In this article you can read the instructions for use of the drug Atenolol. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Atenolol in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Atenolol in the presence of existing structural analogues. Use for the treatment of angina pectoris, cardiac arrhythmias and blood pressure reduction in adults, children, as well as during pregnancy and lactation.

Atenolol- has antianginal, antihypertensive and antiarrhythmic effects. It does not have membrane stabilizing or internal sympathomimetic activity. Reduces catecholamine-stimulated formation of cyclic adenosine monophosphate (cAMP) from adenosine triphosphate (ATP), reduces intracellular Ca2+ current. 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, which gradually returns to the original value within 1-3 days, and then gradually decreases. The hypotensive effect is associated with a decrease in minute blood volume, 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 minute blood volumes.

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 the second week 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 stimulation. Lowers 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 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.

Increases the survival rate of patients who have had myocardial infarction (reduces the incidence of ventricular arrhythmias and angina attacks).

Practically does not weaken the bronchodilating effect of isoproterenol.

In contrast to non-selective beta-blockers, when prescribed in average therapeutic doses, it has a less pronounced effect on organs containing beta2-adrenergic receptors (pancreas, skeletal muscles, smooth muscles of peripheral arteries, bronchi and uterus), and on carbohydrate metabolism; the severity of the atherogenic effect does not differ from the effect of propranolol. To a lesser extent it has a negative bathmo-, chrono-, ino- and dromotropic effect. When used in large doses (more than 100 mg per day), it has a blocking effect on both subtypes of beta-adrenergic receptors.

Compound

Atenolol + excipients.

Pharmacokinetics

Absorption from the gastrointestinal tract is rapid, incomplete (50-60%). It penetrates poorly through the blood-brain barrier and passes in small quantities through the placental barrier and into breast milk. Practically not metabolized in the liver. Excreted by the kidneys by glomerular filtration (85-100% unchanged).

Indications

• arterial hypertension;
• prevention of angina attacks (with the exception of Prinzmetal angina);
• heart rhythm disturbances: sinus tachycardia, prevention of supraventricular tachyarrhythmias, ventricular extrasystole;
• acute myocardial infarction with stable hemodynamic parameters.

Release forms

Tablets (including film-coated ones) 25 mg, 50 mg and 100 mg.

Instructions for use and dosage regimen

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.

For coronary heart disease, tachysystolic heart rhythm disturbances - 50 mg 1 time per day.

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.

Elderly patients and patients with impaired renal excretory function require adjustment of the dosage regimen.

In elderly patients, the initial single dose is 25 mg (can be increased under the control of blood pressure and heart rate).

Side effect

• development (worsening) of symptoms of chronic heart failure (swelling of the ankles, feet, shortness of breath);
• disturbance of atrioventricular conduction;
• arrhythmias;
• bradycardia;
• pronounced decrease in blood pressure;
• heartbeat;
• weakening of myocardial contractility;
• orthostatic hypotension;
• manifestations of vasospasm (coldness of the lower extremities, Raynaud's syndrome);
• chest pain;
• dizziness;
• decreased ability to concentrate;
• decreased reaction speed;
• drowsiness or insomnia;
• depression;
• hallucinations;
• increased fatigue;
• headache;
• weakness;
• "nightmare" dreams;
• anxiety;
• confusion or short-term memory loss;
• paresthesia in the limbs (in patients with intermittent claudication and Raynaud's syndrome);
• muscle weakness;
• convulsions;
• dry mouth;
• nausea, vomiting;
• diarrhea;
• abdominal pain;
• constipation or diarrhea;
• change in taste;
• bronchospasm;
• nasal congestion;
• platelet purpura, anemia (aplastic);
• thrombosis;
• decreased potency;
• decreased libido;
• hypothyroid condition;
• hives;
• dermatitis;
• skin itching;
• photosensitivity;
• increased sweating;
• skin hyperemia;
• exacerbation of psoriasis;
• visual impairment;
• decreased secretion of tear fluid;
• dry and sore eyes;
• conjunctivitis;
• back pain;
• withdrawal syndrome (tachycardia, increased frequency of angina attacks, increased blood pressure, etc.).

