An important role in the treatment of hypertension is given to drugs from the group of beta-blockers. They effectively lower blood pressure, prevent blood pressure spikes and protect the heart. One of the most popular drugs in this group is atenolol, which is part of a large number of medicines for the treatment of hypertension.
Atenolol is the name of the active ingredient that is included in various drugs. Nevertheless, on the shelves of pharmacies you can also find the medicine Atenolol, produced by a domestic manufacturer. When choosing a drug, it is necessary to carefully study the composition, since a foreign medication based on atenolol will have to pay a larger amount than for the Russian Atenolol.
The drug Atenolol of domestic production is available only in tablets. However, the packaging of the drug depends on the number of tablets and dosage, Atenolol can be found both in conventional blisters of 10 tablets, and in polymer cans of 50 and 100 tablets per package.
The medicine is available in three dosages - 25, 50 and 200 mg of active ingredient in one tablet. The dosage is selected by the doctor and depends on the severity of the symptoms, the degree of hypertension and the age of the patients. The most in demand is the average dosage or 50 mg Atenolol tablets.
Atenolol - the name of both the active substance and the drug
The composition of the drug is atenolol and form-forming components (lactose, povidone, starch, talc, silicon dioxide). The tablets are small in size and lack a pronounced taste, they are easy to swallow with a little water. The drug, packed in polymer bottles, is convenient to carry with you. This form of Atenolol release allows you to put the medicine in your pocket or bag without worrying about its safety.
The drug is presented in any pharmacy, the medicine is affordable for everyone, since the price of the largest package with the maximum dosage of the active ingredient does not exceed 60 rubles.
Due to its affordable cost, high efficacy and good tolerance, Atenolol has gained wide popularity among patients and doctors. Cardiologists prescribe this medication both as mono-therapy and as part of the combined treatment of hypertension.
The principle of the drug
The properties of atenolol are hypotensive and cardioprotective. The action of the drug is based on blocking receptors that are sensitive to adrenaline and aldosterone. These hormones increase vascular tone and stimulate a jump in blood pressure. Blocking receptors that are sensitive to enzymes that increase pressure, allows you to effectively control the value of blood pressure and avoid sudden jumps.
The increase in adrenaline negatively affects the work of the heart in patients with hypertension. Beta-blocker drugs, including atenolol-based drugs, protect the myocardium from the negative effects of hormones that stimulate an increase in blood pressure. Due to this property, Atenolol is widely used in the treatment of angina pectoris, tachycardia and various heart pains, provoked, among other things, by heart failure.
Unlike drugs like Anaprilin, Atenolol acts faster and causes side effects less often. According to doctors, this medicine is almost universal, as it suits the majority of patients in cardiology departments of polyclinics.
Thus, the action of Atenolol is manifested in the following:
- effective reduction of blood pressure;
- preventing an increase in blood pressure in hypertensive patients;
- normalization of the heart rate;
- reduction of symptoms of angina pectoris;
- relief of tachycardia;
- prevention of pathological changes in the myocardium against the background of an increase in blood pressure.
Atenolol tablets act quickly, therefore, they can be used to relieve hypertensive crisis, especially if it is accompanied by pain in the heart and palpitations.
The mechanism of action of the drug:
- normalization of the frequency and strength of heart contractions;
- decreased cardiac output;
- reduced production of renin;
- oppression of the nervous system;
- decreased vascular tone.
Thus, the drug is used to support heart function and help reduce the risk of myocardial infarction in patients.
The drug quickly reduces blood pressure and effectively protects the heart
In what cases is the drug prescribed?
Before you start taking Atenolol tablets, the instructions for use should be carefully studied. As with any drugs that affect blood pressure, Atenolol can only be used as directed by a doctor. Self-medication can lead to dangerous consequences.
Taking the drug is advisable for the treatment of the following diseases:
- arterial hypertension 2 and 3 degrees;
- coronary heart disease;
- angina of any form;
- heart attack;
- arrhythmia;
- tachycardia;
- tremor.
The drug is used for hypertensive crisis as an ambulance. In this case, taking 1 tablet of the drug is indicated.
The drug can be prescribed to patients who have recently had myocardial infarction as a means of preventing complications after a heart attack.
Indications for the use of Atenolol include hypertension of the second and third degree, however, for constant use, it is advisable to replace the drug with an analogue because of the negative effect on metabolism. Atenolol is considered an outdated drug, which leads to a large list of contraindications and possible side effects.
Drug treatment regimen
The dosage of Atenolol from pressure is selected exclusively by a doctor on an individual basis. It is contraindicated to independently increase the dose of Atenolol due to the risks of side effects and the risk of overdose.
Atenolol for hypertension is taken at 25 mg per day. In the absence of the expected therapeutic effect, it is possible to increase the dosage to 50 mg. It is recommended to increase the amount of the drug taken after a week of treatment with a minimum dosage. This will make it possible to trace the dynamics of changes in blood pressure during drug treatment and to correctly select the optimal dose of the drug.
The instructions say that the maximum daily dose can be increased to 100 mg, but only as directed by a doctor. Nevertheless, it is not advisable to take large doses of Atenolol on an ongoing basis, therefore, if treatment with low and medium doses is ineffective, you should consult a cardiologist about the selection of a complex combination therapy. Due to the high risk of side effects, it is advisable to use new generation beta-blockers for hypertension, rather than high-dose Atenolol.
The drug can not be changed to newer medicines only if high doses of the medicine are well tolerated by the patient's body, and there are no side effects at all.
With angina pectoris and other functional disorders of the myocardium, it is practiced to take 25 mg of the drug daily. The duration of the course of treatment depends on the severity of the symptoms. In some cases, a lifelong intake of the drug is practiced to normalize the heart rate.
In case of hypertensive crisis, you should put 1 tablet of the drug at a dosage of 25 mg under the tongue and wait until it is completely dissolved. Blood pressure should be measured after 20 minutes. If there is no improvement in well-being, an hour later, you can take another 25 mg of the drug.
