Amlodipine + Atenolol

Amlodipine + Atenolol is a antihypertensive combination (calcium channel blocker + beta-blocker) medicine available in Bangladesh under many brand names. Below are its uses, side effects and precautions — and every brand with its current price.

• High blood pressure (hypertension) not adequately controlled by a single medicine
• Angina pectoris — effort-related chest pain
• Patients who need both a calcium channel blocker and a beta-blocker in one convenient tablet

Possible side effects include:

• Ankle or foot swelling (from amlodipine — often less than with amlodipine alone)
• Slow pulse, tiredness, weakness (from atenolol)
• Dizziness, light-headedness, headache
• Flushing, palpitations
• Cold hands and feet
• Sleep disturbance, vivid dreams
• Stomach upset, nausea
• Seek medical help for fainting, very slow pulse, marked breathlessness or severe swelling

• Monitor blood pressure and pulse regularly; keep a record for your doctor.
• Tell your doctor if you have asthma, COPD, diabetes, heart failure, liver or kidney disease, or circulation problems.
• Diabetics: the atenolol component can mask the warning signs of low blood sugar — check sugar levels more often.
• May cause dizziness or tiredness — judge your response before driving.
• Rise slowly from sitting or lying down.
• Inform your doctor or dentist before surgery or anaesthesia.
• Report ankle swelling that is severe or one-sided (one-sided swelling needs urgent assessment).

• Verapamil, diltiazem: with the beta-blocker component, risk of dangerously slow heart rate — avoid unless closely supervised
• Other blood pressure medicines: additive lowering of pressure
• Digoxin, amiodarone: further slowing of the heart
• Insulin and diabetes medicines: masked hypoglycaemia warning signs
• NSAID painkillers: may blunt the antihypertensive effect
• Simvastatin (high dose): amlodipine raises simvastatin levels — dose limits apply
• Clonidine: careful sequence needed when stopping
• Grapefruit juice (large amounts): may increase amlodipine levels

• Allergy to amlodipine, atenolol, other dihydropyridines or beta-blockers
• Very slow heart rate, sick sinus syndrome or second/third-degree heart block without a pacemaker
• Cardiogenic shock, severe low blood pressure (systolic below about 90 mmHg)
• Uncontrolled heart failure
• Severe asthma or history of severe bronchospasm
• Untreated phaeochromocytoma
• Severe aortic stenosis

Pregnancy: This combination is generally avoided in pregnancy. The atenolol component has been linked to slower growth of the baby, so doctors usually switch to pregnancy-safe alternatives such as labetalol or methyldopa. Tell your doctor immediately if you are or plan to become pregnant.

Lactation: Atenolol passes into breast milk in significant amounts and may slow the baby's heart; amlodipine also passes in small amounts. This combination is usually avoided during breastfeeding — ask your doctor for a safer option.

Store below 30°C in a cool, dry place away from light and moisture. Keep in the original pack and out of the reach of children. Do not use after the expiry date.