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Atenolol

Atenolol

Atenolol is an FDA-approved beta-blocker used to manage high blood pressure and angina and reduce risks post-heart attack. By blocking adrenaline’s effect on beta receptors in the heart, it lowers blood pressure, reduces heart rate, and alleviates stress on the heart. Atenolol requires careful dosage adjustments, particularly for seniors and those with kidney disease. It is not recommended for children or during pregnancy without medical advice. Common side effects may include cold extremities, fatigue, and dizziness. This medication also comes under the brand name Tenormin. To avoid adverse interactions, patients should consult healthcare providers before combining Atenolol with other medications.

Product Overview

Atenolol is primarily prescribed to treat chest pain (angina) and high blood pressure (hypertension) and to improve survival after a heart attack. As a beta-blocker, this medication works by blocking or inhibiting the action of some natural chemicals in the body, like adrenaline, on the heart and blood vessels. This action helps to lower heart rate, blood pressure, and strain on the heart. The medication comes in oral tablet form and is taken once daily, with doses varying based on the condition being treated. 

While Atenolol is effective for adults, it has not been adequately studied in children and is not recommended for use in patients under 18 years old. In elderly patients, who may process drugs more slowly, a lower initial dose may be necessary. Atenolol is generally safe but can interact with other medications, including certain antihypertensives, antivirals, and diabetes medications, potentially requiring dose adjustments or additional monitoring. Patients who have a history or still have severe allergic reactions to Atenolol components, chronic respiratory conditions, severe heart disorders, or those pregnant or breastfeeding should discuss risks with their healthcare provider.

Side effects may range from mild, such as tiredness and dizziness, to more severe, including shortness of breath and heart complications. If you missed dose or overdose mistakenly, follow specific guidelines or seek immediate medical attention. It’s crucial for patients to maintain consistent communication with primary caregivers to ensure the safe use of Atenolol, particularly when starting treatment or adjusting dosages. This medication is also available as the brand Tenormin. Atenolol’s effectiveness in managing heart conditions while maintaining a relatively low profile of side effects makes it a staple in cardiovascular therapy.

Uses of Atenolol

Atenolol is approved for the following uses:

  • Lowering high blood pressure (hypertension)
  • Alleviating angina (chest pain)
  • Reducing the workload of the heart muscle after a heart attack
  • Over-the-counter use for migraines

How to Use Atenolol?

Dosage

It comes in the form of an oral tablet and has three strengths that are mentioned below:

  • Atenolol 25 mg tablets 
  • Atenolol 50 mg tablets
  • Atenolol 100 mg tablets

Recommended Dosage for Different Patients

  • Dosage for High Blood Pressure
      • Adult (18 to 64 Years): Atenolol typically starts at a dose of 50 mg one time daily. The dosage can be adjusted as necessary.
      • Child (0 to 17 Years): This medication has not been tested in children. It is not recommended for anyone under 18 years old.
      • Senior (65 Years & Older): There are no specific dosage guidelines for seniors. Older adults may metabolize drugs more slowly, leading to higher than normal drug levels in the body. If you are a senior, you might need a lower dose or maybe a different dosing schedule.
  • Dosage for Angina (Chest Pain)
      • Adult (18 to 64 Years): Atenolol typically starts at a dose of 50 mg one time daily. The dosage can be adjusted as necessary.
      • Child (0 to 17 Years): This medication has not been tested in children. It is not recommended for anyone under 18 years old.
      • Senior (65 Years & Older): There are no specific dosage guidelines for seniors. Older adults may metabolize drugs more slowly, leading to higher than normal drug levels in the body. If you are a senior, you might need a lower dose or maybe a different dosing schedule.
  • Dosage After a Heart Attack
      • Adult (18 to 64 Years): Post-heart attack dosing of this drug is customized for each patient based on the specific circumstances & outcomes of the heart attack. Doctors will assess your heart function and blood pressure regularly to determine the right dosage. Initially, treatment usually begins in the hospital setting. Atenolol is commonly prescribed at 100 mg per day, which may be taken as a single dose or split into two doses. Adjustments to the dosage may be made as needed.
      • Child (0 to 17 Years): This medication has not been tested in children. It is not suitable for individuals under 18 years old.
      • Senior (65 Years & Older): Specific dosage guidelines for seniors are not available. Older adults often metabolize medications more slowly, which may lead to higher medication levels in the body. Seniors may require a reduced dosage or an altered dosing schedule.
  • Special Dosage Considerations
    • For People with Kidney Disease: This disease may impair your ability to eliminate this drug from your system, affecting how much you should take. It’s important to discuss with your doctor the most appropriate dosage for your specific condition.
    • For Seniors: Seniors may start with a lower dose of Atenolol due to increased sensitivity to medications and a slower drug clearance rate as they age. Initially, a small dosage is recommended, which can be gradually increased based on individual response & tolerance.