After suffering a myocardial infarction, the medicine is taken within 10 days. The dosage is selected only by a doctor, in order to avoid negative consequences.
The drug is not contraindicated in an elderly patient, however, you should monitor your health and start treatment with small doses. If, after 10 days of taking Atenolol at a dosage of 25 mg, there are no side effects, the amount of the drug can be doubled.
Elderly the drug is prescribed with extreme caution.
Application during pregnancy
You should consult your doctor about the possibility of using Atenolol tablets during pregnancy. This medication belongs to dangerous drugs that can provoke fetal malformations. There is a high risk of developmental delay in a child if a woman took the indicated drug during pregnancy.
Nevertheless, the drug can be taken in short courses at a later date, but only in a minimal dosage. The feasibility of drug treatment is determined based on the potential benefits to the mother. Regardless of whether the doctor approved the drug, it should be remembered that Atenolol can negatively affect the development of the child. In the early stages, taking the drug can lead to a change in the blood supply to the placenta and provoke a miscarriage.
Taking the drug during lactation, a woman should stop breastfeeding her baby. This is due to the fact that the components of the drug pass into breast milk and can affect the baby.
Side effects
A large number of undesirable effects and side effects of Atenolol are due to the fact that the drug is an obsolete drug. If the state of health worsens against the background of drug treatment, the drug should be discontinued and a doctor should be consulted about replacing Atenolol with an analogue.
Most often, patients taking this drug experience a sharp drop in blood pressure and bradycardia. This is due to the rapid action of the drug. Often, while taking the medication, there is a decrease in the heart rate below the permissible value, respiratory failure, migraine. In especially severe cases, against the background of drug treatment, symptoms of acute heart failure appear.
A sharp drop in blood pressure can lead to the development of shock, orthostatic collapse, fainting, hypoxia. These are dangerous symptoms that require immediate discontinuation of the drug.
The beginning of taking the drug is accompanied by diarrhea, nausea, dry mouth. These symptoms go away on their own after a few days and in most cases do not require treatment or discontinuation of the drug.
The drug has a negative effect on the nervous system, exerting a depressing effect. This may be accompanied by a loss of strength, drowsiness, and emotional lability. Often, taking Atenolol leads to the development of asthenic syndrome. During treatment, insomnia, impaired coordination of movements, lethargy may occur. This necessitates refraining from driving vehicles during Atenolol therapy.
Erectile dysfunction may occur in men against the background of Atenolol. If such a violation occurs, the drug should be abandoned.
In case of individual intolerance to the drug, an allergic skin reaction develops, manifested by urticaria and itching.
The drug has a large list of serious side effects
Contraindications and precautions
When taking Atenolol, contraindications relate primarily to acute heart failure. The drug is prohibited from taking with bradycardia, since there is a risk of complete cardiac arrest due to the active component of the tablets.
Among the absolute indications, the instructions also indicate cardiogenic shock and a history of angioedema. In severe chronic insufficiency, the drug is contraindicated.
This medicine is not intended for use in children. With hypotension, taking Atenolol can lead to cardiac arrest or coma.
For more information on precautions and contraindications, you should consult your doctor. Despite the fact that renal failure is not an absolute contraindication to taking the drug, in some cases the drug can adversely affect the functioning of the kidneys, therefore it requires either a dosage reduction or replacement of the drug with an analogue.
Overdose symptoms
When taking Atenolol, an overdose is manifested by the following symptoms:
- hypotension or orthostatic collapse;
- bradycardia;
- bronchospasm;
- a sharp decrease in blood glucose levels;
- heart failure;
- fainting;
- breathing disorder.
Due to the risk of lowering glucose levels, the drug is prescribed with caution in patients with diabetes mellitus. If symptoms of an overdose appear, you should immediately consult a doctor. In case of a rapidly falling heart rate, it is recommended to call an ambulance.
An overdose develops when taking more than 200 mg of the drug, however, in patients with hypersensitivity, these symptoms may appear even with a smaller amount of the drug taken.
When symptoms of an overdose appear, gastric lavage and symptomatic therapy are practiced. In the case of a particularly serious condition of the patient, dialysis may be prescribed.
If you experience any ailments associated with taking the drug, you should consult your doctor about discontinuing the drug and selecting an analogue.
Atenolol's analogs
To replace Atenolol, analogs should only be selected by a doctor. Of the modern drugs of the beta-blocker group, preference is given to the following medicines:
- Betalok ZOK;
- Lokren;
- Biprol;
- Concor.
These drugs are less likely to cause side effects and do not provoke a strong drop in blood pressure, which is accompanied by a breakdown and a number of specific symptoms. The listed drugs have a lesser effect on the nervous system. Men who experience erectile dysfunction during treatment with Atenolol should consult a doctor about the possibility of continuing therapy with one of the listed drugs.
With the low effectiveness of beta-blockers as an independent agent for the treatment of hypertension, combination therapy is recommended, including the use of ACE inhibitors and diuretics. Such drugs cause fewer side effects and show good results in 80% of cases.
Composition
Contains an active ingredient atenolol (in 1 tablet 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.
Release form
Available in tablet form.
pharmachologic effect
Cardioselective beta-1-blocker .
Pharmacodynamics and pharmacokinetics
The drug has antiarrhythmic, antianginal, hypotensive effects. It has negative dromotropic, chronotropic, inotropic and batmotropic effects.
Hypotensive effect achieved by influencing the nervous system, decreasing the sensitivity of baroreceptors on the aortic arch, decreasing activity renin-angiotensin system , decreasing the IOC.
The drug lowers the systolic and diastolic blood pressure, decreases the volumetric flow rate, blood volume flow rate.
The drug does not affect the tone of the peripheral arteries in therapeutic doses.
