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Indications & Uses
Atenolol is indicated for:
Pharmacology
Atenolol was developed in the search for a β-adrenoceptor antagonist that would block β1 (cardiac) receptors selectively, without affecting β2-receptors. It is classified as a β1-selective (cardioselective) β-adrenergic receptor antagonist, with no membrane-stabilising activity and no partial agonist activity. Among the β-blockers currently available, it is the most hydrophilic, and for this reason it penetrates the lipid layer of cell membranes poorly.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Hypertension: The initial dose of Atenolol is 50 mg, taken as one tablet daily, either alone or added to diuretic therapy. The full effect of this dose is usually seen within one to two weeks. If the response is not optimal, the dose should be increased to 100 mg of Atenolol as one tablet daily. Increasing the dose beyond 100 mg a day is unlikely to give any further benefit.
Angina Pectoris: The initial dose of Atenolol is 50 mg given as one tablet daily. If the response is not optimal within one week, the dose should be increased to 100 mg of Atenolol as one tablet daily. Some patients may need a dose of 200 mg once daily for the best effect. Full, twenty four hour control with once daily dosing is achieved by giving doses larger than what is needed for an immediate maximum effect. The greatest early effect on exercise tolerance occurs with doses of 50 to 100 mg, but at these doses the effect at 24 hours is reduced, averaging about 50% to 75% of that seen with a once daily oral dose of 200 mg.
Acute Myocardial Infarction: In patients with definite or suspected acute myocardial infarction, treatment with Atenolol I.V. Injection should begin as soon as possible after the patient arrives at the hospital and eligibility is confirmed. Treatment should start with an intravenous dose of 5 mg Atenolol given over 5 minutes, followed by another 5 mg intravenous injection 10 minutes later. In patients who tolerate the full intravenous dose (10 mg), Atenolol Tablets 50 mg should be started 10 minutes after the last intravenous dose, followed by another 50 mg oral dose 12 hours later. After this, Atenolol can be given orally, either 100 mg once daily or 50 mg twice daily, for a further 6 to 9 days or until discharge from the hospital. If bradycardia or hypotension needing treatment, or any other unwanted effects occur, Atenolol should be stopped.
Side Effects
In studies looking at atenolol's use after a heart attack, slow heart rate and low blood pressure occurred more often, which is expected for any beta blocker. Beyond this, a range of other side effects has been reported with beta-adrenergic blocking drugs generally, and these should be considered possible side effects of Tensin as well. Blood disorders: a severe drop in a type of white blood cell (agranulocytosis). Allergic reactions: fever along with body aches and sore throat, spasm of the voice box, and difficulty breathing. Nervous system: mental depression that can progress to a state of unresponsiveness (catatonia) if not reversed; a temporary episode of confusion about time and place; short-term memory loss; emotional instability with mild clouding of alertness; and reduced performance on tests of mental function. Digestive system: blood clots in the arteries supplying the intestines, and reduced blood flow to the colon (ischemic colitis). Other reported effects: skin rashes and/or dry eyes have been associated with beta-adrenergic blocking drugs in general, as has a reddish skin rash. If any of these reactions occurs without another clear explanation, stopping the medicine should be considered, and patients should be watched closely after treatment ends.
Cautions & Contraindications
Warnings & Precautions
General: Patients already taking a beta blocker should be carefully evaluated before starting Tensin. The initial and follow-up doses of Tensin may need to be adjusted downward based on clinical findings, including pulse rate and blood pressure. Tensin may worsen peripheral arterial circulatory disorders. Impaired Renal Function: This medicine should be used with caution in patients who have impaired kidney function. Geriatric Use: For hypertension and angina pectoris due to coronary atherosclerosis, dose selection in elderly patients should be cautious, usually starting at the lower end of the dosing range, since these patients more often have reduced hepatic, renal, or cardiac function, as well as concurrent illness or other drug therapy. The same caution applies to dosing after acute myocardial infarction, again starting at the lower end of the range for the same reasons. Evaluation of elderly patients with hypertension or myocardial infarction should always include an assessment of kidney function.
