Pharmacodynamics and pharmacokinetics
The drug has antiarrhythmic, antianginal, and hypotensive effects. It has negative dromotropic, chronotropic, inotropic and bathmotropic effects.
The hypotensive effect is achieved by influencing the nervous system, reducing the sensitivity of baroreceptors on the aortic arch, reducing the activity of the renin-angiotensin system , and reducing the IOC.
The drug reduces systolic and diastolic blood pressure, reduces IOC, SV.
The medication does not affect the tone of peripheral arteries in therapeutic doses.
The antianginal effect is ensured by a decrease in the oxygen demand of myocardial cardiomyocytes, which leads to a decrease in heart rate. The drug reduces heart rate at rest and during physical activity.
The antiarrhythmic effect is ensured by the elimination of arrhythmogenic factors (arterial hypertension, increased cAMP content, increased activity of the sympathetic nervous system, tachycardia), slowing down atrioventricular conduction , and reducing the rate of spontaneous excitation of the ectopic and sinus pacemaker.
When taking Atenolol, the survival rate of patients who have suffered a myocardial infarction increases significantly.
The drug does not weaken the bronchodilatory effect of isoproterenol.
Pharmacological properties of the drug Atenolol
A selective β1-adrenergic receptor blocker without BCA, which does not have membrane stabilizing activity. Due to its cardioselectivity and hydrophilicity, atenolol is much less likely to induce the development of bronchospasm and peripheral circulatory disorders, sleep or emotional disturbances. Cardioselectivity is lost when used in high doses. Reduces heart rate, cardiac output, systolic and diastolic blood pressure at rest and during exercise, has an antiarrhythmic effect by eliminating adrenergic effects on the heart, and reduces myocardial oxygen demand. Used as a hypotensive and antianginal agent. With long-term use, the antihypertensive activity of atenolol does not decrease. After oral administration, it is quickly but not completely absorbed from the digestive tract. 50–60% of the dose taken orally is absorbed, the remaining amount of atenolol is excreted unchanged in the feces. The β-adrenergic blocking effect of atenolol occurs within 1 hour after a single oral dose. The maximum effect develops after 2–4 hours. The half-life is 6–9 hours, however, the pharmacological effects of atenolol persist for a longer time (about 24 hours). In renal failure, the half-life is significantly prolonged. Less than 5% of atenolol is bound to plasma proteins, the volume of distribution is 0.7 l/kg body weight. Most of the atenolol that enters the systemic circulation (85%) is excreted unchanged in the urine. With long-term use, the pharmacokinetics of atenolol remains virtually unchanged. Penetrates the placental barrier and enters breast milk. Atenolol practically does not penetrate the BBB.
Indications for use of Atenolol
What are the pills for?
The medicine is prescribed for hypertensive crisis , arterial hypertension, angina pectoris, ischemic heart disease, neurocirculatory dystonia , hyperkinetic cardiac syndrome of functional origin, withdrawal syndrome, tremor, essential tremor, agitation.
The drug is recommended for use for the prevention of rhythm disturbances, myocardial infarction, ventricular extrasystole , sinus tachycardia, atrial flutter, atrial fibrillation, and ventricular tachycardia.
The medication is prescribed for migraine, thyrotoxicosis, pheochromocytoma .
Indications for use of Atenolol Nycomed are similar.