Antianginal effects is provided by a decrease in the oxygen demand of myocardial cardiomyocytes, which leads to a decrease in heart rate. The drug reduces the pulse at rest and during physical activity.
Antiarrhythmic effect is provided by the elimination of arrhythmogenic factors (arterial hypertension, an increase in the cAMP content, an increase in the activity of the sympathetic part of the nervous system, tachycardia), atrioventricular conduction , a decrease in the rate of spontaneous excitation of the ectopic and sinus pacemaker.
When taking Atenolol, the survival rate of patients who have had myocardial infarction significantly increases.
The drug does not weaken the bronchodilating effect of isoproterenol.
Indications for the use of Atenolol
What are the pills from?
The medicine is prescribed for hypertensive crisis , angina pectoris, ischemic heart disease, neurocirculatory dystonia , hyperkinetic cardiac syndrome of functional origin, with withdrawal symptoms, essential tremor, agitation.
The drug is recommended for use for the prevention of rhythm disturbances, myocardial infarction, ventricular premature beats , sinus tachycardia, atrial flutter, atrial fibrillation, ventricular tachycardia.
The medication is prescribed for migraine, thyrotoxicosis, pheochromocytoma .
Indications for use of Atenolol Nycomed are similar.
Contraindications
The medicine is not used for severe bradycardia, atrioventricular blockade of 2-3 degrees, cardiogenic shock , decompensated form of CHF, acute heart failure, SA-blockade, with prinzmetal angina , intolerance to the active ingredient, cardiomegaly, breastfeeding, taking MAO inhibitors.
With emphysema, allergies, metabolic acidosis, diabetes mellitus, hypoglycemia, pheochromocytoma, thyrotoxicosis, myasthenia gravis, liver failure , pregnancy, psoriasis, depression, children and the elderly, with Raynaud's syndrome, the drug is used with caution.
Side effects
Senses: conjunctivitis , visual impairment, dry eyes, decreased production of tear fluid, soreness in the eyes.
Nervous system: depression, insomnia, headaches, dizziness, weakness, asthenia, drowsiness, depression, paresthesia in the limbs , concentration disorders, short-term memory loss, convulsions, myasthenia gravis.
The cardiovascular system: chest pain, vasculitis, coldness of the lower extremities, angiospasm, orthostatic hypotension, CHF, weakening of myocardial contractility, arrhythmia, palpitations, bradycardia, myocardial conduction disturbances.
Digestive system: changes in taste, epigastric pain, nausea, vomiting, dry mouth, stool disorders: 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, hyperemia of the skin.
Back pain is also noted, bradycardia , decreased potency, weakening of libido, arthralgia, intrauterine growth retardation.
The severity of side effects directly depends on the dose of the drug.
Instructions for use of Atenolol (Way and dosage)
The tablets are taken orally, washed down with liquid, not chewed.
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.
With tachysystolic disorders, with ischemic heart disease, Atenolol is prescribed 1 time per day, 50 mg.
Acute myocardial infarction with stable hemodynamic parameters: intravenous infusions, then taking a 50 mg tablet after 10 minutes, after 12 hours the dose is repeated.
With cardiac hyperkinetic syndrome, 25 mg per day is indicated.
The drug acts during the day, more than 1 time a day, the drug is not used. It is not recommended to prescribe more than 200 mg per day. The medication is withdrawn gradually, every 3 days - ¼ of the dose.
Instructions for use of Atenolol Nycomed are similar.
Overdose
It appears bronchospasm , cyanosis of the nail plates, convulsions , shortness of breath, arrhythmia, fainting, drop in blood pressure, severe bradycardia.
An emergency gastric lavage is required.
In case of violation of atrioventricular conduction, with bradycardia, a temporary pacemaker is administered intravenously or installed.
With a sharp drop in blood pressure, the patient is given trendelenburg position .
In the absence of signs of pulmonary edema, plasma-substituting solutions are administered intravenously, in case of ineffectiveness, , epinephrine,.
With convulsive syndrome, intravenous infusion is indicated. Dialysis effective.
Interaction
In patients taking Atenolol, allergen extracts for skin tests, and allergens for immunotherapy significantly increase the risk of severe systemic, anaphylaxis. Risk anaphylactic reactions increases with intravenous administration of X-ray contrast agents.
A drop in blood pressure and cardiodepressive effects are noted with intravenous infusion of phenytoin, as well as with the use of drugs for inhaled general anesthesia. The drug is able to mask the signs of developing hypoglycemia with the simultaneous use of oral hypoglycemic agents, insulin.
Atenolol reduces the clearance of xanthines. Estrogens, glucocorticosteroids, NSAIDs, BMCC, guanfacine, cardiac glycosides, amiodarone, and many antiarrhythmic medications increase the likelihood of developing atrioventricular blockade, bradycardia, cardiac arrest, and worsening heart failure.
Hydralazine, sympatholytics, diuretics, antihypertensive drugs, BMCC can significantly lower blood pressure.
Atenolol lengthens the duration of action of coumarins, non-depolarizing muscle relaxants. Antipsychotics, sedatives, hypnotics, ethanol, tetracyclic and tricyclic antidepressants increase the depressing effect on the central nervous system.
Simultaneous administration of MAO inhibitors is unacceptable due to the risk of hypotension. Violation of peripheral circulation is noted when using medications with non-hydrogenated ergot alkaloids.
Terms of sale
Prescription required.
Storage conditions
Store in a dry place, out of the reach of children, at a temperature no more than 30 degrees Celsius.
Shelf life
No more than three years.
special instructions
Taking the drug should be accompanied by regular measurement, determination of the pulse, sugar level in persons with diabetes mellitus .
Elderly patients are shown periodic monitoring of the state of the renal system. The doctor needs to instruct the patient and teach how to correctly measure the heart rate. In 20% of patients with angina pectoris, adrenergic blockers do not give the desired effect due to severe coronary atherosclerosis with a low ischemia threshold, impaired subendocardial blood flow .
