult
  • Recommended: 100 mg once daily or 50 mg twice a day for a period of 6-9 days

Dosage for irregular heartbeat

Adult
  • Recommended: 50-100 mg once daily as a single dose.

Forms

Tablet
Strength: 25 mg, 50 mg, 100 mg
Injection, solution
Strength: 5mg/10 ml
Oral solution
Strength: 5 mg/ml

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed one.

Overdose

What to do if you overdose on Atenolol?
General treatment includes the process of cleaning out the contents of the stomach (gastric lavage), use of a laxative, close supervision of the patient, treatment in an intensive care ward, activated charcoal (to prevent absorption of any drug still present in the stomach and intestinal tract), the use of plasma or plasma substitutes to treat irregular heartbeat and shock. Filtration of the blood (hemoperfusion or hemodialysis) may be considered. Low heartbeat can be managed with atropine 1–2 mg given directly into a vein (intravenously) or electrical impulses by electrodes to contract the heart muscles (cardiac pacemaker) followed by a dose of 10 mg glucagon intravenously, if necessary. This can be repeated or followed by an intravenous infusion of glucagon 1–10 mg/hour depending on response. if glucagon is unavailable, or no response to glucagon occurs, intravenous infusion of a beta-adrenoceptor stimulant such as dobutamine 2.5 to 10 micrograms/kg/minute may be given. Dobutamine could also be used to treat low blood pressure and heart failure. The dose of dobutamine should, therefore, be increased if necessary to achieve the required response according to the clinical condition of the patient. Bronchodilators can usually reverse spasm of bronchial smooth muscle.
Symptoms of an overdose of Atenolol
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • acute heart failure
  • decreased heartbeat
  • low blood pressure
  • spasm of bronchial smooth muscles
If you think you have overdosed on Atenolol, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Atenolol

Before you use Atenolol, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.
Before you use Atenolol, tell your doctor of your medical history including allergic reaction to a variety of allergens, difficulty in breathing due to inflammation and narrowing of airways (asthma), heart problems, hormone-secreting tumour in the adrenal glands (pheochromocytoma), excessive quantities of acid in body (metabolic acidosis), excessive amount of sugar in the blood (diabetes), kidney problems, heart failure, or patients with excessive production of thyroid hormone (thyrotoxicosis). Patients with the history of allergic reactions to certain substances may experience more severe outcomes on repeated exposure which can be therapeutic, accidental, or diagnostic. These patients may not be responsive to the usual doses of epinephrine which is used to treat the allergic reactions. Before having any surgery, discuss with your doctor and dentist about medicines you use including prescription medicines, non-prescription medicines, and herbal supplements.
The use of Atenolol may change left ventricular end-diastolic pressure, which is an essential measure of ventricular performance. Patients who are on treatment with beta-blockers along with calcium channel blockers such as verapamil or diltiazem are at an increased risk to experience an increase in left ventricular end-diastolic pressure.
Atenolol is not safe for use in women who are pregnant. If you are pregnant or planning to become pregnant, you should discuss the impact on the fetus with your doctor before you start using this medicine. Atenolol can cause harm to an unborn baby (fetus) when it is given to a pregnant woman, as well as it crosses the placental barrier and therefore appears in the cord blood. If it is used in pregnancy, or if the patient becomes pregnant when taking this drug, the patient should be informed about the harmful effects it can have on the fetus. Caution should be used when Atenolol is given to pregnant women. Atenolol is not safe for use in women who are breastfeeding. If you are breastfeeding, discuss with your doctor if you should either discontinue breastfeeding, or stop using this medicine during this period. Neonates born to mothers who are breastfeeding are at an increased risk for low sugar levels (hypoglycemia) and slow heartbeat (bradycardia). Atenolol should be used with caution in women who are breastfeeding. Atenolol may impact fertility in women. If you are trying to conceive, discuss with your doctor on the use of this medicine. If the patient becomes pregnant when trying to conceive, the patient should be informed of all the possible harmful effects to the fetus.
Atenolol can make you feel sleepy. Be careful, especially while driving, while using heavy machinery, or when doing any activity that needs you to be completely alert. The consumption of alcohol with Atenolol can worsen the sleepiness.
Older patients may have a higher incidence of side-effects when using Atenolol.
The results obtained from long-term studies have shown no reduction in the antihypertensive effect of Atenolol when used for a long time.