Special instructions for the use of the drug Atenolol
Persons with coronary artery disease who have taken atenolol should be warned about the danger of abrupt withdrawal. In patients with angina pectoris, upon abrupt withdrawal of beta-adrenergic receptor blockers, a withdrawal syndrome of varying severity is observed (from an increase in frequency and intensity of angina attacks to myocardial infarction and cardiac arrhythmias). The relative β1-selectivity of atenolol allows it to be used with caution in patients with bronchospastic diseases resistant to other antihypertensive drugs. Atenolol should be prescribed in minimally effective doses. Atenolol should be prescribed with caution to patients with diabetes mellitus, since β-adrenergic receptor blockers can mask the manifestations of hypoglycemia and potentiate the hypoglycemic effect of antidiabetic agents; β-adrenergic receptor blockers can mask the severity of some clinical manifestations of hyperthyroidism (for example, eliminate tachycardia). Abrupt withdrawal of β-adrenergic receptor blockers can provoke the development of a thyrotoxic crisis, therefore, if it is necessary to discontinue β-adrenergic receptor blockers in such patients, careful medical supervision is required. Atenolol penetrates the placental barrier and may have a pathological effect on the fetus. Prescribing atenolol starting from the second trimester of pregnancy can lead to the birth of premature babies. Atenolol is excreted in breast milk, so children may experience severe bradycardia. Caution should be exercised when prescribing atenolol during breastfeeding. Premature babies and children with kidney damage are more likely to develop side effects. The safety and effectiveness of atenolol in pediatric practice have not been established.
Contraindications
The medicine is not used for severe bradycardia, 2-3 degree atrioventricular block, cardiogenic shock , decompensated form of CHF, acute heart failure, SA blockade, Prinzmetal angina , intolerance to the active component, cardiomegaly, breastfeeding, taking MAO inhibitors.
For pulmonary emphysema, allergies, metabolic acidosis, diabetes mellitus, hypoglycemia, pheochromocytoma, bronchial asthma, thyrotoxicosis, myasthenia gravis, liver failure , pregnancy, psoriasis, depression, children and the elderly, and Raynaud's syndrome, the drug is used with caution.
Side effects
Sense organs: conjunctivitis , visual disturbances, dry eyes, decreased tear production, sore eyes.
Nervous system: depression, insomnia, headaches, dizziness, weakness, asthenia, drowsiness, depression, paresthesia in the extremities , impaired concentration, short-term memory loss, convulsions, myasthenia gravis.
Cardiovascular system: chest pain, vasculitis, coldness of the lower extremities, vasospasm, orthostatic hypotension, CHF, weakened myocardial contractility, arrhythmia, atrioventricular block, palpitations, bradycardia, myocardial conduction disturbances.
Digestive system: changes in taste perception, epigastric pain, nausea, vomiting, dry mouth, stool disorders: constipation , diarrhea.
Respiratory system: bronchospasm, laryngospasm , difficulty breathing, nasal congestion.
Endocrine system: hypothyroid state, hyperglycemia, hypoglycemia.
Skin: reversible alopecia, psoriasis-like skin rashes, increased sweating, exacerbation of psoriasis symptoms, skin hyperemia.
Also noted are back pain, bradycardia , decreased potency, decreased libido, arthralgia, and intrauterine growth retardation.
The severity of side effects directly depends on the dose of the drug.
Side effects of the drug Atenolol
Most side effects are mild and temporary. Most likely are bradycardia, a feeling of coldness in the extremities, paresthesia, pain in the lower extremities, nausea, increased concentrations of liver enzymes and/or bilirubin in the blood serum, dizziness, headache, orthostatic hypotension, collapse, fatigue, weakness, drowsiness, general malaise, depression, hallucinations, psychosis, diarrhea, nausea, dyspnea, psoriasiform rash or exacerbation of psoriasis, purpura, reversible alopecia, thrombocytopenia and visual disturbances. Atenolol, like other β-adrenergic receptor blockers, can promote the formation of antinuclear antibodies and the development of lupus syndrome.
Instructions for use of Atenolol (Method and dosage)
The tablets are taken orally, washed down with liquid, and do not chew.
The initial dosage is 25-50 mg per day, after a week, if necessary, the amount of the drug is increased by 50 mg, the average daily dosage is 100 mg.
For tachysystolic disorders and for ischemic heart disease, Atenolol is prescribed once a day, 50 mg.
Acute myocardial infarction with stable hemodynamic parameters: intravenous infusions, then take a 50 mg tablet after 10 minutes, repeat after 12 hours.
For cardiac hyperkinetic syndrome, 25 mg per day is indicated.