In patients with nicotine dependence, the effectiveness of the drug Atenolol is significantly lower than in patients who do not smoke. Against the background of therapy, it is possible to reduce the production of tear fluid, which is necessary to warn patients who wear contact lenses.
The drug can mask the clinical picture of thyrotoxicosis (tachycardia). Abrupt withdrawal of the drug in patients with the risk of increased severity of the symptoms of the disease is unacceptable. Atenolol is able to mask tachycardia in hypoglycemia. The medication is canceled a few days before the planned general anesthesia with ether or chloroform. Otherwise, the patient is selected a drug for general anesthesia, which has a minimal inotropic effect.
Intravenous administration of atropine eliminates reciprocal activation of the vagus nerve. The drug can be prescribed to patients with bronchospastic pathology with ineffectiveness or intolerance to other antihypertensive drugs with strict adherence to the dosage regimen.
With the development of arterial hypotension in elderly people, increasing bradycardia, ventricular arrhythmias, bronchospasm, severe disorders in the liver and kidneys, the dosage of the drug is reduced or the therapy is completely stopped. When depression develops, the drug is replaced. Abrupt withdrawal can cause myocardial infarction, a severe form of arrhythmia. Cancellation of the drug is carried out by gradually reducing the dosage over two weeks.
Before determining the level of normetanephrine, catecholamines, antinuclear body titers, vanillyl mandelic acid, Atenolol is canceled. The medication affects the management of vehicles.
Recipe in Latin:
Rp: Atenololi 0.05
D. t. d. N 30 in tab.
S. 1 tablet 1 time per day.
During pregnancy
Used with care. Contraindicated during lactation.
When carrying a pregnancy, the appointment of a medication is justified in case of vital necessity.
Atenolol's analogs
Matching ATX level 4:Analogues of Atenolol are: Atenobene , Atenova , Atenol , Tenolol.
Reviews about Atenolol
The drug is effective for hypertension and arrhythmias, and is quite inexpensive. However, side effects are common, such as hallucinations and low blood sugar levels. Reviews about Atenolol Nycomed are generally better than about preparations released by other manufacturers.
Tradename:
ATENOLOL (Atenolol)
Reg: P No. 012672 / 01-2001
International non-proprietary name:
ATENOLOL (Atenolol)
Dosage form:
tablets
Composition:
1 tablet contains the active substance atenolol 50 mg or 100 mg, and
Auxiliary components:
microcrystalline cellulose, sodium croscarmellose, sodium lauryl sulfate, polyethylene glycol 6000, silicon dioxide, talc, magnesium stearate.
Description:
tablets 50 mg - tablets of white or white with a yellowish tinge color, with slight marbling, round in shape with a beveled edge, with a scribble on one side and an embossed company trademark on the other.
tablets 100 mg - tablets of white or white with a yellowish sheen in color, with slight marbling, round in shape with a beveled edge, with a scribble on one side and an embossed PLIVA designation on the other.
Pharmacotherapeutic group:
beta 1-blocker selective.
Code: ATX
Indications for use
Arterial hypertension;
Prevention of angina attacks, with the exception of Prinzmetal's angina;
Cardiac arrhythmias: sinus tachycardia, prevention of supraventricular tachyarrhythmias, ventricular premature beats, ventricular tachycardia.
Contraindications
Hypersensitivity to the drug, cardiogenic shock, atrioventricular block II or III degree, severe bradycardia, sick sinus syndrome, sinoauricular block, acute heart failure, chronic heart failure (in the stage of decompensation), cardiomegaly without signs of heart failure, angina pectoris Prinzmethala (in case of use in myocardial infarction, systolic blood pressure less than 100 mm Hg), bronchial asthma, lactation period, simultaneous administration of MAO inhibitors, age up to 18 years (efficacy and safety have not been determined).
With caution - diabetes mellitus, metabolic acidosis, hypoglycemia, allergic reactions in history, chronic obstructive pulmonary disease (including emphysema), AV block I degree, chronic heart failure, obliterating peripheral vascular disease ("intermittent" claudication, syndrome Raynaud), pheochromocytoma, chronic renal failure, liver failure, myasthenia gravis, thyrotoxicosis, depression (including a history), psoriasis, pregnancy, old age.
Method of administration and dosage
The drug is taken orally before meals, without chewing, with a small amount of liquid.
Arterial hypertension.
Treatment begins with taking 50 mg of atenolol 1 time per day. To achieve a stable hypotensive effect, 1-2 weeks of admission are required. In case of insufficient severity of the hypotensive effect, the dose of the drug is increased to 100 mg per dose. Further dose increases are not recommended as it is not accompanied by increased clinical effect.
Angina pectoris.
The initial dose is 50 mg per day. If the optimal therapeutic effect is not achieved within a week, the dose is increased 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 function need to adjust the dose depending on creatinine clearance. In patients with renal failure, with creatinine clearance values \u200b\u200babove 35 ml / min / 1.73 m (normal value is 100-150 ml / min / 1.73 m2), atenolol does not significantly accumulate. The following maximum doses are recommended for patients with renal insufficiency:
For patients on hemodialysis, atenolol is prescribed 50 mg per day immediately after each dialysis in stationary conditions under close medical supervision, since there is a risk of arterial hypotension. In elderly patients, the initial single dose is 25 mg (it can be increased under the control of blood pressure, heart rate).
An increase in the daily dose over 100 mg is not recommended, because the therapeutic effect is not enhanced, and the likelihood of side effects increases. The maximum daily dose is 200 mg. Dose reduction in case of planned cancellation is performed at 1/4 dose every 3-4 days.
Side effect
Most of the side effects associated with the use of atenolol are mild and transient.