[Note: Remember these recommendations may vary depending on person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

  • Follow all the instructions on your prescription label & read any medication guides or instruction sheets provided. 
  • Your doctor might adjust your dose from time to time.
  • Take Atenolol exactly as your doctor has prescribed. 
  • It’s important to have your blood pressure checked regularly.
  • If you’re scheduled for surgery, inform the surgeon that you are taking Atenolol in advance. You might need to stop using the medication temporarily.
  • Continue using Atenolol as instructed, even if you don’t see an immediate improvement in your symptoms. Discuss any concerns with your doctor.
  • Do not stop taking Atenolol suddenly, as it could worsen your condition.
  • If you’re treating high blood pressure, continue using Atenolol even if you feel fine. High blood pressure often shows no symptoms, and you might need to take blood pressure medication for life.
  • Your treatment might include a combination of different drugs. Follow your doctor’s directions for all medications, and read the guides or instructions that come with each one. Don’t alter your doses or medication schedule without consulting your doctor.
  • Atenolol is intended for long-term use. If it’s working well and you’re not experiencing serious side effects, you’ll likely continue taking it for a long time.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Atenolol Work?

Atenolol is part of a group of medications known as beta blockers. These medications have a similar way of working and are often used to treat alike health issues. Beta receptors, which are found on heart cells, react to adrenaline by raising blood pressure and heart rate. Atenolol blocks adrenaline from reaching these receptors in the heart and blood vessels. This blockage helps the blood vessels to widen or relax. When the vessels relax, it helps to lower blood pressure and lessen chest pain.

Additionally, it reduces the heart’s need for oxygen. Beta-blockers don’t cure high blood pressure or chest pain but are used to manage their symptoms. Atenolol starts to act immediately once taken, and its effects last for about 24 hours. Therefore, it is important to take Atenolol consistently every day to maintain its effectiveness.

Important Safety Information

Side Effects

Common side effects of Atenolol may include:

  • Shortness of breath
  • Feeling dizzy
  • Constipation
  • Pain in the legs
  • Decreased sexual desire or difficulty achieving an erection
  • Feeling of coldness in the hands and feet
  • Blood pressure that is lower than normal
  • Diarrhea
  • Unusual tiredness
  • Headaches

Serious side effects of Atenolol may include the following:

  • Depression:
    • Anxiety
    • Fatigue
    • Difficulty concentrating
    • Persistent feelings of sadness or hopelessness
  • Heart problems, including cardiogenic shock & cardiac arrest, signs may include:
    • Elevated heart rate
    • Breathing faster than usual
    • Low blood pressure
    • Sweating
    • Loss of consciousness
  • Allergic reaction:
    • Swelling of the ankles, hands, and feet
    • Large & red rash
    • Fever
    • Swelling of the tongue or throat, which may cause difficulty breathing
  • Unusual weight gain:
    • Noticeable swelling in the ankles, feet, or arms
  • Heart attack or worsening of heart problems in people with coronary artery disease or CAD who suddenly stop taking Atenolol: This can happen if Atenolol is abruptly discontinued without proper medical supervision.

