Atenolol

Atenolol (brand name: Tenormin) is a beta blocker medication which treats high blood pressure (hypertension), irregular heartbeats (arrhythmia) and angina.[1]

Atenolol
Clinical data
Trade namesTenormin, others
AHFS/Drugs.comMonograph
MedlinePlusa684031
License data
Pregnancy
category
  • AU: C
Routes of
administration		oral, Intravenous (IV)
Drug classSelective β1 receptor antagonist
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability40–50%
Protein binding6–16%[2]
MetabolismMinimal[2]
Onset of actionIV: <5 minutes[2]
Oral: <1 hour[2]
Elimination half-life6–7 hours[2]
Duration of action>24 hours[2]
ExcretionUrine (>85% IV, 50% oral)[2]
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
ECHA InfoCard100.044.941
Chemical and physical data
ChiralityRacemic mixture
  (verify)

source Wikipedia

It is unwise to stop taking atenolol suddenly, especially if there is heart disease. This can make medical conditions worse.[1] This medicine is only available on prescription.

Most adults can take atenolol. It's sometimes prescribed for babies and children.[1] It is important to treat high blood pressure during pregnancy. Although atenolol can be taken in pregnancy, other drugs are preferred.[1]

This medicine can cause serious allergic reactions that require emergency treatment. Make sure the signs of these reactions are known: read allergic reaction symptoms of drugs.


Pregnancy category: US: D[3], AU C[4]: , UK: 'can be'[1].

Atenolol was patented in 1969 and approved for medical use in 1975.[5] It is on the World Health Organization's List of Essential Medicines.[6] It is available as a generic medication.[7] In 2021, it was the 47th most commonly prescribed medication in the United States, with more than 14 million prescriptions.[8][9][10]

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Uses

For people with high blood pressure, taking atenolol (or other beta blockers) helps prevent future heart disease, heart attacks and strokes. It can also be used to prevent chest pain caused by angina. Atenolol is sometimes prescribed to prevent migraines and help with anxiety.[1]

Action

Atenolol works by slowing down the heart rate, making it easier for the heart to pump blood around the body.[1]

Increased risks (other conditions/medicines)

Atenelol is not suitable for everyone. To make sure it's safe, before starting atenolol, the doctor should answer the the patients questions and find:[1]

  • previous allergic reaction to atenolol or any other medicine
  • low blood pressure (hypotension) or a slow heart rate
  • have Raynaud's phenomenon, which may make the fingers and toes tingle, turn paler than usual or turn blue
  • have metabolic acidosis – when there's too much acid in the blood
  • have lung disease or asthma
  • trying to get pregnant, are already pregnant or breastfeeding

Interactions with other medicines

There are some medicines that may affect the way atenolol works:[1]

  • other medicines for high blood pressure – the combination with atenolol can sometimes lower blood pressure too much, which may make the person taking it feel dizzy or faint
  • other medicines for an irregular heartbeat (arrhythmia), such as amiodarone or flecainide
  • medicines for asthma or chronic obstructive pulmonary disease (COPD)
  • medicines for diabetes, particularly insulin – atenolol may make it more difficult to recognise the warning signs of low blood sugar. Report it to a doctor if there are times with low blood sugar levels without getting any of the usual warning signs. Check blood sugar after exercise and follow the usual advice about checking it before driving or operating machinery
  • medicines to treat nose or sinus blockage or congestion, or other cold remedies (including those from a pharmacy)
  • medicines for allergies, such as ephedrine, noradrenaline or adrenaline

There's not enough information to say that herbal remedies and supplements are safe to take with atenolol. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.[1]

Use in pregnancy

It is more common to take labetalol (a similar medicine that works in the same way). This is because there is more safety information available for labetalol. Talk to a doctor about which blood pressure medicine for what unique scenarios.[1]

There's also a small chance that atenolol can affect a baby's blood sugar levels just after birth. Because of this, baby may have their blood sugar levels monitored in hospital for the first 24 hours to make sure everything's OK before going home. Atenolol can affect the baby's growth in the womb, so there may be extra scans. [1]If the doctor or health visitor says that baby is healthy, it might be OK to take atenolol while breastfeeding.[1]

Atenolol passes into breast milk in different amounts, and sometimes these have been quite high. It's important to treat high blood pressure to keep the mother well. Breastfeeding will also benefit both mother and baby.[1]

Side effects

This medicine can cause allergic reaction, which may be serve. Call an ambulance if symptoms of a reaction appear.

Common

These common side effects of atenolol happen in more than 1 in 100 people. They're usually mild and only last for a short time. Some are:[1]

There are therapies for these side effects to help with managing.[1]

Severe

Serious side effects rarely happen. Some people have serious side effects when taking atenolol. These side effects present should be 'call emergency services if there is' or if:[1]

  • shortness of breath with a cough that gets worse with exercise (like walking up stairs)
  • swollen ankles or legs, or an irregular heartbeat – these can be signs of heart problems
  • shortness of breath, wheezing and tightening of the chest – these can be signs of lung problems
  • the whites of the eyes turn yellow, or skin turns yellow (although this may be less obvious on brown or black skin), or pale poo or dark pee. These can all be signs of liver problems
  • unexplained bruising, bruising more easily than usual. This can be signs of low numbers of platelets in the blood (thrombocytopenia)

Forms

It comes as tablets or as a liquid meant to be swallowed. It can also be given as an injection, but this is usually done in hospital.[1]

Atenolol can also be mixed with other medicines such as nifedipine (brand name Tenif). Mixed with chlortalidone it is so called co-tenidone or by the brand names Tenoret or Tenoertic.[1]

The usual dose for adults is:[1]

  • high blood pressure – 25mg to 50mg, taken once a day
  • angina (chest pain) – 100mg, taken once a day, or split into two 50mg doses
  • irregular heartbeats (arrhythmia) – 50mg to 100mg, taken once a day
  • migraine – 25mg to 100mg, taken twice a day

References
  1. "Atenolol: medicine for high blood pressure and angina". nhs.uk. 2022-04-06. Retrieved 2024-05-29.
  2. "DailyMed - TENORMIN- atenolol tablet". DailyMed. 30 June 2021. Archived from the original on 27 January 2022. Retrieved 20 November 2023.
  3. ([.PDF)
  4. "Atenolol (Tenormin) Use During Pregnancy". Drugs.com. Retrieved 2024-05-30.
  5. Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 461. ISBN 9783527607495.
  6. World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
  7. "Atenolol Monograph for Professionals". Drugs.com. AHFS. Archived from the original on 18 April 2019. Retrieved 23 December 2018.
  8. "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
  9. "Atenolol - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.
  10. Source Wikipedia
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