The most common side effects are mainly associated with the pharmacological action of the drug and are expressed as follows:
on the part of the cardiovascular system: the appearance of symptoms of heart failure, violation of atrioventricular conduction, bradycardia, a marked decrease in blood pressure, palpitations.
from the central nervous system: dizziness, sleep disturbance, decreased ability to concentrate, drowsiness, depression, hallucinations, lethargy, feeling tired, headache, weakness, headache, insomnia, nightmares, anxiety, confusion or short-term memory loss, weakening of reactivity, parasthesia in the extremities (in patients with "intermittent" claudication and Raynaud's syndrome), muscle weakness, convulsions;
from the gastrointestinal tract: dry mouth, nausea, vomiting, diarrhea, abdominal pain, constipation;
from the respiratory system: dyspnea, apnea, bronchospasm; hematological reactions: thrombocytopenic purpura, anemia (aplastic); thrombosis;
from the endocrine system: gynecomastia, decreased potency, decreased libido; hyperglycemia (in patients with non-insulin dependent diabetes mellitus), hypoglycemia (in patients treated with insulin), hypothyroidism; metabolic reactions: hyperlipidemia;
skin reactions: urticaria, dermatitis, itching, photosensitivity, increased sweating, skin hyperemia, exacerbation of psoriasis;
sense organs: blurred vision, decreased secretion of tear fluid, dry and sore eyes, conjunctivitis, vasculitis, chest pain;
effect on the fetus: intrauterine growth retardation, hypoglycemia, bradycardia;
laboratory parameters: agranulocytosis, leukopenia, changes in the activity of "liver" enzymes, the level of bilirubin;
others: withdrawal syndrome (increased angina attacks, increased blood pressure), reversible alopecia, back pain, arthralgia.
The incidence of side effects increases with increasing dose of the drug.
Overdose
Symptoms:bradycardia, atrioventricular block II and III degree, marked decrease in blood pressure, increased symptoms of heart failure, bronchospasm, hypoglycemia, dizziness, fainting, arrhythmia, ventricular extrasystole, cyanosis of fingernails or palms, convulsions.
Treatment:gastric lavage and the appointment of adsorbing agents. When bronchospasm occurs, inhalation or intravenous administration of the beta 2-adrenergic agonist salbutamol is indicated. In case of violation of AV conduction, bradycardia, intravenous administration of 1-2 mg of atropine, epinephrine or setting a temporary pacemaker. With ventricular extrasystole - lidocaine (class IA drugs should not be used), with arterial hypotension - the patient should be in the Trendelenburg position. If there are no signs of pulmonary edema - intravenous plasma-substituting solutions, if ineffective - the introduction of epinephrine, dopamine, dobutamine. With heart failure - cardiac glycosides, diuretics, glucagon, with convulsions - intravenous diazepam. Dialysis is possible.
Interaction with other medicinal products
With the simultaneous use of ATENOLOL and insulin (or other oral antidiabetic agents), their hypoglycemic effect may be enhanced.
The simultaneous administration of atenolol with antihypertensive drugs of other groups leads to an increase in the hypotensive effect. When atenolol is taken with verapamil (or diltiazem), the cardiodepressant effect is mutually reinforced.
The antihypertensive effect is weakened by estrogens (sodium retention)
When administered together with cardiac glycosides, the risk of developing bradycardia and atrioventricular conduction disturbances increases.
With simultaneous administration with reserpine, methyldopa, clonidine, verapamil, severe bradycardia may occur.
Patients taking atenolol and clonidine at the same time, clonidine is canceled only after a few days after stopping treatment with atenolol.
Simultaneous intravenous administration of verapamil and diltiazem can provoke cardiac arrest, nifedipine can lead to a significant decrease in blood pressure
With the simultaneous administration of atenolol with derivatives of ergotamine, xanthine, nonsteroidal anti-inflammatory drugs, the effectiveness of atenolol decreases.
Concomitant use with lidocaine can reduce its excretion and increase the risk of toxic effects of lidocaine.
The combined use of atenolol with phenothiazine derivatives increases the concentration of each drug in the blood serum.
When administered intravenously, phenytoin, a general anesthetic agent, enhances the severity of the cardiodepressant effect.
When taken simultaneously with aminophylline and theophylline, mutual suppression of the therapeutic effect is possible.
Allergens used for immunotherapy or allergen extracts for skin tests increase the risk of severe systemic allergic reactions or anaphylaxis.
Means for inhalation anesthesia (hydrocarbon derivatives) increase the risk of suppression of myocardial function and the development of arterial hypotension.
Amiodarone increases the risk of bradycardia and inhibits AV conduction.
Cimitidine increases plasma concentration (inhibits metabolism).
Prolongs the action of non-polarizing muscle relaxants, the anticoagulant effect of coumarins.
Tri- and tetracyclic antidepressants, antipsychotics, sedatives, hypnotics, and ethanol 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 in patients with diabetes mellitus (once every 4-5 months). In elderly patients, it is recommended to monitor renal function (1 time in 4-5 months).
The patient should be trained in the method of calculating the heart rate and instructed on the need for medical advice if the heart rate is less than 50 / min.
In thyrotoxicosis, atenolol can mask certain clinical signs of hyperthyroidism (eg, tachycardia). Abrupt withdrawal in patients with thyrotoxicosis is contraindicated, since it can increase the symptoms. In contrast to non-selective beta-blockers, it practically does not increase insulin-induced hypoglycemia and does not delay the restoration of blood glucose concentration to normal levels.
In patients with ischemic heart disease (IHD), abrupt withdrawal of beta-blockers can cause an increase in the frequency or severity of anginal attacks, therefore, discontinuation of atenolol in patients with IHD should be carried out gradually.
The selection of doses in patients with cardiac decompensation also requires special attention. Compared to nonselective beta-blockers, cardioselective beta-blockers have less effect on lung function, however, in obstructive airway diseases, Atenolol should be prescribed only in case of absolute indications. If necessary, their appointment in some cases, you can recommend the use of beta 2-adrenergic agonists.
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. Overdose is dangerous for the development of bronchospasm.