The drug is effective for 24 hours; the drug is not used more than once a day. It is not recommended to prescribe more than 200 mg per day. The medication is withdrawn gradually, every 3 days - ¼ dose.
Instructions for use of Atenolol Nycomed are similar.
Use of the drug Atenolol
For hypertension (arterial hypertension) it is prescribed orally at an initial dose of 50 mg once a day. Used as monotherapy or in combination with other antihypertensive drugs. The maximum therapeutic effect usually develops after 1–2 weeks of treatment. If necessary, the dose can be increased to 100 mg 1 time per day; further increase in dose does not increase the effectiveness of treatment. For angina pectoris, a dose of 50–100 mg is prescribed once a day; in some cases, to achieve optimal effect it is necessary to use atenolol at a dose of 200 mg once a day. Atenolol should be withdrawn gradually. Elderly patients and those with kidney disease may require a reduction in the dose of atenolol. With a creatinine clearance of 15–35 ml/min, the half-life of atenolol is 16–27 hours, and the maximum daily dose is 50 mg; with creatinine clearance less than 15 ml/min, the half-life is more than 27 hours, and the maximum daily dose is 25 mg. Patients on hemodialysis should be prescribed 25 or 50 mg of atenolol after each procedure (only in a hospital due to the possibility of a sharp decrease in blood pressure).
Overdose
Manifested by bronchospasm , cyanosis of the nail plates, convulsions , difficulty breathing, arrhythmia, fainting, drop in blood pressure, dizziness, severe bradycardia.
Emergency gastric lavage is required.
In case of atrioventricular conduction disturbance or bradycardia, atropine, epinephrine is administered intravenously, or a temporary pacemaker is installed.
If there is a sharp drop in blood pressure, the patient is placed in the Trendelenburg position .
In the absence of signs of pulmonary edema, plasma-substituting solutions are administered intravenously; in case of ineffectiveness, dobutamine , epinephrine, and dopamine are administered.
For convulsive syndrome, intravenous infusion of diazepam is indicated. Dialysis is effective.
Overdose of the drug Atenolol, symptoms and treatment
An overdose of atenolol has been described in patients who took a single dose of about 5 g. Early manifestations of an overdose are drowsiness, respiratory failure, wheezing, and bradycardia. Congestive heart failure, arterial hypotension, bronchospasm and hypoglycemia may develop. Gastric lavage is performed, activated charcoal is prescribed orally, and glucagon is administered. Atenolol can be removed from the systemic circulation by hemodialysis. For bradycardia or AV block, atropine or isoproterenol is administered; if drug treatment is ineffective, transesophageal pacing is performed. For congestive heart failure, digitalization is performed and diuretics are prescribed.
List of pharmacies where you can buy Atenolol:
- Moscow
- Saint Petersburg
Interaction
In patients taking Atenolol, allergen extracts for skin testing, as well as allergens for immunotherapy, significantly increase the risk of developing severe systemic allergic reactions, anaphylaxis. The risk of anaphylactic reactions increases with intravenous administration of radiocontrast agents.
A fall in blood pressure and cardiodepressive effects have been observed with intravenous infusion of phenytoin, as well as with the use of drugs for inhaled general anesthesia. The drug can mask the signs of developing hypoglycemia with the simultaneous use of oral hypoglycemic agents and insulin.
Atenolol reduces the clearance of xanthines and lidocaine . Estrogens, glucocorticosteroids, NSAIDs, BMCC, guanfacine, reserpine, methyldopa , cardiac glycosides, amiodarone, Diltiazem , Verapamil and many antiarrhythmic medications increase the likelihood of developing atrioventricular block, bradycardia, cardiac arrest, and worsening heart failure.
Hydralazine, sympatholytics, clonidine, diuretics, antihypertensive drugs, BMCC can significantly reduce blood pressure.
Atenolol prolongs the duration of action of coumarins, non-depolarizing muscle relaxants. Neuroleptics, sedatives, hypnotics, ethanol, tetracyclic and tricyclic antidepressants increase the inhibitory effect on the central nervous system.