Contraindications

• cardiogenic shock;
• atrioventricular (AV) block 2-3 degrees;
• severe bradycardia (heart rate less than 40 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 (MAO);
• age under 18 years (the effectiveness and safety of the drug have not been established);
• hypersensitivity to the drug.

Use during pregnancy and breastfeeding

Atenolol penetrates the placental barrier and is found in umbilical cord blood. There have been no studies on the use of atenolol in the first trimester and, therefore, the possibility of a damaging effect on the fetus cannot be excluded. For the treatment of arterial hypertension in the third trimester of pregnancy, the drug is used under close medical supervision. The use of atenolol during pregnancy may cause fetal growth disturbances.

Atenolol should be prescribed to pregnant women or women planning pregnancy only in cases where the benefit to the mother outweighs the potential risk to the fetus, especially in the first and second trimester of pregnancy, since beta-blockers reduce the level of placental perfusion, which can lead to intrauterine fetal death or its immaturity and premature birth. In addition, side effects such as hypoglycemia and bradycardia may occur in both the fetus and the newborn.

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 (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 necessary 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) may 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 liver and kidney dysfunction in elderly patients, it is necessary to reduce the dose or stop treatment.

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. 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 if the drug is indicated during breastfeeding, it is better to stop breastfeeding for a while.

Impact on the ability to drive vehicles 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.

Drug interactions

With the simultaneous use of atenolol with insulin, hypoglycemic agents for oral administration, their hypoglycemic effect is enhanced. When used together with antihypertensive drugs of different groups or nitrates, the hypotensive effect is enhanced. The simultaneous use of atenolol and verapamil (or diltiazem) may cause mutual enhancement of the 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 stopping the combined use of atenolol and clonidine, treatment with clonidine is continued for several 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 radiocontrast agents 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, antipsychotics (neuroleptics), ethanol, sedatives and hypnotics increase depression of the central nervous system.

Non-hydrogenated ergot alkaloids increase the risk of developing peripheral circulatory disorders.

Analogues of the drug Atenolol

Structural analogues of the active substance:

• Atenobene;
• Atenova;
• Atenol;
• Atenolan;
• Atenolol Belupo;
• Atenolol Nycomed;
• Atenolol Stada;
• Atenolol Agio;
• Atenolol AKOS;
• Atenolol Acri;
• Atenolol ratiopharm;
• Atenolol Teva;
• Atenolol UBF;
• Atenolol FPO;
• Atenosan;
• Betacard;
• Velorin 100;
• Vero Atenolol;
• Ormidol;
• Prinorm;
• Sinar;
• Tenormin.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Beta 1 adrenergic blocker

Active ingredient

Atenolol

Release form, composition and packaging

10 pcs. - contour cellular packaging (1) - cardboard packs.
10 pcs. - contour cell packaging (2) - cardboard packs.
10 pcs. - contour cell packaging (3) - cardboard packs.

Pharmacological action

Beta 1 adrenergic blocker. It has antianginal, antihypertensive 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 output, a reactive increase in total peripheral vascular resistance is observed, the severity of which gradually decreases over 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 effects on the central nervous system. The hypotensive effect is manifested by both a decrease in systolic and diastolic blood pressure, 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 the second week 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 stimulation. Reduces heart rate 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 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 is rapid, incomplete (50-60%), bioavailability - 40-50%, time to reach Cmax in the blood - 2-4 hours. It penetrates poorly through 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. T1/2 - 6-9 hours (increases in elderly patients).

Excreted by the kidneys by glomerular filtration (85-100% unchanged).

Impaired renal function is accompanied by prolongation of T1/2 and cumulation: with CC below 3 5 ml/min/1.73 m2 T1/2 is 16-27 hours, with CC below 15 ml/min/1.73 m - more than 27 hours (necessary dose reduction). It is excreted during hemodialysis.