Particular attention is required in cases where surgery is required under anesthesia in patients taking Atenolol. The drug should be discontinued 48 hours before surgery. As an anesthetic, one should choose a drug with the lowest possible negative inotropic effect.
With the simultaneous use of Atenolol and clonidine, the administration of Atenolol is stopped a few days earlier than clonidine in order to avoid the withdrawal symptom of the latter.
Perhaps an increase in the severity of the hypersensitivity reaction and the lack of effect from usual doses of epinephrine against the background of a burdened allergic history.
Drugs that reduce the supply of catecholamines (for example, reserpine) can enhance the action of beta-blockers, so patients taking such combinations of drugs should be under constant medical supervision for arterial hypotension or bradycardia.
If elderly patients develop severe 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, 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 for patients who use contact lenses.
It is impossible to abruptly interrupt treatment due to the risk of developing severe arrhythmias and myocardial infarction. Cancellation is carried out gradually, reducing the dose for 2 weeks or more (reduce the dose by 25% in 3-4 days).
The drug should be discontinued before testing the blood and urine levels of catecholamines, normetanephrine, and vanillyl mandelic acid; antinuclear antibody titers.
In smokers, the effectiveness of beta-blockers is lower.
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, therefore, it should be taken only in exceptional cases with great caution during the nursing period.
Release form
Tablets of 50 and 100 mg. 10 tablets in a strip (50 mg). 3 strips each with instructions for use in a cardboard box. 14 tablets in a strip (100 mg). 1 strip together with instructions for use in a cardboard box.
Atenolol is a beta-blocker drug. In turn, beta blockers affect the cardiovascular system (veins and arteries) and the heart. The drug is prescribed to lower blood pressure, relieve chest pain (angina pectoris), slow the heart rate, and reduce the risk of recurrent heart attacks.
Atenolol is available in the form of tablets with an active substance content of 25, 50 and 100 mg per tablet. You can also find a drug called Atenolol Nycomed, which has the same properties as the classic remedy.
Pharmacological action of Atenolol
The drug blocks nerve impulses, which causes a decrease in the frequency and strength of heart contractions. Many reviews about Atenolol also confirm such pharmacological properties as pressure reduction (hypotensive effect), elimination of cardiac arrhythmias (antiarrhythmic effect), elimination of 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 such an action begins to decrease. The hypotensive effect is manifested by a decrease in the minute and stroke volume, the highest and lowest blood pressure due to the action of the active substance of the drug.
Reviews of Atenolol say that the decrease in pressure under the influence of the drug lasts an average of 24 hours, and if you use it regularly, then after one and a half to two weeks the results will stabilize.
The antianginal effect of the drug is aimed at reducing myocardial oxygen demand by reducing the number of heart contractions. Conducted clinical studies confirm that the use of Atenolol in dosages recommended by a doctor, depending on the diagnosis, significantly reduces mortality among patients who have had myocardial infarction. This result is a consequence of a decrease in the frequency of ventricular arrhythmias and angina attacks.
Absorption of Atenolol occurs in the gastrointestinal tract and is half of the dose taken. The binding to blood proteins reaches 6 to 16 percent. After 2-4 hours after oral administration, the therapeutic effect of the drug is observed, which lasts a day.
The drug is almost not metabolized by the liver. Atenolol is excreted by the kidneys and during hemodialysis. It should be noted that this drug in small amounts penetrates into breast milk, as well as through the blood-brain and placental barriers.
Indications for the use of Atenolol
According to the instructions for Atenolol, indications for the use of the drug are:
- Arterial hypertension (high blood pressure), hypertension;
- Decreased muscle tone at the mitral valve and hyperkinetic cardiac syndrome;
- Unstable angina, exertional angina and rest angina;
- Essential tremor, senile tremor and tremor that accompanies withdrawal symptoms;
- neurocirculatory failures with hypertensive complications;
- coronary heart disease.
Also, the instructions for Atenolol indicate that the drug can be used for prophylactic purposes in relation to the following diseases:
- Arrhythmias of various etiologies;
- Myocardial infarction;
- Atrial flutter;
- Sinus tachycardia, paroxysmal atrial tachycardia, supraventricular and ventricular extrasystoles.
Often there are positive reviews about Atenolol in the complex treatment of thyrotoxicosis and hypertrophic obstructive cardiomyopathy.
Method of using Atenolol
According to the instructions, Atenolol is recommended to be taken before meals with a small amount of liquid (drink tablets). The drug should not be chewed. The dosage of the drug is set individually for each patient by his attending physician.
For the treatment of angina pectoris, arterial hypertension and tachyarrhythmias at the initial stage, the recommended dose is 50 mg per day, this amount must be taken at a time. If, due to the use of Atenolol, the pressure does not decrease, then the dosage is increased to 100 mg per dose.
To achieve a stable hypotensive effect, you need to take the drug for 1-2 weeks. If, after 2 weeks, the patient does not have a decrease in pressure, other drugs are prescribed that lower blood pressure.
When using a maintenance dose of the drug (25 mg) for the treatment of arterial hypertension, it is necessary to monitor the stability of the effectiveness of this therapy, namely, to measure blood pressure before prescribing the next dosage.
The maximum amount of the drug for patients with angina pectoris is 0.2 g per day.
Patients with impaired renal function are prescribed 0.05 g per day daily, if the CC is 15-35 ml / min, and 50 mg every other day with CC less than 15 ml / min.
According to the instructions for Atenolol, it is impossible to abruptly stop taking drugs, only in a gradual mode - a quarter of the dose every three to four days.
Side effects of Atenolol
According to reviews about Atenolol, this drug can cause the following negative effects:
- hallucinations, tremors, anxiety, depression, convulsions;
- decreased concentration, dizziness, increased fatigue, weakness, decreased memory;
- arrhythmia, heart failure, hypotension, bradycardia, chest pain, agranulocytosis, thrombocytopenia, atrioventricular block;
- decreased activity of the glands of external secretion, impaired vision;
- shortness of breath, laryngospasm, bronchospasm;
- dry mouth, abnormal liver function, nausea, vomiting, pain in the epigastric region, abnormal stool;
- decreased libido, decreased body temperature in the extremities, changes in the activity of certain enzymes, impotence, increased levels of bilirubin in the blood;
- allergic skin reactions.