The simultaneous administration of MAO inhibitors is unacceptable due to the risk of hypotension. Impaired peripheral circulation is observed when using medications with non-hydrogenated ergot alkaloids.
Drug interactions Atenolol
With the simultaneous use of atenolol with reserpine, methyldopa, clonidine, guanfacine and verapamil, severe arterial hypotension and bradycardia may develop. With simultaneous treatment with clonidine, it can be discontinued only a few days after stopping taking atenolol. Atenolol potentiates the hypoglycemic effect of oral antidiabetic agents and insulin. A few days before anesthesia with the use of drugs that have a cardiodepressive effect, it is necessary to stop taking atenolol; If it is impossible to discontinue atenolol, narcotic drugs with minimal negative inotropic effect should be used.
special instructions
Taking the drug should be accompanied by regular measurement of blood pressure, pulse, and sugar levels in people with diabetes .
Elderly patients are advised to periodically monitor the condition of the renal system. The doctor needs to instruct the patient and teach him how to measure heart rate correctly. In 20% of patients with angina, adrenergic blockers do not provide the desired effect due to severe coronary atherosclerosis with a low ischemic threshold and impaired subendocardial blood flow .
In patients with nicotine addiction, the effectiveness of Atenolol is significantly lower than in patients who do not smoke. During therapy, there may be a decrease in the production of tear fluid, which should be warned about in patients who wear contact lenses.
The drug may mask the clinical picture of thyrotoxicosis (tachycardia). Abrupt withdrawal of the drug in patients with thyrotoxicosis is unacceptable due to the risk of increasing the severity of the symptoms of the disease. Atenolol is able to mask tachycardia during hypoglycemia. The medication is discontinued several days before the planned general anesthesia with ether or chloroform. Otherwise, the patient is selected a drug for general anesthesia, which has minimal inotropic effects.
Intravenous administration of atropine eliminates reciprocal activation of the vagus nerve. The drug can be prescribed to patients with bronchospastic pathology if other antihypertensive drugs are ineffective or intolerant, subject to strict adherence to the dosage regimen.
If elderly people develop arterial hypotension, increasing bradycardia, ventricular arrhythmia, bronchospasm, severe disorders of the liver and kidneys, the dosage of the drug is reduced or therapy is stopped completely. If depression develops, the drug is replaced. Abrupt withdrawal can cause myocardial infarction, a severe form of arrhythmia. The drug is discontinued by gradually reducing the dosage over two weeks.
Before determining the level of normetanephrine, catecholamines, antinuclear body titers, and vanillylmandelic acid, Atenolol is discontinued. The medication affects the control of vehicles.
Recipe in Latin:
Rp: Atenololi 0.05 D. td N 30 in tab. S. 1 tablet 1 time per day.
Atenolol 100 mg
Atenolol
Registration number: РN 001152/01
Trade name of the drug: Atenolol
International nonproprietary name (INN): Atenolol
Dosage form: tablets
Composition: one tablet contains:
Active substance: atenolol 0.05 g (50 mg) or 0.01 g (100 mg)
Excipients: magnesium hydroxycarbonate (main magnesium carbonate), corn starch, food gelatin, magnesium stearate.
Description
Tablets from white to white with a creamy tint, flat-cylindrical in shape with a bevel on both sides (for a dosage of 50 mg) and with a bevel on both sides and a score on one side (for a dosage of 100 mg); Minor marbling is allowed.
Pharmacotherapeutic group: selective beta 1-adrenergic blocker.
ATH CODE: [С07АВ0З]
Pharmacological properties
Pharmacodynamics
It has antianginal, hypotensive and antiarrhythmic effects.
It does not have membrane stabilizing or internal sympathomimetic activity. Reduces the formation of cAMP from ATP stimulated by catecholamines.
In the first 24 hours after oral administration, against the background of a decrease in cardiac output, a reactive increase in total peripheral vascular resistance is observed, the severity of which gradually decreases within 1-3 days.
