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CARDIOVASCULAR SYSTEM › BETA BLOCKING AGENTS › BETA BLOCKING AGENTS › Beta blocking agents, selective
atenolol
C07AB03
Forms & Strengths
- Oral Tablet: 25 mg
- Oral Tablet: 50 mg
- Oral Tablet: 100 mg
- Intravenous Injection: 5 mg/10 mL
Adult Dosing
- Hypertension: 50 mg orally once daily, may increase to 100 mg once daily after 1 to 2 weeks.
- Angina Pectoris: 50 mg orally once daily, may increase to 100 mg (sometimes 200 mg) once daily.
- Acute Myocardial Infarction: 5 mg IV over 5 minutes, followed by another 5 mg IV 10 minutes later; then 50 mg orally 15 minutes after the second IV dose, followed by 50 mg orally 12 hours later, then 100 mg orally daily for 6-9 days.
Pediatric Dosing
- Hypertension (Children > 6 years): 0.5 to 1 mg/kg orally once daily, titrated up to a maximum of 2 mg/kg/day (not to exceed 100 mg/day).
Indications
- Management of hypertension
- Management of angina pectoris
- Reduction of mortality in suspected or definite acute myocardial infarction in hemodynamically stable patients
Mechanism of Action
- Cardioselective beta-1 adrenergic receptor blocker.
- Decreases heart rate, cardiac output, and blood pressure.
- Decreases myocardial oxygen demand.
- Inhibits renin release via beta-1 receptors in the juxtaglomerular apparatus.
Contraindications
- Sinus bradycardia
- Second- and third-degree atrioventricular (AV) block
- Cardiogenic shock
- Decompensated heart failure
- Severe peripheral arterial circulatory disorders
- Hypersensitivity to atenolol or any component of the formulation
Adverse Reactions
- Bradycardia
- Hypotension
- Fatigue and lethargy
- Dizziness
- Cold extremities
- Nausea and diarrhea
- Bronchospasm (at higher doses due to loss of cardioselectivity)
- Depression
Drug Interactions
- Calcium channel blockers (verapamil, diltiazem): Increased risk of bradycardia, AV block, and heart failure.
- Digitalis glycosides: Enhanced slowing of AV conduction and bradycardia.
- Catecholamine-depleting drugs (reserpine): Additive hypotensive and bradycardic effects.
- Clonidine: Risk of rebound hypertension; withdraw beta-blocker several days before gradual withdrawal of clonidine.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): May decrease the antihypertensive effect of atenolol.
Curated Content: Needs Vetting Before Put to Clinical Use