Contraindications to the use of Atenolol
Atenolol is contraindicated in the following diseases:
- sinus bradycardia;
- sinoauricular block;
- cardiogenic shock;
- atrioventricular block 1 and 3 degrees;
- acute and chronic heart failure;
- arterial hypotension;
- bronchial asthma;
- violation of the acid-base balance towards acidosis.
Also, the drug is not prescribed for people with hypersensitivity to the components of the drug.
It is necessary to monitor pregnant and lactating women, children and the elderly, patients with psoriasis, myasthenia gravis and depression who take Atenolol.
Atenolol Nycomed
Atenolol Nycomed has the same pharmacological properties, indications, contraindications and side effects as Atenolol. The drug is available in tablets of 0.05 and 0.1 g.
Storage conditions
Atenolol should be stored in a dry and dark place at a temperature not exceeding 25 degrees. The shelf life from the date of production is 3 years.
Beta 1 -adrenergic blocker
Active substance
Atenolol (atenolol)
Release form, composition and packaging
10 pieces. - contour cell packaging (1) - cardboard packs.
10 pieces. - contour cell packages (2) - cardboard packs.
10 pieces. - contour cell packages (3) - cardboard packs.
pharmachologic effect
Beta 1 -adrenergic blocker. It has antianginal, antihypertensive and antiarrhythmic effects. Does not possess membrane stabilizing and internal sympathomimetic activity. Reduces catecholamine-stimulated formation of cAMP from ATP. In the first 24 hours after oral administration, against the background of a decrease in ejection, a reactive increase in the total peripheral vascular resistance is noted, 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, the sensitivity of baroreceptors and an effect on the central nervous system. The antihypertensive effect is manifested by both a decrease in systolic and diastolic blood pressure, a decrease in stroke and minute volumes. In medium therapeutic doses, it does not affect the tone of the peripheral arteries. The antihypertensive effect lasts 24 hours, 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 (lengthening of diastole and an improvement in myocardial perfusion) and contractility, as well as a decrease in myocardial sensitivity to sympathetic stimulation. Reduces heart rate at rest and during exercise. By increasing the end-diastolic pressure in the left ventricle and increasing the stretching of the muscle fibers of the ventricles, it can increase the demand for oxygen, especially in patients with chronic heart failure.
The antiarrhythmic effect is manifested by the suppression of sinus tachycardia and is associated with the elimination of arrhythmogenic sympathetic influences on the cardiac conduction system, 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 automatism of the sinus node, hardens the heart rate, slows down AV conduction, reduces myocardial contractility, reduces myocardial oxygen demand. Reduces myocardial excitability. When used in moderate 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 fast, incomplete (50-60%), bioavailability is 40-50%, the time to reach C max in the blood is 2-4 hours. Poorly penetrates the blood-brain barrier, passes in small amounts through the placental barrier and into breast milk. The connection with blood plasma proteins is 6-16%.
Virtually not metabolized in the liver. T 1/2 - 6-9 hours (increases in elderly patients).
It is excreted by the kidneys by glomerular filtration (85-100% unchanged).
Renal dysfunction is accompanied by lengthening T 1/2 and cumulation: with CC below 3 5 ml / min / 1.73 m 2 T 1/2 is 16-27 hours, with CC below 15 ml / min / 1.73 m - more than 27 hours (it is necessary dose reduction). It is excreted during hemodialysis.
Indications
- arterial hypertension;
- prevention of angina attacks (except for Prinzmetal's angina);
- cardiac arrhythmias: sinus tachycardia, prevention of supraventricular tachyarrhythmias, ventricular extrasystole.
Contraindications
- cardiogenic shock;
- AV blockade of II and III degree;
- 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 intake of MAO inhibitors;
- age up to 18 years (efficacy and safety have not been established);
- patients on hemodialysis;
- elderly age;
- hypersensitivity to the drug.
Carefully: diabetes mellitus, metabolic acidosis, hypoglycemia, history of allergic reactions, chronic obstructive pulmonary disease (including pulmonary emphysema), 1st degree AV block, chronic heart failure (compensated), obliterating peripheral vascular disease ("intermittent" claudication, Raynaud's syndrome), pheochromocytoma, liver failure, chronic renal failure, myasthenia gravis, thyrotoxicosis, depression (including a history), psoriasis, pregnancy, old age.
Dosage
Assign orally before meals, without chewing, drinking 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 admission are required. If the hypotensive effect is insufficient, the dose is increased to 100 mg at a time. Further dose increases are not recommended as they are not accompanied by an increase in the clinical effect.
Angina pectoris.The initial dose is 50 mg / day. If the optimal therapeutic effect is not achieved within a week, the dose is increased to 100 mg / day. Elderly patients and patients with impaired renal excretory function need to adjust the dosage regimen.
In the presence of renal failure
Have elderly patients
Side effects
The cardiovascular system:development (aggravation) 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, convulsions.
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 flushing, exacerbation of psoriasis, reversible alopecia.
Senses:blurred vision, decreased secretion of lacrimal 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 dose 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 the appointment of adsorbent drugs; if bronchospasm occurs, inhalation or intravenous administration of beta 2 -adrenomimetic is indicated. In case of violation of AV conduction, bradycardia - intravenous administration of 1-2 mg of atropine, epinephrine or setting a temporary pacemaker; with ventricular premature beats - lidocaine (class 1A drugs are not used); with a decrease in blood pressure - the patient should be in the Trendelenburg position. If there are no signs of pulmonary edema - IV, if ineffective - the introduction of epinephrine, dopamine, dobutamine; with chronic heart failure - cardiac glycosides, diuretics, glucagon; with 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) can cause mutual enhancement of the cardiodepressant effect.