The hypotensive effect is associated with a decrease in cardiac output, a decrease in the activity of the renin-angiotensin system, baroreceptor sensitivity and an effect on the central nervous system. The hypotensive effect is manifested by both a decrease in systolic and diastolic blood pressure (BP), a decrease in stroke and cardiac output.
In average therapeutic doses it has no effect on the tone of peripheral arteries. The hypotensive effect lasts 24 hours, and with regular use it stabilizes by the end of 2 weeks of treatment.
The antianginal effect is determined by a decrease in myocardial oxygen demand as a result of a decrease in heart rate (prolongation of diastole and improvement of myocardial perfusion) and contractility, as well as a decrease in the sensitivity of the myocardium to the effects of sympathetic innervation. Reduces heart rate (HR) at rest and during physical activity. By increasing end-diastolic pressure in the left ventricle and increasing the stretch of ventricular muscle fibers, it can increase oxygen demand, especially in patients with chronic heart failure.
The antiarrhythmic effect is manifested by suppression of sinus tachycardia and is associated with the elimination of arrhythmogenic sympathetic influences on the conduction system of the heart, a decrease in the rate of propagation of excitation through the sinoatrial node and an extension of the refractory period. It inhibits the conduction of impulses in the antegrade and, to a lesser extent, in the retrograde directions through the AV (atrioventricular) node and along additional conduction pathways.
The negative chronotropic effect appears 1 hour after administration, reaches a maximum after 2-4 hours, and lasts up to 24 hours.
Reduces the automaticity of the sinus node, reduces heart rate, slows down atrioventricular (AV) conduction, reduces myocardial contractility, and reduces myocardial oxygen demand. Reduces myocardial excitability.
When used in average therapeutic doses, it has a less pronounced effect on the smooth muscles of the bronchi and peripheral arteries than non-selective beta-blockers.
Pharmacokinetics
Absorption from the gastrointestinal tract - fast, incomplete (50-60%), bioavailability -40-50%, time to reach maximum concentration in blood plasma - 2-4 hours. Poorly penetrates the blood-brain barrier, passes in small quantities through the placental barrier and into breast milk. Communication with blood plasma proteins - 6-16%. Practically not metabolized in the liver. The half-life is 6-9 hours (increases in elderly patients). Excreted by the kidneys by glomerular filtration (85-100% unchanged). Impaired renal function is accompanied by an extension of the half-life and cumulation: with creatinine clearance below 35 ml/min/1.73 m2, the half-life is 16-27 hours, with creatinine clearance below 15 ml/min/1.73 m2 - more than 27 hours (necessary dose reduction). It is excreted during hemodialysis.
Indications for use
- arterial hypertension;
- prevention of angina attacks (with the exception of Prinzmetal's angina);
— heart rhythm disturbances: sinus tachycardia, prevention of supraventricular tachyarrhythmias, ventricular extrasystole
Contraindications
Hypersensitivity to the drug, cardiogenic shock, atrioventricular (AV) block II-III stage, severe bradycardia (heart rate less than 45-50 beats/min.), sick sinus syndrome, sinoauricular block, acute or chronic heart failure (in the stage of decompensation ), cardiomegaly without signs of heart failure, Prinzmetal's angina, arterial hypotension (if used for myocardial infarction, systolic blood pressure less than 100 mm Hg), lactation period, simultaneous use of monoamine oxidase inhibitors (MAOIs), age up to 18 years (efficacy and security not installed).
With caution: diabetes mellitus, metabolic acidosis, hypoglycemia, history of allergic reactions, chronic obstructive pulmonary disease (including emphysema), first degree AV block, chronic heart failure (compensated), obliterating peripheral vascular disease (“intermittent” lameness, Raynaud's syndrome), pheochromocytoma, liver failure, chronic renal failure, myasthenia gravis, thyrotoxicosis, depression (including a history), psoriasis, pregnancy, old age.
