Atenolol

Atenolol is a beta-blocker (cardioselective) medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• High blood pressure (hypertension) — alone or with other medicines
• Angina pectoris — to prevent effort-related chest pain
• Cardiac arrhythmias — to control fast or irregular heartbeats
• After a heart attack — to reduce the risk of further events
• Sometimes used for migraine prevention (doctor's decision)

Your doctor will decide the dose of Atenolol based on your condition, pulse rate and blood pressure, and will adjust it gradually if needed.

• Take it once daily (or as prescribed) at the same time each day, with or without food.
• Check your pulse regularly — if it falls below about 50–55 beats per minute or you feel very dizzy, inform your doctor before the next dose.
• If you miss a dose, take it when you remember unless the next one is near; never double the dose.

Never stop Atenolol suddenly or on your own — abrupt stopping can trigger rebound high blood pressure, severe chest pain or even a heart attack. Your doctor will taper it slowly if it ever needs to be stopped, and this is a long-term medicine even when you feel completely well.

Possible side effects of atenolol include:

• Slow pulse (bradycardia), tiredness, weakness
• Cold hands and feet
• Dizziness, especially on standing
• Sleep disturbance, vivid dreams, low mood
• Stomach upset, nausea
• Worsening of breathing in asthma/COPD patients (wheeze)
• Erectile difficulty in some men
• See a doctor promptly for very slow pulse, fainting, severe breathlessness or swelling of the ankles

• Check your pulse and blood pressure regularly; keep a record for your doctor.
• Tell your doctor if you have asthma, COPD, diabetes, thyroid disease, kidney disease or circulation problems.
• Diabetics beware: atenolol can mask the warning signs of low blood sugar (fast heartbeat, tremor) — monitor sugar levels carefully.
• May cause tiredness or dizziness — assess your response before driving.
• Inform your doctor or dentist before any surgery or anaesthesia.
• In kidney disease the dose may need to be reduced.

• Verapamil, diltiazem (calcium channel blockers): can dangerously slow the heart — combination needs close supervision
• Other blood pressure medicines: additive lowering of pressure and pulse
• Digoxin, amiodarone: further slowing of heart rate
• Insulin and diabetes medicines: hypoglycaemia symptoms may be masked
• NSAID painkillers (ibuprofen, diclofenac): may reduce the blood-pressure effect
• Clonidine: special care needed when stopping either medicine
• Salbutamol and asthma inhalers: beta-blockers may oppose their effect

• Allergy to atenolol or other beta-blockers
• Very slow heart rate (severe bradycardia) or certain heart blocks (second/third degree) without a pacemaker
• Cardiogenic shock or uncontrolled, severe heart failure
• Severe peripheral circulation disorders
• Untreated phaeochromocytoma
• Severe asthma or history of severe bronchospasm (use only if doctor judges essential)

Pregnancy: Atenolol is generally avoided in pregnancy, especially in early pregnancy, as it has been linked to slower growth of the baby. If you are pregnant or planning pregnancy, your doctor will usually switch you to a safer alternative such as labetalol or methyldopa.

Lactation: Atenolol passes into breast milk in significant amounts and can slow the baby's heart rate. It is usually avoided while breastfeeding; consult your doctor for a safer choice.

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