Contraindications
Atenolol should not be used in patients with sinus bradycardia, heart block more severe than first degree, cardiogenic shock, or overt heart failure. It is also not suitable for anyone with a known hypersensitivity to atenolol or to any other ingredient in the product.
Pregnancy & Breastfeeding
Pregnancy Category D. Atenolol should be used cautiously in breastfeeding mothers, as clinically significant bradycardia has been reported in infants who were breastfed while their mothers took this medicine. Premature babies and those with reduced kidney function may be more prone to such effects.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Elderly Patients or Patients with Renal Impairment
Atenolol is excreted by the kidneys, so the dose should be adjusted in cases of severe renal impairment. For an elderly patient, choose the dose carefully and usually start at the low end of the dosing range. This reflects the greater frequency of decreased hepatic, renal or cardiac function in older people, and of concomitant disease or other drug therapy.
The following maximum oral doses are recommended for elderly patients with renal impairment and for patients with renal impairment due to other causes:
Creatinine clearance 15-35 ml/min/1.73 m2: maximum dosage 50 mg daily.
Creatinine clearance <15 mL/min/1.73 m2: maximum dosage 25 mg daily.
Some elderly or renal impaired patients being treated for hypertension may need a lower starting dose of Atenolol, which is 25 mg given as one tablet a day. Patients on hemodialysis should be given 25 mg or 50 mg after each dialysis. This should be done under hospital supervision, because marked falls in blood pressure can occur.
Overdose
Overdose with Atenolol has been reported, and some patients have survived single doses as high as 5 g. One death was reported in a man who may have taken as much as 10 g at once. The main symptoms seen after an Atenolol overdose are lethargy, disorder of respiratory drive, wheezing, sinus pause and bradycardia.
Other effects are common with an overdose of any beta-adrenergic blocking agent, and they might also be expected with Atenolol. These are congestive heart failure, hypotension, bronchospasm and/or hypoglycemia.
Treatment should aim to remove any drug that has not yet been absorbed, by induced emesis, gastric lavage, or giving activated charcoal. Atenolol can be cleared from the general circulation by hemodialysis. Depending on how severe the symptoms are, the patient may need intensive supportive care, along with facilities for cardiac and respiratory support.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Don't use Atenolol after the expiry date. Keep it, like all medicines, out of the reach of children. It should be dispensed only on the prescription of a registered physician.
Drug Interactions
Common questions about Atenolol 25 mg
What is Atenolol 25 mg Tablet?
Atenolol 25 mg Tablet is a medicine that contains Atenolol. It is made by Square Pharmaceuticals PLC, Gazipur. It belongs to the Beta-adrenoceptor blocking drugs group of medicines.
What is Atenolol used for?
Atenolol is used for: Hypertension, Angina Pectoris, Myocardial Infarction.
What are the side effects of Atenolol?
In studies looking at atenolol's use after a heart attack, slow heart rate and low blood pressure occurred more often, which is expected for any beta blocker. Beyond this, a range of other side effects has been reported with beta-adrenergic blocking drugs generally, and these should be considered possible side effects of Tensin as well.
Can I take Atenolol during pregnancy or while breastfeeding?
Pregnancy Category D. Atenolol should be used cautiously in breastfeeding mothers, as clinically significant bradycardia has been reported in infants who were breastfed while their mothers took this medicine. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Atenolol?
Overdose with Atenolol has been reported, and some patients have survived single doses as high as 5 g. One death was reported in a man who may have taken as much as 10 g at once. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Atenolol?
Don't use Atenolol after the expiry date. Keep it, like all medicines, out of the reach of children.
Can I take other medicines with Atenolol?
Some medicines can interact with Atenolol, for example: Aluminium Hydroxide + Magnesium Hydroxide + Simethicone, Sodium Alginate + Sodium Bicarbonate + Calcium Carbonate, Sertraline Hydrochloride, Dextromethorphan + Phenylephrine + Triprolidine, Tamsulosin Hydrochloride + Dutasteride, Amlodipine Besilate + Atenolol. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Atenolol?
Atenolol is a prescription (Rx) medicine. Take it as your doctor advises.