Indications

• arterial hypertension;
• prevention of angina attacks (with the exception of Prinzmetal angina);
• heart rhythm disturbances: sinus tachycardia, prevention of supraventricular tachyarrhythmias, ventricular extrasystole.

Contraindications

• cardiogenic shock;
• AV blockade II and III stages;
• 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 MAO inhibitors;
• age under 18 years (efficacy and safety have not been established);
• patients on hemodialysis;
• old age;
• hypersensitivity to the drug.

With caution: diabetes mellitus, metabolic acidosis, hypoglycemia, history of allergic reactions, chronic obstructive pulmonary disease (including emphysema), AV blockade of the first degree, chronic heart failure (compensated), obliterating peripheral vascular diseases ("intermittent" claudication, Raynaud's syndrome), pheochromocytoma, liver failure, chronic renal failure, myasthenia gravis, thyrotoxicosis, depression (including a history), psoriasis, pregnancy, old age.

Dosage

Prescribed orally before meals, without chewing, with a small amount of liquid.

Arterial hypertension. Treatment begins with 50 mg of Atenolol 1 time / 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/day. If the optimal therapeutic effect is not achieved within a week, increase the dose to 100 mg/day. Elderly patients and patients with impaired renal excretory function require adjustment of the dosage regimen.

Subject to availability renal failure

U elderly patients

Side effects

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.

CNS: dizziness, decreased ability to concentrate, decreased reaction speed, drowsiness or insomnia, depression, hallucinations, increased 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.

Others: 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 a beta 2-adrenergic agonist is indicated. In case of impaired AV conduction, bradycardia - intravenous administration of 1-2 mg of atropine, epinephrine or installation 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 - intravenously, if ineffective - administration of epinephrine, dopamine, dobutamine; for chronic heart failure - cardiac glycosides, diuretics, glucagon; for convulsions - intravenous diazepam. Dialysis is possible.

Drug interactions

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.

The simultaneous use of atenolol and (or diltiazem) may cause mutual enhancement of the cardiodepressive effect.

The hypotensive effect is weakened by estrogens (sodium retention) and NSAIDs, corticosteroids.

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 stopping the combined use of atenolol and clonidine, treatment with clonidine is continued for several 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 developing 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 CNS depression.

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 (once every 4-5 months). In elderly patients, it is recommended to monitor renal 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 drugs, it practically does not enhance insulin-induced hypoglycemia and does not delay the restoration of blood glucose to normal concentrations.

In patients with coronary artery disease, abrupt withdrawal of beta-blockers may cause an increase in the frequency or severity of anginal attacks, therefore, discontinuation of atenolol in patients with coronary artery disease must be carried out 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 beta 2-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 necessary 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) may 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), AV blockade, bronchospasm, ventricular arrhythmias, severe liver and kidney dysfunction in elderly patients, it is necessary to reduce the dose or stop treatment.

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 vehicles 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.

Pregnancy and lactation

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.

Use in childhood

Contraindication: age under 18 years (efficacy and safety have not been established).

For impaired renal function

Subject to availability renal failure Dose adjustment is recommended depending on creatinine clearance. In patients with renal failure with CC values ​​above 35 ml/min/1.73 m 2 (normal values ​​are 100-150 ml/min/1.73 m), significant accumulation of atenolol does not occur. The following maximum doses are recommended for patients with renal failure:

To ensure the dosage regimen listed below, it is possible to use Atenolol in the dosage form of a 25 mg tablet.

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.

For liver dysfunction

WITH caution: liver failure.

Use in old age

U elderly patients initial single dose - 25 mg (can be increased under the control of blood pressure, heart rate).

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

Store in a dry place, out of reach of children, at a temperature not exceeding 30°C. Shelf life - 3 years. Do not use after expiration date.

Atenolol is an antihypertensive, antiarrhythmic, and antianginal drug. Instructions for use prescribe taking 25 mg, 50 mg and 100 mg Nycomed tablets for high blood pressure and heart disease. At what pressure to take the medicine to reduce it, you can find out in the article.

