Atenolol for hypertension, angina, and post-heart attack management

Atenolol is a beta1-selective beta-adrenergic blocker used orally in tablet form. It primarily treats high blood pressure (hypertension), angina pectoris, and reduces cardiovascular mortality in certain patients after a heart attack. Atenolol works by blocking specific heart receptors to lower heart rate and blood pressure.

Hypertension: Atenolol is prescribed to lower high blood pressure, reducing the risk of strokes and heart attacks. It is used as part of comprehensive cardiovascular risk management and may be combined with other blood pressure medications.

Angina pectoris: Atenolol is used for long-term management of chest pain due to coronary artery disease.

Acute myocardial infarction: Atenolol is indicated for hemodynamically stable patients with definite or suspected acute heart attack to reduce cardiovascular death, started as soon as clinically appropriate.

Atenolol

Atenolol selectively blocks beta1-adrenergic receptors in the heart, decreasing heart rate, cardiac output, and blood pressure. This reduces the oxygen demand of the heart and helps manage angina symptoms. Atenolol's beta1 selectivity means it has less effect on beta2 receptors found in the lungs and blood vessels, lowering the risk of bronchoconstriction compared to nonselective beta-blockers.

The antihypertensive effect is likely due to a combination of reduced cardiac output, decreased sympathetic nervous system activity, and lowered renin release by the kidneys. Beta-blockade also reduces arrhythmias and chest pain following heart attacks.

Atenolol is available as oral tablets in 25 mg, 50 mg, and 100 mg strengths. Dosing varies based on the condition treated and patient response.

Hypertension and angina: Once daily dosing is common, with doses up to 100 mg per day; doses above 100 mg daily do not increase antihypertensive effect.

Post-myocardial infarction: Initial treatment may include intravenous atenolol 5 to 10 mg over 5 minutes, followed by oral dosing of 50 mg every 12 hours on day one, then either 100 mg once daily or 50 mg twice daily from days 2 to 7.

Dosing adjustments may be necessary in patients with impaired kidney function because atenolol is primarily eliminated renally; accumulation can occur if creatinine clearance is below 35 mL/min/1.73 m².

• Sinus bradycardia
• Heart block greater than first degree (second or third degree AV block)
• Cardiogenic shock
• Overt cardiac failure
• Hypersensitivity to atenolol or any tablet components

• Atenolol is contraindicated in sinus bradycardia, second- or third-degree heart block, cardiogenic shock, and overt cardiac failure.
• Beta-blockade can worsen heart failure by further depressing myocardial contractility; monitor patients carefully, and discontinue atenolol if heart failure progresses despite treatment.
• Atenolol should not be abruptly stopped in patients with coronary artery disease, as sudden withdrawal can cause severe angina, myocardial infarction, or ventricular arrhythmias. Gradual tapering is advised with close monitoring.
• Use caution in patients with borderline low blood pressure (<100 mm Hg systolic) or bradycardia (<50 bpm).

• Common side effects include fatigue, cold extremities, and slow heart rate.
• Potential serious effects include worsening heart failure, bradycardia, hypotension, and bronchospasm, especially at higher doses or in susceptible patients.

• Atenolol is compatible with thiazide diuretics, methyldopa, hydralazine, and prazosin, resulting in additive blood pressure lowering effects.
• Because it is primarily renally cleared and has low protein binding, atenolol has fewer hepatic metabolism-related interactions compared to other beta-blockers.

No specific storage instructions are provided in the label.