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

  • For People with Hyperthyroidism (an Overactive Thyroid): Atenolol can conceal crucial symptoms of an overactive thyroid, such as a rapid heartbeat. Abruptly stopping the medication can intensify these symptoms and may become life-threatening. It is important not to discontinue Atenolol without consulting your healthcare provider.
  • Allergy Warning: Atenolol may cause a severe allergic reaction. If you experience these symptoms, immediately call 911 or go to the nearest emergency room. If you have previously had an allergic reaction to Atenolol, do not take it again, as it could be life-threatening. Symptoms of such a reaction include:
    • A large, red rash
    • Fever
    • Swelling of the hands, feet, and ankles
    • Swelling of your throat or tongue makes it difficult to breathe.
  • Asthma/Chronic Obstructive Pulmonary Disease (COPD) Warning: People who have asthma or COPD are generally advised not to take Atenolol. In some cases, a doctor might prescribe it, but only in small doses and under strict supervision. Atenolol is designed to block beta receptors on heart cells. However, at higher doses, it can also block other types of beta receptors located in the airways. This can cause the airways to narrow, potentially worsening asthma or COPD symptoms.
  • Diabetes Warning: Atenolol may hide important signs of low blood sugar, such as shaking and an increased heart rate. These signs are crucial for recognizing when your blood sugar levels are dangerously low. Without these indicators, it might be more difficult to detect and respond to a drop in blood sugar.
  • Poor Circulation Warning: If you suffer from poor circulation, particularly in your hands and feet, taking Atenolol could worsen your symptoms. This medication lowers blood pressure, which can reduce blood flow to your extremities, potentially aggravating circulation problems.
  • Warning for Untreated Pheochromocytoma: A pheochromocytoma is a type of tumour that can cause your body to produce excessive amounts of catecholamines, which are a type of hormone. If Atenolol is taken by someone with an untreated pheochromocytoma, it can lead to serious complications. The medication might cause severe spikes in blood pressure and could also result in pulmonary edema, where the lungs fill with fluid. It’s crucial to inform your doctor if you have a pheochromocytoma before starting treatment with Atenolol.

Boxed Warning

Sudden Discontinuation of Atenolol in People with Coronary Artery Disease (CAD): This drug carries a boxed warning, which is the most stringent warning issued by the Food & Drug Administration or FDA. A boxed warning is used to alert doctors and patients to potential serious side effects of a medication. For individuals with coronary artery disease (CAD)—where the arteries in the heart are narrowed—abruptly stopping Atenolol can be dangerous. Suddenly discontinuing Atenolol may lead to worsened chest pain, heightened blood pressure, or even a heart attack. If you have CAD and need to discontinue Atenolol, it is vital to consult with your doctor. They will develop a treatment plan to taper off the medication gradually, ensuring it is safe to stop taking it completely.

Precautions

  • You should not use Atenolol if you are allergic to it or if you have certain serious heart conditions, including:
    • “AV block” (second or third degree), which is a type of heart rhythm problem;
    • Unusually slow heartbeats;
    • Heart failure;
    • Inadequate heart function, where your heart is unable to pump blood effectively.
  • Before starting Atenolol, it’s important to ensure it’s safe for you. Inform your doctor if you have any of the following:
    • Congestive heart failure;
    • Coronary artery disease (hardened arteries);
    • Respiratory conditions like asthma, bronchitis, or emphysema;
    • Diabetes;
    • Overactive thyroid;
    • Liver or kidney disease;
    • Pheochromocytoma (a tumor on the adrenal gland);
    • Peripheral vascular disease, such as Raynaud’s syndrome;
    • Allergies, especially if you are currently receiving allergy treatments or undergoing skin testing.
  • Discussing these conditions with your doctor can help determine the best & safest treatment options for you.
  • Atenolol may pose risks during pregnancy. If you are pregnant or become pregnant while taking this medication, it’s crucial to inform your doctor.
  • Additionally, Atenolol can transfer into breast milk and potentially harm a nursing infant. If you are breastfeeding, make sure to discuss this with your doctor.
  • Atenolol is not approved for use in individuals under 18 years of age.

Other Important Precautions

For Pregnant Women: Atenolol is classified as a Category D pregnancy drug. This classification indicates two key aspects:

  1. Studies have demonstrated a risk of adverse effects on the fetus when this medicine is taken by the mother.
  2. Despite these risks, there may be circumstances where the benefits of using Atenolol during pregnancy outweigh the potential risks.

Use of Atenolol during the second trimester has been linked to babies being born smaller than normal. Additionally, newborns whose mothers took Atenolol close to the time of birth may face risks of hypoglycemia (low blood sugar levels) and bradycardia (slower than normal heart rate).

If you are taking Atenolol and are planning to become pregnant, or if you find out you are pregnant, it is crucial to consult your doctor immediately. There are alternative medications available for managing high blood pressure that may have fewer risks during pregnancy and while breastfeeding. Your doctor can guide you on whether switching drugs or adjusting your dosage might be safer.