Release form and composition

Atenolol is available in tablet form. Contains the active component atenolol (1 tablet contains 25, 50 or 100 mg of this substance).

Indications for use

What does Atenolol help with? Tablets are 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 medication is prescribed for migraine, thyrotoxicosis, pheochromocytoma.

Indications for use of Atenolol Nycomed are similar.

Instructions for use

Atenolol is 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. For coronary heart disease, tachysystolic heart rhythm disturbances - 50 mg 1 time per day.

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. Elderly patients and patients with impaired renal excretory function require adjustment of the dosage regimen.

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.

Read also: how to take a close analogue for high blood pressure - .

Pharmacological action

The use of Atenolol tablets helps to provide hypotensive, antiarrhythmic and antianginal effects.

When using tablets in an average dosage, there is no effect on the tone of peripheral arteries. The hypotensive effect of Atenolol develops throughout the day. The development of a sustainable therapeutic effect (normalization of blood pressure) is observed after 14 days of regular medication use.

The antianginal effect of the drug occurs due to the ability of the drug to reduce the excitability and oxygen demand of the myocardium. Taking the pills helps reduce the heart rate when the patient performs any physical activity or is at rest.

The use of Atenolol helps to increase the survival rate of patients who have suffered a myocardial infarction. In this case, the use of the drug can reduce the number of attacks of ventricular arrhythmias and angina pectoris.

Contraindications

• Severe bradycardia (with heart rate less than 45-50 beats/min.).
• Systolic blood pressure (BP) less than 100 mm Hg.
• Cardiomegaly without signs of heart failure.
• Cardiogenic shock.
• Atrioventricular (AV) block II-III stage.
• Chronic or acute heart failure (in the stage of decompensation).
• Sick sinus syndrome (SSNS).
• Prinzmetal's angina.
• Increased individual sensitivity to the components of the drug.
• The period of breastfeeding (lactation).
• Age up to 18 years (safety and effectiveness of the drug have not been determined).
• Sinoauricular block.
• Arterial hypotension (if used for myocardial infarction).
• Concomitant use of monoamine oxidase inhibitors (MAO).

The drug is prescribed with caution for: history of allergic reactions, diabetes mellitus, hypoglycemia, metabolic acidosis, first degree atrioventricular block, chronic renal and liver failure, chronic heart failure (compensated), chronic obstructive pulmonary disease (including emphysema) , pheochromocytoma, obliterating diseases of peripheral vessels (Raynaud's syndrome, intermittent claudication), psoriasis, thyrotoxicosis, myasthenia gravis, depression (including a history), pregnancy, elderly patient.

Side effects

• Skin: reversible alopecia, psoriasis-like skin rashes, increased sweating, exacerbation of psoriasis symptoms, skin hyperemia.
• Nervous system: depression, insomnia, headaches, dizziness, weakness, asthenia, drowsiness, depression, paresthesia in the extremities, impaired concentration, short-term memory loss, convulsions, myasthenia gravis.
• Respiratory system: bronchospasm, laryngospasm, difficulty breathing, nasal congestion.
• Sense organs: conjunctivitis, visual disturbances, dry eyes, decreased tear production, sore eyes.
• Endocrine system: hypothyroid state, hyperglycemia, hypoglycemia.
• Digestive system: changes in taste perception, epigastric pain, nausea, vomiting, dry mouth, stool disorders: constipation, diarrhea.
• Cardiovascular system: chest pain, vasculitis, coldness of the lower extremities, vasospasm, orthostatic hypotension, CHF, weakened myocardial contractility, arrhythmia, atrioventricular block, palpitations, bradycardia, myocardial conduction disorders.

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.

Children, pregnancy and breastfeeding

Atenolol penetrates the placental barrier and is found in umbilical cord blood. There have been no studies on the use of atenolol in the first trimester and, therefore, the possibility of a damaging effect on the fetus cannot be excluded.