Pregnancy and lactation period. Pregnant women should be prescribed atenolol only in cases where the benefit to the mother outweighs the potential risk to the fetus. Atenolol is excreted in breast milk, so during breastfeeding it should be taken only in exceptional cases and with great caution.
Directions for use and doses
Prescribed orally before meals, without chewing, with a small amount of liquid.
Arterial hypertension. Treatment begins with 50 mg of atenolol 1 time per day. To achieve a stable hypotensive effect, 1-2 weeks of administration are required. If the hypotensive effect is insufficient, the dose is increased to 100 mg in one dose. Further increase in dose is not recommended, as it is not accompanied by an increase in clinical effect.
Angina pectoris. The initial dose is 50 mg per day. If the optimal therapeutic effect is not achieved within a week, increase the dose to 100 mg per day. Sometimes it is possible to increase the dose to 200 mg once a day. Elderly patients and patients with impaired renal excretory function require adjustment of the dosage regimen. In the presence of renal failure, dose adjustment is recommended depending on creatinine clearance. In patients with renal failure with creatinine clearance values above 35 ml/min/1.73 m2 (normal values are 100-150 ml/min/1.73 m2), significant accumulation of Atenolol does not occur.
For patients on hemodialysis, atenolol is prescribed 25 or 50 mg/day immediately after each dialysis, which must be done in a hospital setting, as a decrease in blood pressure may occur.
In elderly patients, the initial single dose is 25 mg (can be increased under the control of blood pressure and heart rate).
Increasing the daily dose above 100 mg is not recommended, since the therapeutic effect is not enhanced, and the likelihood of side effects increases.
Side effect
Cardiovascular system: development (worsening) of symptoms of chronic heart failure (swelling of the ankles, feet; shortness of breath), impaired atrioventricular conduction, arrhythmias, bradycardia, marked decrease in blood pressure, orthostatic hypotension, palpitations.
Central nervous system: dizziness, decreased ability to concentrate, decreased reaction speed, drowsiness or insomnia, depression, hallucinations, fatigue, headache, weakness, nightmares, anxiety, confusion or short-term memory loss, paresthesia in the extremities ( in patients with intermittent claudication and Raynaud's syndrome), muscle weakness, cramps.
Gastrointestinal tract: dry mouth, nausea, vomiting, diarrhea, abdominal pain, constipation, change in taste.
Respiratory system: dyspnea, bronchospasm, apnea, nasal congestion.
Hematological reactions: platelet purpura, anemia (aplastic), thrombosis.
Endocrine system: gynecomastia, decreased potency, decreased libido, hyperglycemia (in patients with non-insulin-dependent diabetes mellitus), hypoglycemia (in patients receiving insulin), hypothyroid state.
Metabolic reactions: hyperlipidemia.
Skin reactions: urticaria, dermatitis, itching, photosensitivity, increased sweating, skin hyperemia, exacerbation of psoriasis, reversible alopecia.
Sense organs: blurred vision, decreased secretion of tear fluid, dry and sore eyes, conjunctivitis.
Effect on the fetus: intrauterine growth retardation, hypoglycemia, bradycardia. Laboratory indicators: agranulocytosis, leukopenia, increased activity of liver enzymes, hyperbilirubinemia.
Other: back pain, arthralgia, withdrawal syndrome (increased angina attacks, increased blood pressure).
The frequency of side effects increases with increasing dosage of the drug.
Overdose
Symptoms: severe bradycardia, AV block II-III degree, increasing symptoms of heart failure, excessive decrease in blood pressure, difficulty breathing, bronchospasm, dizziness, fainting, arrhythmia, ventricular extrasystole, cyanosis of fingernails or palms, convulsions.
Treatment: gastric lavage and administration of adsorbent drugs; if bronchospasm occurs, inhalation or intravenous administration of the beta 2-adrenergic agonist salbutamol is indicated. In case of impaired AV conduction, bradycardia - intravenous administration of 1-2 mg of atropine, epinephrine or placement of a temporary pacemaker; for ventricular extrasystole - lidocaine (class 1A drugs are not used); when blood pressure decreases, the patient should be in the Trendelenburg position. If there are no signs of pulmonary edema - intravenous plasma replacement solutions, if ineffective - administration of epinephrine, dopamine, dobutamine; for chronic heart failure - cardiac glycosides, diuretics, glucagon; for convulsions - intravenous diazepam. Dialysis is possible.