For Women Who Are Breastfeeding: Atenolol can pass into breast milk & can affect the nursing infant. Infants breastfed by mothers who are taking Atenolol could also be at risk of hypoglycemia and bradycardia. If you are breastfeeding, discuss with your doctor the potential risks and consider possible alternatives to ensure the safety of your child.

Contraindications

Individuals with the following conditions should not use Atenolol due to the potential for severe adverse effects:

  • Known allergy to the drug
  • Persistent low heart rate (bradycardia)
  • Poor blood circulation due to heart failure
  • Pregnancy
  • Breastfeeding mother
  • Clinical depression
  • Second or third-degree heart block
  • Tumor of the adrenal gland called pheochromocytoma

Missed Dose

  • If you miss a dose of Atenolol, contact your doctor’s office for advice. 
  • Your doctor or their medical staff will guide you on the best time to take your next dose. 
  • To prevent missing doses in the future, consider setting a reminder on your phone. 
  • Using a kitchen timer can also be an effective way to remember your medication schedule.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

If you take too much of your drug or seek symptoms of an overdose, seek immediate medical attention or contact the Poison Help line. Symptoms of overdose may include:

  • Extreme weakness or fatigue
  • Very slow heart rate
  • Shortness of breath
  • Fainting

Prompt medical intervention is crucial if you suspect an overdose of Atenolol to prevent serious complications.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Storage

  • Always keep this drug at a room temperature, from 68°F-77°F (20°C-25°C).
  • Store your medicine (Atenolol) in a tightly closed container that blocks light.
  • Always make sure it’s stored away from moisture.
  • Avoid keeping this medication in places that are humid or damp, like bathrooms, to keep it effective and safe.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Atenolol Interactions

Atenolol has the potential to interact with several other medications. These interactions can lead to various effects. For example, some interactions may reduce the effectiveness of a drug, while others may increase side effects or make them more severe.

Interactions with Other Medications: Below are lists of medications that can interact with Atenolol. However, these lists are not exhaustive. Before starting Atenolol, it’s essential to discuss your medication regimen with your doctor and pharmacist. Be sure to inform them about all prescription, over-the-counter, and other medications you are taking, as well as any vitamins, herbs, or supplements. Sharing this information may help you prevent potential interactions. If you have any questions about how drug interactions may affect you, don’t hesitate to ask your healthcare providers for guidance.

Interactions with Disopyramide: Combining Atenolol with disopyramide (Norpace, Rythmodan) can lead to a dangerously slow heart rate. Disopyramide is used to treat irregular heart rhythms. Symptoms of a slow heart rate may include lightheadedness, dizziness, and fainting. If you need to take disopyramide while using Atenolol, your doctor will closely monitor your heart function during treatment to ensure your safety.

Interactions with Calcium Channel Blockers: Combining blood pressure drugs (known as calcium channel blockers) with Atenolol can potentially lead to excessively low blood pressure and heart rate. This interaction may result in symptoms such as lightheadedness, dizziness, and fainting.

Examples of calcium channel blockers include:

  • Diltiazem hydrochloride (Tiazac, Cardizem CD)
  • Amlodipine besylate (Lotrel, Norvasc)

If you need to take calcium channel blockers while using Atenolol, your doctor will closely monitor your heart function and blood pressure throughout your treatment. This monitoring is essential for managing any potential adverse effects and ensuring your safety.

Interactions with Amiodarone: Taking Atenolol with amiodarone (Pacerone, Nexterone) can also result in a slow heart rate. Amiodarone is used to treat heart rhythms that are irregular. Similar symptoms of a slow heart rate may occur, including dizziness, lightheadedness, and fainting. If you require treatment with amiodarone while using Atenolol, your doctor will closely monitor your heart function to manage any potential adverse effects.

Interactions with Drugs that Lower Prostaglandin Levels: Combining Atenolol with medications that lower prostaglandin levels may reduce Atenolol’s effectiveness in treating high blood pressure. Prostaglandins are substances in the body that have hormone-like effects. If Atenolol is less effective, it may not effectively lower blood pressure as usual. An example of a medication that lowers prostaglandin levels is the pain reliever indomethacin (Indocin). If you need medication that lowers prostaglandin levels while using Atenolol, your doctor will closely monitor your blood pressure during treatment to ensure it remains well controlled.

