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atenololol
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atenololol

Cardioselective beta blockers – will be excreted unchanged over the kidneys.

Prescription required
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What is atenololol?

Atenolol is a cardioselective beta-1 blocker that has been used in high-pressure therapy since the 1970s. A special feature is that atenolol is hardly degraded via the liver, but is excreted almost unchanged via the kidneys.

Atenolol is used in high blood pressure, angina pectoris and certain cardiac arrhythmias. In recent years it has been more rarely prescribed than bisoprolol or metoprolol, as recent studies showed a somewhat lower protective effect against stroke. However, it still has its place in therapy, especially in patients with liver diseases.

Active Ingredients & Mechanism of Action

Active ingredient: Atenolol

Atenolol selectively blocks the beta-1 receptors:

Active mechanism:

  • Cardioselective Beta-1 blockade
  • Lowers heart rate and heart rate
  • Inhibits renin release
  • No intrinsic sympathomimetic activity (ISA)

Pharmacokinetic characteristics:

  • Hydrophilic beta blocker (water soluble)
  • Low passage of the blood-brain barrier
  • Less central side effects (sleep disorders, nightmares)
  • No liver metabolisation – renal elimination
  • half-life: 6-9 hours

Activity: The blood pressure-lowering effect lasts about 24 hours, although the half-life is shorter. Once daily intake is sufficient for most patients.

Who is it suitable for?

Atenolol is suitable for:

  • Adults with high blood pressure
  • Angina pectoris
  • Heart rhythm disorders (tachyarrhythmia)

Especially suitable for:

  • Liver disease (no hepatic metabolization)
  • Patients with sleep disorders among other beta blockers
  • If less CNS side effects are desired

Not suitable:

  • Heavy asthma bronchiale
  • AV block II/III. Grades
  • Heavy bradycardia
  • Decompensated heart failure
  • Heavy kidney failure (dose adjustment required)
  • phenochromocytoma (untreated)

Available Dosages

High blood pressure:

  • start dose: 50 mg once a day
  • usual dose: 50-100 mg once a day
  • Maximum dose: 100 mg daily

Angina pectoris:

  • 50-100 mg once a day

For renal insufficiency:

  • GFR 15-35 ml/min: 50 mg daily or 100 mg each second day
  • GFR under 15 ml/min: 25-50 mg daily

Available starches:

  • 25 mg, 50 mg, 100 mg tablets

How to Take

Intake:

  • Once a day, preferably morning
  • Take before meals
  • Suck with sufficient water
  • Always at the same time

**

  • Do not drop abruptly (slips over 1-2 weeks)
  • Regular blood pressure and pulse control
  • In case of renal insufficiency
  • Informing anaesthesia before operations

For forgotten dose:

  • Over a few hours
  • Otherwise next dose at the usual time
  • Never take double dose

Contraindications

**Atenolol may not be taken at:* *

  • hypersensitivity to atenolol
  • AV block II/III. Grades
  • Sick sine syndrome
  • Heavy bradycardia (under 50/min)
  • Heavy hypotension
  • Cardiogenic shock
  • Untreated phenochromocytoma
  • Heavy asthma bronchiale
  • Metabolic aziosis

Preview at:

  • Kidney insufficiency (dose adjustment)
  • Diabetes mellitus
  • Peripheral blood circulation disorders
  • Myasthenia gravis
  • Psoriasis

pregnant: Only with strict indication. Can lead to growth delay and neonatal bradycardia.

Possible Side Effects

Acid (1-10%):

  • fatigue
  • Cold extremities
  • Bradykardie
  • Gastrointestinal complaints
  • Squeeze

** Occasionally (0,1-1%):* *

  • Sleep disorders (similar to lipophilic beta blockers)
  • Potency disorders
  • Muscle weaknesses
  • Skin rash
  • Dry eyes

Selten:

  • Bronchospasmus
  • Depressive detunement
  • liver value increases
  • Deterioration of Psoriasis

Advantage: As a hydrophilic beta blocker, Atenolol causes fewer nightmares and sleep disorders than lipophilic beta blockers (Metoprolol, Propranolol), as it passes the blood-brain barrier worse.

Interactions

Contraint with: Verapamil or Diltiazem i.v.

Preview at:

  • calcium antagonists (Verapamil, Diltiazem) orally → reinforced bradycardia
  • Antiarrhythmic → additive cardioid pressing effect
  • Clonidine → Rebound hypertension while simultaneously setting
  • Digitalis preparations → reinforced bradycardia
  • NSAR → reduced blood pressure reduction
  • anesthetic → enhanced heart action

** Since atenolol is not degraded via the liver, there are fewer pharmacokinetic interactions via CYP enzymes than with metoprolol.

Frequently Asked Questions

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Is atenololol right for you?

A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.

Important Notice

This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor or pharmacist.

Important Safety Information

This service operates under German pharmaceutical law (HWG). For risks and side effects, read the package leaflet and consult your doctor or pharmacist. All medications are dispensed from a licensed pharmacy in Germany.