ā/ten’ ō/lol

Brand Name: Tenormin®

• Generic Available

Common Dosage Forms:

  • Tablets: 25 mg, 50 mg, and 100 mg

FDA Indications/Dosages:

  • Management of hypertension (oral): Initially give 50 mg once a day, alone or with a diuretic. Use 50 mg to 100 mg once a day for maintenance.
  • Angina pectoris (oral): 50 mg to 200 mg once daily. Start with 50 mg and titrate after 7 days.
  • Usage in severe renal impairment: See manufacturer’s literature for treatment when creatinine clearance falls below 35 mL/min/1.73 m2.

Monitor: BP

Pharmacology/Pharmacokinetics:

Atenolol is a relatively cardioselective beta-1- adrenergic receptor blocker which results in: (1) decreased heart rate and cardiac output; (2) a decrease in systolic and diastolic blood pressure; (3) inhibition of isoproterenol tachycardia; (4) a decrease of reflex orthostatic tachycardia. Atenolol does not cross the blood brain barrier. Oral bioavailability is approximately 50%. Peak plasma levels after an oral dose are reached in 2-4 hours with a half-life of 6-7 hours. Onset of action occurs in 1 hour and lasts for 24 hours. Excretion of unchanged drug occurs in the urine.

Drug Interactions:

May decrease effects of CLONIDINE. Nonsteroidal anti-inflammatory agents may decrease effects. Toxic effects may be increased with VERAPAMIL. May increase toxic effects of lidocaine. Use with prazosin may increase postural hypotension. Ampicillin may decrease effects.

Contraindications/Precautions:

Use is contraindicated in patients with sinus bradycardia, heart block greater than first degree, cardiogenic shock, and overt cardiac failure. Use with caution in patients with bronchial asthma, congestive heart failure, diabetes mellitus, hyper- thyroidism, and in patients with impaired renal function. Use during pregnancy and nursing may increase the risk of neonatal hypoglycemia and bradycardia. Pregnancy Category D.

Adverse Effects:

Dizziness, fatigue, drowsiness, nausea, brady- cardia, and hypotension.

Patient Consultation:

  • May be taken with food or milk if GI upset occurs.
  • May cause drowsiness. Use caution while operating machinery or when mental alertness is required.
  • Avoid abrupt withdrawal from therapy.
  • Patients with diabetes need to be aware that this agent can cause masking of hypoglycemic symptoms.
  • Store in a cool, dry place away from sunlight and children.
  • If a dose is missed take it as soon as possible. If it is closer to the time of your next dose than the dose you missed, skip the missed dose and return to your dosing schedule. Do not double doses.
  • Contact a physician if the above side effects are severe or persistent.