Atenolol Side-effects

The following side-effects may commonly occur when using Atenolol. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
Rarely, the use of Atenolol may cause the following side-effects:
The following severe side-effects may also occur when using Atenolol:
  • psychiatric disorders (abnormality of movement and behaviour (catatonia))
    Symptoms: sleep disturbances of the type noted with other beta-blockers, mood changes, nightmares, confusion, psychoses, hallucinations, depressed mood or loss of interest in activities memory loss
  • eye disorders
    The use of this medicine should be discontinued if the symptoms worsen. Proper monitoring of the patient is recommended after cessation of therapy.
  • vascular disorders
    Symptoms: cold hands and feet, low blood pressure by standing up from sitting or lying down, temporary loss of consciousness leg pain
    The patient should discontinue the use of this medicine.
  • gastrointestinal disorders
    Symptoms: stomach and intestinal disturbances, dry mouth, diarrhea nausea
  • skin and subcutaneous tissue disorders
    Symptoms: hair loss, long-term skin reaction, worsening of skin disease, skin rashes, severe allergic reaction hives
    The use of this medicine should be discontinued if the symptoms worsen. Proper monitoring of the patient is recommended after cessation of therapy.
  • blood and lymphatic system disorders
    Symptoms: red or purple discolored spots on the skin, abnormally low levels of thrombocytes reduced number of white blood cells
  • nervous system disorders
    Symptoms: dizziness, headache abnormal sensation in the body
  • heart disorders
    Symptoms: slow heartbeat, heart failure, precipitation of heart block, irregular heartbeat, second attack of obstruction of the blood supply to an organ (reinfarction), hole in the heart (development of ventricular septal defect), fast irregular beating of heart's upper chambers (atrial flutter) sudden loss of heart function
    The patient should discontinue the use of this medicine.
  • respiratory, thoracic and mediastinal disorders
    Symptoms: narrowing of the airway muscles, wheeziness shortness of breath
  • hepatobiliary disorders
    Symptoms: elevations of transaminase levels liver damage (intrahepatic cholestasis)
Your doctor has prescribed Atenolol because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Atenolol.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Patients undergoing surgical procedures

The inability of the heart to show a response to pathways existing between the heart and nervous systems (reflex adrenergic stimuli) may enhance the risks of general anesthesia and surgical procedures. Discontinue the use of Atenolol at least 24 hours before undergoing the surgical procedure.

Patients with decreased blood flow to heart (coronary artery disease)

The patients with coronary artery disease who are on treatment with beta-blockers may experience worsening of chest pain, heart attack, and fast or slow heartbeats when treatment with beta-blockers is abruptly discontinued. Patients in whom Atenolol is to be discontinued should be carefully observed and should be advised to limit the physical activity. In case the chest pain worsens, and blood supply to vessels slows, the treatment with Atenolol should be started again temporarily. Therapy with Atenolol should not be discontinued abruptly even in patients with high blood pressure.

Pregnancy

Atenolol can cause harm to an unborn baby (fetus) when it is given to a pregnant woman, as well as it crosses the placental barrier and therefore appears in the cord blood. If Atenolol is used in pregnancy, or if the patient becomes pregnant while using this drug, the patient should be informed about the harmful effects of this medicine on the fetus.

High level of thyroid hormone in the body (Thyrotoxicosis)

The patients with condition of high levels of thyroid hormone in the body are at an increased risk when using this medicine. Such patients may experience fast heartbeats remaining unnoticed. Also, if treatment with Atenolol is stopped immediately, it may result in worsening of a thyroid problem (thyroid storm). Take necessary precautions while withdrawal treatment with Atenolol.

Low blood sugar levels (hypoglycemia)

Patients with low blood glucose levels are at an increased risk when using this medicine. Beta-blockers such as Atenolol results in fast heartbeats that may remain unnoticed in patients with low blood glucose (hypoglycemia) and other problems such as dizziness and sweating may not be affected significantly.

Increased glucose levels (diabetes)

Diabetic patients should take necessary precautions while using Atenolol.

Constraction and tightening of the airways of lungs (bronchospastic diseases)

Patients with a history of bronchospastic lung conditions are at an increased risk when using this medicine. Take necessary precautions while using Atenolol in patients with bronchospastic diseases who cannot tolerate any other blood pressure lowering treatment. The lowest possible dose of Atenolol of 50 mg should be given along with bronchodilator. When the dose of Atenolol is to be increased, it must be divided in order to achieve lower blood levels.

Calcium channel blockers

Patients who on treatment with beta-blockers along with calcium channel blockers are at an increased risk when using this medicine. Such patients are at an increased risk to experience slow heartbeats, heart block, and a rise in left ventricular end-diastolic pressure, which is an important measure of ventricular performance. Patients with a history of heart conduction abnormalities are more susceptible to these conditions of the heart.

Patients without a history of heart failure

Patients who are using beta-blockers such as Atenolol for a longer period of time are at an increased risk when using this medicine which can cause the depressing effect on heart muscles as well as pose further risk of heart failure. This medicine should not be used in such patients. If cardiac failure continues despite adequate treatment, Atenolol should be withdrawn. The use of Atenolol in patients should be discontinued who are not being adequately treated with appropriate treatment.

