Bpnol

• Hypertension - alone or with thiazide diuretics
• Angina pectoris - long-term management
• Acute myocardial infarction - to reduce cardiovascular mortality
• Arrhythmia
• Migraine prevention

Atenolol is a competitive cardioselective beta1-blocker. It competitively blocks beta1 (cardiac) receptors but has no effect on beta2-receptors except in high doses. It has no membrane-stabilizing or partial agonist activity.

Atenolol is the most hydrophilic of currently available beta-blockers, thus it poorly penetrates cell membrane lipids. It reduces resting and exercise-induced heart rate and myocardial contractility.

Hypertension: 50 mg once daily. May increase to 100 mg once daily if needed. Doses above 100 mg are unlikely to provide additional benefit.

Angina Pectoris: 50 mg once daily. May increase to 100 mg once daily if needed. Some patients may require 200 mg once daily for optimal effect.

Acute Myocardial Infarction (IV + Oral): 5 mg IV over 5 minutes, followed by another 5 mg IV 10 minutes later. If tolerated, 50 mg oral 10 minutes after last IV dose, then another 50 mg oral 12 hours later. Then 100 mg once daily or 50 mg twice daily for 6-9 days.

Renal Dose: CrCl 15-35 mL/min: max 50 mg/day; CrCl <15 mL/min: max 25 mg/day; Hemodialysis: 25-50 mg after each dialysis.

• Cold extremities
• Fatigue
• Bradycardia
• Nausea
• Diarrhea
• Dizziness
• Orthostatic hypotension

Rare: Agranulocytosis, allergic fever, laryngospasm, respiratory distress, reversible mental depression, skin rash, dry eyes

[CONSULT YOUR DOCTOR] Atenolol is unsafe during pregnancy (Category D). There is definite evidence of risk to the developing baby. Use only if potential benefit justifies the risk.

Serious Precautions:

• Do not stop suddenly - may cause rebound hypertension, increasing risk of heart attack and stroke
• Caution in diabetic patients - may mask hypoglycemia symptoms (tachycardia)
• May aggravate peripheral arterial circulatory disorders
• Dose adjustment needed in renal impairment
• Pregnancy Category D - risk to fetus in third trimester
• Caution during breastfeeding - neonatal bradycardia reported
• Caution with clonidine - withdraw atenolol several days before clonidine

Symptoms: Lethargy, respiratory drive disorder, wheezing, sinus pause, bradycardia, congestive heart failure, hypotension, bronchospasm, hypoglycemia.

Treatment: Induced emesis, gastric lavage, activated charcoal. Atenolol can be removed by hemodialysis. Cardiac and respiratory support may be required.

Do not use after expiry date. Keep out of reach of children. Dispense only on prescription of a registered physician.