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Atenolol

    Brands

    DEA Class;  Rx

    Common Brand Names; Tenormin

    • Beta-Blockers, Beta-1 Selective

    Beta-1-selective adrenergic antagonist; similar to metoprolol but atenolol has a longer plasma half-life; does not possess ISA or membrane-stabilizing activity; atenolol has the lowest lipid solubility within the class.

    Indicated for the treatment of angina pectoris.

    For the treatment of hypertension.
    For the treatment of acute myocardial infarction, STEMI and for the reduction of cardiovascular mortality and secondary myocardial infarction prophylaxis.
    For paroxysmal supraventricular tachycardia (PSVT) prophylaxis in patients with recurrent PSVT due to AV reentry.
    For migraine prophylaxis.
    For the adjunct treatment of alcohol withdrawal.
    For heart rate control in patients with atrial fibrillation or atrial flutter.
    For the treatment of thyrotoxicosis.

    2°/3° heart block in patients without pacemaker

    Cardiogenic shock

    Sinus bradycardia

    Sinus node dysfunction

    Hypersensitivity

    Uncompensated cardiac failure

    Pulmonary edema

    • Fatigue (13%)
    • Hypotension (10%)
    • Bradycardia (8%)
    • Cold extremities (0.5- 7%)
    • Postural hypotension (2-4%)
    • Depression (3%)
    • Nausea (2-3%)
    • Dreaming (2%)
    • Drowsiness (2%)
    • Diarrhea (1-2%)
    • Fatigue (1-2%)
    • Leg pain (1-2%)
    • Lethargy (1-2%)
    • Lightheadedness (1-2%)
    • Vertigo (1-2%)
    • Dyspnea (0.4-2%)
    • 2°/3° atrioventricular (AV) block (1%)

    Use with caution in anesthesia or surgery (myocardial depression), bronchospastic disease, cerebrovascular insufficiency, diabetes mellitus, hyperthyroidism or thyrotoxicosis, liver disease, renal impairment, peripheral vascular disease, compromised left ventricular function, advanced age, heart failure

    May mask effects of hyperthyroidism

    Risk of hypoglycemia and bradycardia in neonates born to mothers who receive the drug at parturition or while breastfeeding, especially in premature infants and those with renal impairment

    Use with caution in patients taking calcium-channel blockers or cardiac glycosides or using inhaled anesthetics

    Avoid abrupt withdrawal; sudden discontinuance can exacerbate angina and lead to MI

    Increased risk of stroke after surgery

    In patients receiving clonidine, atenolol should be discontinued several days before withdrawal of clonidine

    May cause or exacerbate CNS depression (use with caution in patients with psychiatric illness)

    Pregnancy category: D

    Lactation: Drug enters breast milk; neonates born to mothers who are receiving atenolol at parturition or breastfeeding may be at risk for hypoglycemia and bradycardia; use with caution

    Adults

    100 mg/day PO for hypertension; 100 mg/day PO for acute myocardial infarction or myocardial infarction prophylaxis; 200 mg/day PO for angina.

    Elderly

    100 mg/day PO for hypertension; 100 mg/day PO for acute myocardial infarction or myocardial infarction prophylaxis; 200 mg/day PO for angina.

    Adolescents

    100 mg/day PO based on adult dosage guidelines.

    Children

    2 mg/kg/day PO.

    Atenolol

    tablet

    • 25mg
    • 50mg
    • 100mg