Patients with heart failure

These patients with poor heart conditions are at an increased risk when using this medicine. As beta-blockers such as Atenolol holds the potential hazard of further depressing the ability of the heart muscles to contract and leads to severe heart failure so this medicine is not approved for the treatment of patients with heart failure.

Patients with a history of allergic conditions

The patients who have a history of allergic reactions to certain substances (allergens) are at an increased risk when using this medicine and such patients may not be responsive to the usual treatment with agents such as adrenaline (epinephrine) which is used to treat the allergic reactions. Such patients may experience allergic symptoms such as hives and swelling of the lower layer of skin.

Elderly patients with abnormal functioning of the kidneys

Such patients are at an increased risk when using this medicine. Treatment with lower dose is to be recommended in elderly patients suffering from abnormal functioning of the kidney.

Patients with creatinine clearance below 35 ml/min/1.73 m2 (measuring parameter for the functioning of kidneys.

Dosage in patients with a creatinine clearance of below 35 ml/min/1.73 m2 should be started at a low dose.

Interactions with Atenolol

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Atenolol interacts with disopyramide, which is used in the treatment of irregular heartbeat. The patients who use Atenolol in combination with disopyramide are at an increased risk to develop severely reduced heartbeat, lack of tissue contraction from the heart muscles (asystole), and heart failure.
There may be an interaction of Atenolol with calcium channel blockers, which are used to treat high blood pressure. Patients who are on treatment with Atenolol along with calcium channel blockers such as verapamil or diltiazem are at an increased risk of reduced heartbeat and heart block as well as left ventricular end diastolic pressure, which is an important measure of ventricular performance. Particularly the patients with existing problems with conduction of heart are at increased risk.
Atenolol may interact with catecholamine-depleting drugs such as reserpine, which is used to treat high blood pressure and mental illness (psychosis). Reserpine has an additive effect when given in combination with Atenolol and may result in low blood pressure and reduced heartbeat that can further lead to vertigo, fainting, and fall in blood pressure when a person stands. Patients who are on treatment with both Atenolol and reserpine should be monitored carefully for these side-effects.
Your doctor's guidelines may need to be followed while taking this medicine along with clonidine, which is used to treat a variety of problems such as high blood pressure, anxiety, migraine, diarrhea, and certain pain conditions. The patients who are on both beta blockers and clonidine may experience rebound high blood pressure during withdrawal of clonidine. When beta blockers such as Atenolol is given in combination with clonidine, the withdrawal of beta blockers should be done several days before the withdrawal of clonidine. If clonidine is to be replaced by beta-blocker therapy, the starting therapy of beta-blockers should be postponed for some days after the use of clonidine is stopped.
Special instructions need to be followed while taking this medicine along with amiodarone, which is used to treat increased or decreased heartbeats. Use of Atenolol with amiodarone may have an enhancing effect on conduction of the electrical impulses throughout the atria of the heart and induce the weakening of heart muscle contractions.
Your doctor's guidelines may need to be followed while taking this medicine along with insulin, which is used to treat high blood sugar levels. Use of Atenolol with insulin and other antidiabetic drugs may result in increased blood sugar lowering effects of these drugs. Also, the symptoms of lowered blood sugar (hypoglycemia) and increased heartbeat may be masked. Take necessary precautions while using Atenolol in diabetic patients.
Special instructions need to be followed while taking this medicine along with adrenaline, is a neurotransmitter which is used to treat serious allergic symptoms. The patients who are on treatment with Atenolol and ephedrine may experience a decrease in blood lowering effect of Atenolol.
Atenolol interacts with dihydropyridines such as nifedipine, which is used to manage chest pain and high blood pressure. Patients who are on treatment with Atenolol and nifedipine are at an increased risk of low blood pressure, heart failure in patients with the insufficient flow of blood.
There may be an interaction of Atenolol with digitalis glycosides, which are used to increase the force of the heart and decrease its rate of contractions. Patients who are on treatment with Atenolol and digitalis glycosides are at an increased risk to develop reduced heartbeats, slow atrioventricular conduction and decreased heart rate.
Atenolol may interact with prostaglandin synthase blocking drugs such as indomethacin, which is used to treat pain, swelling, fever and inflammation. The use of prostaglandin synthase preventing drugs in patients who are on therapy with beta blockers such as Atenolol may result in decreased blood pressure lowering effect.
Atenolol may interact with anesthetic agents, which are used to produce a temporary loss of sensation. Use of beta-blockers with anesthetic drugs may result in increased risk of fast heartbeat and low blood pressure conditions. Such patients should use caution while selecting an anesthetic. Anesthetist should be informed that the patient is on treatment with Atenolol and the anesthetic must be an agent that has little weakening action on contractions of heart (negative inotropic activity) as possible.
This page does not contain all the possible interactions of Atenolol. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Atenolol is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

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