Interactions with Clonidine: If you are taking both Atenolol and clonidine (Catapres), it’s important to consult your doctor before discontinuing either medication, as this medication is used to treat high blood pressure. Suddenly stopping either Atenolol or clonidine could lead to a sudden increase in blood pressure, a condition known as rebound hypertension. Therefore, it’s crucial to discuss any changes in your medication regimen with your primary caregiver to avoid potential complications.

Interactions with Drugs that Lower Catecholamine Levels: Taking Atenolol alongside medications that lower your catecholamine levels can result in excessively low blood pressure and heart rate. Catecholamines are specific types of hormones. Combining these medications may exacerbate these effects.

Symptoms of low blood pressure or heart rate can vary but may include fainting, dizziness, and lightheadedness. Examples of medications that lower catecholamine levels include:

  • Clonidine (Catapres), prescribed for high blood pressure
  • Reserpine (Serpasil), prescribed for high blood pressure
  • Disulfiram (Antabuse), prescribed for alcohol misuse

If you need to take medications that lower catecholamine levels while using Atenolol, your doctor will carefully monitor your heart function and blood pressure throughout your treatment. This monitoring is crucial for ensuring your safety and well-being.

Interactions with Herbs & Supplements: While there are no specific herbs or supplements reported to interact with Atenolol, it’s essential to consult with your primary caregiver or pharmacist before using any of these products while taking Atenolol. This precaution ensures that any potential interactions or adverse effects are appropriately addressed.

Interactions with Digitalis Glycosides: Combining Atenolol with certain heart medications known as digitalis glycosides can result in a dangerously slow rate of heartbeat. An example of a digitalis glycoside drug is Lanoxin (digoxin). Symptoms of a slow heart rate also include lightheadedness, dizziness, and fainting. If you require treatment with a digitalis glycoside drug while using Atenolol, your doctor will closely monitor your heart function during treatment to mitigate any potential adverse effects.

Interactions with Certain Foods: There are no specific foods reported to interact with Atenolol. However, if you have any concerns or questions about consuming certain foods while taking Atenolol, it’s advisable to discuss them with your doctor for personalized guidance.

[Note: This isn’t a complete list, and there could be other drugs that interact with Atenolol. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Atenolol Alternatives

  • Prinivil (lisinopril)
  • Cozaar (losartan)
  • Zestril (lisinopril)
  • Lopressor (metoprolol tartrate)
  • Lotrel (amlodipine besylate)
  • Norvasc (amlodipine besylate)
  • Durlaza (aspirin)
  • Cardizem CD (diltiazem hydrochloride)
  • Lasix (furosemide)
  • Tiazac (diltiazem hydrochloride)
  • Microzide (hydrochlorothiazide) 
  • Coreg (carvedilol)
  • Aldactone (spironolactone)
  • Bayer Buffered Aspirin (aspirin)
  • Hydralazine
  • Lipitor (atorvastatin)
  • Minipress (prazosin)
  • Nitrostat (nitroglycerin)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

Frequently Asked Questions

Does Atenolol lower blood pressure quickly?

Yes, Atenolol typically starts to lower high blood pressure after about 3 hours of taking it, but it may take up to 2 weeks to reach its full effectiveness. It’s important to continue taking the medication as prescribed, even if you don’t feel any immediate changes in your blood pressure.

Does Atenolol cause weight gain?

Yes, it is possible for Atenolol to cause weight gain as a side effect. On average, weight gain associated with beta-blockers like Atenolol is about 2.6 pounds (1.2 kilograms). This side effect is more common with older beta-blockers such as Atenolol and metoprolol. If you have concerns about weight gain while taking Atenolol, it’s important to discuss them with your healthcare provider.

Does Atenolol thin your hair?

It is possible that Atenolol, a type of blood pressure medication known as a beta-blocker, may cause thinning of the hair. This is because certain blood pressure medications, like beta-blockers, have been associated with hair loss, a condition known as telogen effluvium. Some other commonly prescribed beta-blockers besides Atenolol include propranolol, metoprolol, timolol, nadolol, and others.

Does Atenolol affect sleep?

Beta-blockers like metoprolol (Lopressor, Toprol XL) and Atenolol are mainly prescribed to manage high blood pressure or irregular heartbeats. One potential side effect is that these medications may lower the body’s natural melatonin levels. Melatonin is a hormone that helps regulate your sleep-wake cycle.

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