Indicated for:

Hypertension:

• The treatment of hypertension, to lower blood pressure. TENORMIN may be administered with other antihypertensive agents.

Angina Pectoris Due to Coronary Atherosclerosis:

• The long-term management of patients with angina pectoris.

Acute Myocardial Infarction:

• The management of hemodynamically stable patients with definite or suspected acute myocardial infarction to reduce cardiovascular mortality. Treatment can be initiated as soon as the patient’s clinical condition allows. In general, there is no basis for treating patients like those who were excluded from the ISIS-1 trial (blood pressure less than 100 mm Hg systolic, heart rate less than 50 bpm) or have other reasons to avoid beta blockade. As noted above, some subgroups (eg, elderly patients with systolic blood pressure below 120 mm Hg) seemed less likely to benefit.

Patients with coronary artery disease, who are being treated with TENORMIN (atenolol tablets), should be advised against abrupt discontinuation of therapy. Severe exacerbation of angina and the occurrence of myocardial infarction and ventricular arrhythmias have been reported in angina patients following the abrupt discontinuation of therapy with beta blockers. The last two complications may occur with or without preceding exacerbation of the angina pectoris. As with other beta blockers, when discontinuation of TENORMIN (atenolol tablets) is planned, the patients should be carefully observed and advised to limit physical activity to a minimum. If the angina worsens or acute coronary insufficiency develops, it is recommended that TENORMIN (atenolol tablets) be promptly reinstituted, at least temporarily. Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue TENORMIN (atenolol tablets) therapy abruptly even in patients treated only for hypertension.

Patients with bronchospastic disease should, in general, not receive beta blockers. Because of its relative beta₁ selectivity, however, TENORMIN (atenolol tablets) may be used with caution in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. Since beta₁ selectivity is not absolute, the lowest possible dose of TENORMIN (atenolol tablets) should be used with therapy initiated at 50 mg and a beta₂-stimulating agent (bronchodilator) should be made available. If dosage must be increased, dividing the dose should be considered in order to achieve lower peak blood levels.

TENORMIN is contraindicated in sinus bradycardia, heart block greater than first degree, cardiogenic shock, overt cardiac failure and in patients with untreated pheochromocytoma.

TENORMIN should be used with caution in diabetic patients if a beta-blocking agent is required. Beta blockers may mask tachycardia occurring with hypoglycemia, but other manifestations such as dizziness and sweating may not be significantly affected.

Beta-adrenergic blockade may mask certain clinical signs (eg, tachycardia) of hyperthyroidism. Abrupt withdrawal of beta blockade might precipitate a thyroid storm; therefore, patients suspected of developing thyrotoxicosis from whom TENORMIN therapy is to be withdrawn should be monitored closely.

Chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery, however the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures.

Bradycardia and heart block can occur and the left ventricular end diastolic pressure can rise when  beta-blockers are administered with verapamil or diltiazem. Patients with pre-existing conduction abnormalities or left ventricular dysfunction are particularly susceptible.

Catecholamine-depleting drugs (eg, reserpine) may have an additive effect when given with beta-blocking agents. Patients treated with TENORMIN plus a catecholamine depletor should therefore be closely observed for evidence of hypotension and/or marked bradycardia which may produce vertigo, syncope, or postural hypotension.

Calcium channel blockers may also have an additive effect when given with TENORMIN.

Disopyramide is a Type I antiarrhythmic drug with potent negative inotropic and chronotropic effects. Disopyramide has been associated with severe bradycardia, asystole and heart failure when administered with beta blockers.

Amiodarone is an antiarrhythmic agent with negative chronotropic properties that may be additive to those seen with beta blockers.

Beta blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine. If the two drugs are coadministered, the beta blocker should be withdrawn several days before the gradual withdrawal of clonidine. If replacing clonidine by beta-blocker therapy, the introduction of beta blockers should be delayed for several days after clonidine administration has stopped.

Concomitant use of prostaglandin synthase inhibiting drugs, eg, indomethacin, may decrease the hypotensive effects of beta blockers.

Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.

Atenolol can cause fetal harm when administered to a pregnant woman. Atenolol crosses the placental barrier and appears in cord blood. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.

Neonates born to mothers who are receiving TENORMIN at parturition or breast-feeding may be at risk for hypoglycemia and bradycardia.

GoToSource

• Use in patients under the age of 18. GoToSource

• Dosage greater than 100 mg per day for hypertension. GoToSource

• Dosage greater than 200 mg per day for angina pectoris. GoToSource

• Marfan syndrome. GoToSource 

• Vasovagal syncope. GoToSource 

• Migraine prevention. GoToSource 

• Refractory hemoptysis in cystic fibrosis. GoToSource 

• Perioperative management of thyroid surgery. GoToSource 

• Lithium-induced tremor. GoToSource 

• Alcohol withdrawal syndrome. GoToSource

Dialysis patients taking beta blockers (including Atenolol) linked with a 1.4 increased risk of dying within 180 days. GoToSource 

Increased risk of stroke in elderly patients. GoToSource 

Fetal injury and death. GoToSource 

Acute respiratory distress syndrome. GoToSource 

Hypotension (low blood pressure). GoToSource

Bradycardia (slow heart rate). GoToSource

Memory loss, constipation, heart failure, syncope (temporary loss of consciousness), visual impairment, alopecia (hair loss), dry mouth, liver injury, psychosis, skin reactions and thrombocytopenia (low blood platelet count). GoToSource

Weight gain, bronchospasm, fatigue, sexual dysfunction, severe depression, nightmares, insomnia, exacerbation of peripheral vascular disease and increased incidence of diabetes. GoToSource

No major injury lawsuits reported.