Interaction with other drugs
With the simultaneous use of atenolol with insulin, oral hypoglycemic drugs, their hypoglycemic effect is enhanced. When used together with antihypertensive drugs of different groups or nitrates, the hypotensive effect is enhanced. Concomitant use of atenolol and verapamil (or diltiazem) may cause a mutually enhanced cardiodepressive effect.
The hypotensive effect is weakened by estrogens (sodium retention) and non-steroidal anti-inflammatory drugs, glucocorticosteroids.
With the simultaneous use of atenolol and cardiac glycosides, the risk of developing bradycardia and atrioventricular conduction disorders increases.
When atenolol is prescribed simultaneously with reserpine, methyldopa, clonidine, verapamil, severe bradycardia may occur.
Simultaneous intravenous administration of verapamil and diltiazem can provoke cardiac arrest; nifedipine can lead to a significant decrease in blood pressure.
When taking atenolol simultaneously with ergotamine and xanthine derivatives, its effectiveness is reduced.
When discontinuing the combined use of atenolol and clonidine, treatment with clonidine is continued for several more days after discontinuation of atenolol.
Concomitant use with lidocaine may reduce its elimination and increase the risk of lidocaine toxicity.
Use together with phenothiazine derivatives helps to increase the concentration of each drug in the blood serum.
Phenytoin, when administered intravenously, and drugs for general anesthesia (hydrocarbon derivatives) increase the severity of the cardiodepressive effect and the likelihood of a decrease in blood pressure.
When used together with aminophylline and theophylline, mutual suppression of therapeutic effects is possible.
Concomitant use with MAO inhibitors is not recommended due to a significant increase in the hypotensive effect; the break in treatment between taking MAO inhibitors and atenolol should be at least 14 days.
Allergens used for immunotherapy or allergen extracts used for skin testing increase the risk of severe systemic allergic reactions or anaphylaxis.
Inhalation anesthetics (hydrocarbon derivatives) increase the risk of suppression of myocardial function and the development of arterial hypertension.
Amiodarone increases the risk of bradycardia and AV conduction depression.
Cimetidine increases plasma concentrations (inhibits metabolism). Iodine-containing radiopaque drugs for intravenous administration increase the risk of anaphylactic reactions.
Prolongs the effect of non-depolarizing muscle relaxants and the anticoagulant effect of coumarins.
Tri- and tetracyclic antidepressants, antipsychotic drugs (neuroleptics), ethanol, sedatives and hypnotics increase depression of the central nervous system.
special instructions
Monitoring of patients taking atenolol should include monitoring heart rate and blood pressure (at the beginning of treatment - daily, then once every 3-4 months), blood glucose levels in patients with diabetes mellitus (once every 4-5 months). In elderly patients, it is recommended to monitor kidney function (once every 4-5 months).
The patient should be taught how to calculate heart rate and instructed about the need for medical consultation if the heart rate is less than 50 beats/min.
In thyrotoxicosis, atenolol may mask certain clinical signs of thyrotoxicosis (eg, tachycardia). Abrupt withdrawal in patients with thyrotoxicosis is contraindicated because it can increase symptoms. In diabetes mellitus, it can mask tachycardia caused by hypoglycemia. Unlike non-selective beta-blockers, it practically does not enhance insulin-induced hypoglycemia and does not delay the restoration of blood glucose to normal concentrations.
In patients with coronary heart disease (CHD), abrupt withdrawal of beta-blockers may cause an increase in the frequency or severity of anginal attacks, so discontinuation of atenolol in patients with CHD should be done gradually.
Compared with non-selective beta-blockers, cardioselective beta-blockers have less effect on pulmonary function, however, for obstructive airway diseases, atenolol is prescribed only when absolutely indicated. If it is necessary to prescribe them, in some cases the use of beta2-adrenergic agonists can be recommended.