For the treatment of arterial hypertension in the third trimester of pregnancy, the drug is used under close medical supervision. The use of Atenolol during pregnancy may cause fetal growth disturbances. Side effects such as hypoglycemia and bradycardia can occur in both the fetus and the newborn.

Special instructions

In case of thyrotoxicosis, atenolol can hide certain clinical manifestations of this disease (for example, tachycardia). Abrupt withdrawal of the drug in patients with thyrotoxicosis is contraindicated, as it can increase symptoms. It is not recommended to abruptly interrupt therapy due to the risk of myocardial infarction and severe arrhythmias.

Cancellation is carried out gradually, reducing the dose of the drug over 2 weeks or more (the dose is reduced by 25% over 3-4 days). In patients with coronary artery disease, abrupt discontinuation of the drug may provoke an increase in the severity or frequency of anginal attacks. To avoid such consequences, discontinuation of Atenolol should be carried out gradually.

The drug must be discontinued before being examined for the content of vanillylmandelic acid, normetanephrine, catecholamines, and antinuclear antibody titers in the urine and blood.

Drug interactions

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.

Analogues of the drug Atenolol

Analogues are determined by structure:

1. Atenova.
2. Atenolan.
3. Tenormin.
4. Prinorm.
5. Atenolol Belupo (Nycomed, Stada, Agio, AKOS, Akri, ratiopharm, Teva, UBF, FPO).
6. Betacard.
7. Athenobene.
8. Ormidol.
9. Atenol.
10. Sinar.
11. Velorin 100.
12. Vero Atenolol.

Vacation conditions and price

The average cost of Atenolol Belupo (25 mg tablets No. 30) in Moscow is 35 rubles. Requires a prescription.

Atenolol is a complex cardiovascular drug that helps to effectively cope with arterial hypertension, as well as coronary heart disease.

This drug has pronounced hypotensive (reducing high blood pressure), antiarrhythmic and antianginal effects.

Regular use helps to significantly reduce the frequency and strength of heart contractions, quickly normalizing the pulse.

With long-term use, the risk of possible development of severe cardiovascular diseases (myocardial infarction, stroke, etc.) is significantly reduced.

After internal administration, the main hypotensive effect appears within 1-2 hours and lasts for more than 20-24 hours.

Main indications for the use of Atenolol:

• arterial hypertension;
• angina pectoris (pain in the heart);
• prevention of myocardial infarction, various cardiac disorders or stroke;
• complex treatment of senile tremor.

Attention: Before using Atenolol, it is recommended to consult with a qualified physician!

Available in the form of soluble tablets for internal use.

How to take Atenolol tablets?

The daily dose for adults is 1 t. (25 mg.) 1-2 r. the day before meals, with a sufficient amount of liquid.

The maximum daily dose should not exceed more than 4 tons (200 mg) per day.

The course of treatment is determined by the attending physician absolutely individually for each patient, depending on the severity of the disease.

The initial dose for the complex treatment of cardiac angina is 2 tons (50 mg), while the maintenance dose should not exceed more than 1 tons (25 mg).

Contraindications to the use of Atenolol

• severe arterial hypotension (very low blood pressure);
• cardiogenic shock;
• children under 12 years of age;
• sinus bradycardia (decreased heart rate);
• hypersensitivity (increased sensitivity of the body to the main active ingredients of the drug);
• acute or chronic form of heart failure;
• pregnancy and lactation (breastfeeding).

Side effects

• dizziness;
• pain in the abdominal area;
• nausea or vomiting (occurs with a significant overdose of the drug);
• local allergic reactions on the skin (urticaria, increased skin itching);
• dry mouth;
• increased anxiety or irritability;
• general weakness;
• memory loss.

If any adverse reactions develop after long-term use of this drug, it is recommended to consult with your doctor!

In this article, we looked at what Atenolol helps with, as well as how to take it correctly.

Atenolol is a very popular medication used to treat heart disease.

It has a general antianginal, as well as antiarrhythmic and hypotensive effect on the body. It is especially valued for its ability to lower heart rate, reduce myocardial excitability or contractility, and also minimize myocardial oxygen demand.