The antihypertensive effect is weakened by estrogens (sodium retention) and NSAIDs, GCS.
With the simultaneous use of atenolol and cardiac glycosides, the risk of developing bradycardia and atrioventricular conduction disturbances increases.
With the simultaneous appointment of atenolol 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.
With the simultaneous administration of atenolol with derivatives of ergotamine, xanthine, its effectiveness decreases.
When the combined use of atenolol and clonidine is discontinued, clonidine treatment is continued for several more days after the discontinuation of atenolol.
Concomitant use with lidocaine can reduce its excretion and increase the risk of toxic effects of lidocaine.
The use together with phenothiazine derivatives increases the concentration of each drug in the blood serum.
When administered intravenously, phenytoin, drugs for general anesthesia (hydrocarbon derivatives) increase the severity of the cardiodepressant effect and the likelihood of lowering blood pressure.
When used together with aminophylline and theophylline, mutual suppression of therapeutic effects is possible.
Simultaneous 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 for skin tests increase the risk of severe systemic allergic reactions or anaphylaxis.
Means for inhalation anesthesia (derivatives of hydrocarbons) increase the risk of suppression of myocardial function and the development of arterial hypertension.
Amiodarone increases the risk of developing bradycardia and inhibition of AV conduction.
Cimetidine increases the concentration in the blood plasma (inhibits metabolism). Iodine-containing X-ray contrast drugs for intravenous administration increase the risk of developing anaphylactic reactions.
Prolongs the action of non-depolarizing muscle relaxants and the anticoagulant effect of coumarins.
Tri- and tetracyclic antidepressants, antipsychotic drugs (antipsychotics), ethanol, sedative and hypnotic drugs increase CNS depression.
special instructions
Monitoring 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 in patients with diabetes mellitus (once every 4-5 months). In elderly patients, it is recommended to monitor kidney function (1 time in 4-5 months).
The patient should be taught the method of calculating the heart rate and instructed on the need for medical advice if the heart rate is less than 50 beats / min. In thyrotoxicosis, atenolol can mask certain clinical signs of thyrotoxicosis (eg, tachycardia). Abrupt withdrawal in patients with thyrotoxicosis is contraindicated, since it can increase the symptoms. In diabetes mellitus, it can mask tachycardia caused by hypoglycemia. Unlike non-selective, it practically does not increase insulin-induced hypoglycemia and does not delay the restoration of blood glucose to normal concentration.
In patients with coronary artery disease, abrupt withdrawal of beta-blockers can cause an increase in the frequency or severity of anginal attacks, therefore, discontinuation of atenolol in patients with coronary artery disease should be carried out gradually.
Compared with nonselective beta-blockers, cardioselective beta-blockers have less effect on lung function, however, in obstructive airway diseases, atenolol is prescribed only in case of absolute indications. If necessary, their appointment in some cases, you can recommend the use of beta 2 -adrenomimetics.
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. Overdose is dangerous for the development of bronchospasm.
Particular attention is required in cases where surgery is required under anesthesia in patients taking atenolol. The drug should be discontinued 48 hours before the intervention. As an anesthetic, you should choose a drug with the lowest possible negative inotropic effect.
With the simultaneous use of atenolol and clonidine, the administration of atenolol is stopped a few days earlier than clonidine in order to avoid the symptom of the latter's withdrawal.
It is possible that the severity of the hypersensitivity reaction and the lack of effect from the usual doses of epinephrine against the background of a burdened allergic history are possible.
Medicines that reduce the supply of catecholamines (for example, reserpine) can enhance the effect of beta-blockers, therefore, patients taking such combinations of medicines should be under constant medical supervision to detect a pronounced decrease in blood pressure or bradycardia.
In case of the appearance in elderly patients of growing 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, 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.
With the use of atenolol, it is possible to reduce the production of tear fluid, which is important in patients using contact lenses.
It is impossible to abruptly interrupt treatment due to the risk of developing severe arrhythmias and myocardial infarction. Cancellation is carried out gradually, reducing the dose within 2 weeks. and more (reduce the dose by 25% in 3-4 days).
It should be canceled before examining the content of catecholamines, normetanephrine and vanillyl mandelic acid in the blood and urine; antinuclear antibody titers.
In smokers, the effectiveness of beta-blockers is lower.
Influence on the ability to drive vehicles and use mechanisms
During the period of treatment, it is necessary to refrain from engaging in potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.
Pregnancy and lactation
Pregnant women should be prescribed atenolol only when the benefit to the mother outweighs the potential risk to the fetus.
Atenolol is excreted in breast milk, so it should be taken only in exceptional cases and with great caution during the nursing period.
Childhood use
Contraindication: age up to 18 years (efficacy and safety have not been established).
With impaired renal function
In the presence of renal failure recommend dose adjustment depending on creatinine clearance. In patients with renal failure with CC values \u200b\u200babove 35 ml / min / 1.73 m2 (normal values \u200b\u200bare 100-150 ml / min / 1.73 m2), atenolol does not significantly accumulate. The following maximum doses are recommended for patients with renal insufficiency:
To ensure the following dosing regimen, it is possible to use Atenolol in a 25 mg tablet dosage form.
For patients on hemodialysis, Atenolol is prescribed at 25 or 50 mg / day immediately after each dialysis, which must be carried out in stationary conditions, since a decrease in blood pressure may occur.
For violations of liver function
FROM caution: liver failure.
Use in the elderly
Have elderly patients initial single dose - 25 mg (can be increased under the control of blood pressure, heart rate).
Terms of dispensing from pharmacies
The drug is available by prescription.
Storage conditions and periods
Store in a dry place out of the reach of children at a temperature not exceeding 30 ° C. The shelf life is 3 years. Do not use after the expiration date.