Patients with bronchospastic diseases can be prescribed cardioselective adrenergic blockers in case of intolerance and/or ineffectiveness of other antihypertensive drugs, but the dosage should be strictly monitored. An overdose is dangerous due to the development of bronchospasm.
Particular attention is required in cases where surgical intervention under anesthesia is required in patients taking atenolol. The drug should be stopped 48 hours before the intervention. As an anesthetic, you should choose a drug with the least possible negative inotropic effect.
When using atenolol and clonidine simultaneously, atenolol should be discontinued several days before clonidine in order to avoid withdrawal symptoms from the latter.
It is possible that the severity of the hypersensitivity reaction may increase and there will be no effect from usual doses of epinephrine against the background of a burdened allergic history.
Medicines that reduce catecholamine reserves (for example, reserpine) can enhance the effect of beta-blockers, so patients taking such combinations of drugs should be under constant medical supervision to detect a pronounced decrease in blood pressure or bradycardia.
In case of increasing bradycardia (less than 50 beats/min), arterial hypotension (systolic blood pressure below 100 mm Hg), atrioventricular block, bronchospasm, ventricular arrhythmias, severe dysfunction of the liver and kidneys, it is necessary to reduce dose or stop treatment.
It is recommended to discontinue therapy if depression caused by taking beta-blockers develops.
If intravenous administration of verapamil is necessary, this should be done at least 48 hours after taking atenolol.
When using atenolol, it is possible to reduce the production of tear fluid, which is important in patients who use contact lenses.
Treatment should not be abruptly interrupted due to the risk of developing severe arrhythmias and myocardial infarction. Cancellation is carried out gradually, reducing the dose over 2 weeks. or more (reduce the dose by 25% in 3-4 days).
Should be discontinued before testing the content of catecholamines, normetanephrine and vanillylmandelic acid in the blood and urine; antinuclear antibody titers.
Beta blockers are less effective in smokers.
Impact on the ability to drive and operate machinery. During the treatment period, it is necessary to refrain from engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
Release form
Tablets of 50 and 100 mg.
10 or 20 tablets per blister pack. 30 or 50 tablets in polymer jars.
A jar of 3 or 5 blister packs of 10 tablets each or 2 blister packs of 20 tablets together with instructions for use are placed in a cardboard pack.
Conditions for dispensing from pharmacies
On prescription.
Storage conditions:
In a dry place, protected from light, at a temperature not exceeding 25°C.
Best before date:
3 years. Do not use after the expiration date.
Units:
pack
Atenolol's analogs
Level 4 ATC code matches:
Biol
Metocard
Metozok
Nebilet
Nebilong
Betaxolol
Bisogamma
Aritel
Cordinorm
Vasocardin
Corvitol
Bidop
Bisoprolol
Nebivolol
Biprol
Bisoprol
Concor Cor
Lokren
Concor
Niperten
Analogues of Atenolol are the following products: Atenobene , Atenova , Atenol , Tenolol.
Reviews of Atenolol
The drug is effective for hypertension and arrhythmia, and is quite inexpensive. However, side effects are common, such as hallucinations and a decrease in blood sugar. Reviews of Atenolol Nycomed are generally better than those of drugs produced by other manufacturers.
Reviews during pregnancy are generally positive; those who used the medication mostly did not notice any side effects. However, it should be remembered that according to the results of clinical studies, such side effects on the fetus are very possible.
Atenolol price, where to buy
Price Atenolol 25 mg, 30 tablets - 17 rubles.
50 mg, 30 pieces - 21 rubles.
- Online pharmacies in RussiaRussia
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ZdravCity
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- ATENOLOL tablets Atenolol tablets 50 mg No. 20 Ukraine, Monfarm JSC
9 UAH order
- ATENOLOL tablets Atenolol tablets 50 mg No. 20 Ukraine, Health LLC
11 UAH order
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