On this page you will find all the information about Atenolol: complete instructions for use for this drug, average prices in pharmacies, complete and incomplete analogues of the drug, as well as reviews of people who have already used Atenolol. Would you like to leave your opinion? Please write in the comments.

Clinical and pharmacological group

Beta 1 adrenergic blocker.

Conditions for dispensing from pharmacies

Dispensed with a doctor's prescription.

Prices

How much does Atenolol cost? The average price in pharmacies is 25 rubles.

Release form and composition

The drug Atenolol is available in tablet form from 14 to 100 pieces in one package.

• Contains the active component atenolol (1 tablet contains 25, 50 or 100 mg of this substance).
• Additional elements: calcium hydrogen phosphate, propyl parahydroxybenzoate, sodium carboxymethyl starch, starch, silicon dioxide, methyl parahydroxybenzoate, magnesium stearate, talc.

Pharmacological effect

The drug blocks nerve impulses, which causes a decrease in the frequency and strength of heart contractions. Many reviews of Atenolol also confirm such pharmacological properties as lowering blood pressure (hypotensive effect), eliminating heart rhythm disturbances (antiarrhythmic effect), eliminating symptoms of myocardial ischemia (antianginal effect).

During the first day after taking the drug, a reactive increase in the total peripheral resistance of blood vessels is observed against the background of a decrease in cardiac output. But within a few days the severity of this effect begins to decrease. The hypotensive effect is manifested by a decrease in minute and stroke volume, maximum and minimum blood pressure due to the action of the active substance of the drug.

Reviews of Atenolol say that the reduction in pressure under the influence of the drug lasts on average 24 hours, and if you use it regularly, then after one and a half to two weeks the results will stabilize.

Indications for use

As an independent medicine:

• of various origins;
• Elimination of limb trembling;
• Treatment ;
• Perforation of the mitral valve;
• Treatment of coronary heart disease;
• Treatment and its prevention;
• Trembling of the limbs and strong emotional arousal during withdrawal syndrome.

As part of the medicinal complex:

• Treatment of pheochromacytoma;
• Prevention of migraine attacks;
• Multiple disorders of the heart muscle associated with an increase in myocardial mass;
• Increased concentration of thyroid hormone.

Contraindications

Doctors prescribe medicine with caution for diseases such as:

• there is a history of an allergic reaction;
• acidosis (metabolic);
• depression;
• psoriasis;
• diabetes mellitus;
• hypoglycemia;
• emphysema;
• Raynaud's syndrome;
• myasthenia gravis;
• old age;
• pregnancy.

The drug is contraindicated in many diseases, such as cardiogenic shock, atrioventricular block, sick sinus syndrome, bradycardia, acute chronic heart failure, arterial hypotension, during lactation, cardiomegaly (without signs of HF - heart failure). It is unacceptable to take the drug together with monoamine oxidase inhibitors and in case of hypersensitivity to Atenolol. Not intended for use by children under 18 years of age.

Use during pregnancy and lactation

Atenolol crosses the placenta, so it is not recommended to prescribe it during pregnancy (especially in the first trimester), and even when planning pregnancy, because the drug can cause fetal immaturity, delayed development and growth of the fetus, premature birth or intrauterine death of the fetus.

The drug may cause low blood glucose levels and bradycardia (low heart rate) in the fetus and newborn baby. Therefore, if it is necessary to use Atenolol in the third trimester of pregnancy, it is necessary to ensure constant medical supervision. It is permissible to use it in cases where the effect for the mother exceeds the potential risk for the fetus.

If the need to prescribe Atenolol arises during breastfeeding, breastfeeding should be stopped.

Instructions for use

The instructions for use indicate that Atenolol tablets should be swallowed without chewing, with a small amount of liquid, before meals, preferably at the same time. The doctor sets the dosage of the drug and the duration of treatment individually depending on the therapeutic effect obtained.

1. Chronic stable and unstable angina: usually prescribed 100 mg of atenolol 1 time per day or 50 mg, which is taken 2 times.
2. Myocardial infarction after intravenous administration, 12:00 after injection is prescribed 50 mg orally and 100 mg after 12:00.
3. For supraventricular (supraventricular) and ventricular (ventricular) arrhythmias, the drug is prescribed 1-2 times a day, 50-100 mg.
4. Arterial hypertension: treatment, as a rule, begins with the use of 100 mg 1 time per day. For some patients, 50 mg per day is enough. The effect is observed after 2 weeks. In case of ineffectiveness, atenolol is used together with diuretics.

The maximum daily dose is 200 mg.

Patients on hemodialysis should use 50 mg after each dialysis. This must be done in a hospital setting, as a noticeable decrease in blood pressure may occur.

In patients with significant renal impairment, the dose of the drug depends on the level of creatinine clearance (CC): with a creatinine clearance of 10-30 ml/min, the dose is reduced by 2 times (50 mg per day or every other day), and with a creatinine clearance of less than 10 ml/min. doses are reduced by 4 times compared to usual.

Side effects

The following side effects are possible when taking Atenolol:

• Sense organs: inflammation of the conjunctiva of the eyes, decreased secretion of tear fluid;
• Hypersensitivity reactions to Atenolol: skin itching;
• Endocrine system: decreased blood glucose levels;
• Metabolic processes: increased sweating;
• Respiratory system: the appearance of symptoms of narrowing of the bronchial tree;
• Reproductive system: decreased potency;
• Central and peripheral nervous system: fatigue, depressive syndrome, sleep disturbances, involuntary muscle contractions of the limbs, dizziness, mild headaches, feeling of coldness in the limbs, decreased reaction;
• Digestive system: dry mouth, nausea, stool disorders, vomiting;
• Cardiovascular system: decreased blood pressure, symptoms of functional myocardial failure, decreased heart rate, disruption of the conduction system of the heart, redness of the skin.

The severity and frequency of side effects directly depends on the dose.

Overdose

Symptoms when taken in excess of the dose of the drug: a sharp increase in difficulty breathing, fainting, dizziness, convulsions, etc. may be caused.

You can help with such conditions in the following way: rinse the stomach, use adsorbent medications. You can also take certain medications depending on the severity of overdose symptoms.

Special instructions

Atenolol is prescribed with extreme caution in groups of patients suffering from a number of diseases such as:

1. chronic heart failure;
2. myasthenia gravis;
3. hypoglycemia;
4. psoriasis;
5. obstructive pulmonary diseases, including chronic ones;
6. liver failure;
7. diabetes mellitus;
8. peripheral vascular diseases (obliterative);
9. depression;
10. pregnancy.

Special monitoring is required for elderly patients, as well as those people with a history of allergic reactions. .

Patients wearing contact lenses may need to use special drops while using Atenolol, since the secretion of tear fluid will decrease.

Drug interactions

1. Simultaneous use of Atenolol and cardiac glycosides can provoke bradycardia.
2. If intravenous administration of the drug Verapamil is required, this can be done no earlier than 2 days after taking the last Atenolol tablet.
3. Concomitant use with antihypertensive drugs of other groups and nitrates may result in increased hypotensive effects.
4. Concomitant use with aminophylline is not recommended due to the risk of reducing the pharmacological effect of both drugs.
5. When used simultaneously with lidocaine, the risk of toxic effects increases.
6. Atenolol is contraindicated for use simultaneously with MAO inhibitors.
7. Concomitant use with Verapamil increases the risk of developing cardiodepressive effects.

Alcohol compatibility

Pharmacists have not yet created such drugs that can be combined with “strong drinks” and not be afraid of the consequences. With drugs that lower blood pressure, such jokes are especially bad. After taking Atenolol, you must refrain from drinking for at least 12 hours. Otherwise, the pressure may drop sharply, sudden weakness and nausea may appear, even fainting. Before performing an operation under anesthesia, the drug should be excluded from the course of therapy 48 hours before.