Indications
Treatment of hypertension, chronic stable angina pectoris, supraventricular tachy-arrhythmia, for early intervention in the acute phase of myocardial infarction and long-term treatment to prevent following acute myocardial infarction.
Contraindications
Metabolic acidosis.
Hypotension.
Severe peripheral arterial circulatory disturbances.
Severe asthma.
Severe chronic obstructive pulmonary disorders.
Untreated phaeochromocytoma.
Sinus bradycardia (< 50 bpm before treatment initiation), AV block greater than first degree, cardiogenic shock, known hypersensitivity to any component of the drug formulations and overt or decompensated cardiac failure.
Concomitant therapy with verapamil.
Compositon/Ingredients
Atenolol 50mg
Dosage and administration
Hypertension: The initial dosage is 25 – 50 mg once daily. The full hypotensive effect may be seen after 1 to 2 weeks. Oral dosage may be increased to 100 mg once daily for optimum response.
Angina pectoris: The initial dosage is 50 mg once daily. If an optimum response is not achieved within one week, oral dosage should be increased to 100 mg once daily.
Cardiac arrhythmias: Following control with intravenous atenolol, a suitable oral maintenance dosage is 50 – 100 mg daily, given as a single dose.
Early management of acute myocardial infarction:
Patients tolerating the total IV dose of 10 mg can receive 50 mg orally 10 minutes later and then 50 mg orally 12 hours later. Dosing is continued orally for 6 – 9 days at 100 mg daily given as a single daily dose or in 2 equally divided doses.
If bradycardia and/or hypotension requiring treatment, or any other untoward effects occur, atenolol should be discontinued.
Patients with renal insufficiency:
The dose of atenolol should be reduced in patients with renal impairment, depending on the creatinine clearance (CC) as follows:
CC 15 – 35 ml/minute per 1.73 m2: A maximum dosage of 50 mg daily is recommended.
CC less than 15 ml/minute per 1.73 m2: 25 mg daily or 50 mg every other day.
Dialysis patients: 25 – 50 mg orally after each dialysis.
Precaution
Beta-receptor blocking drugs should not be withdrawn abruptly.
Particularly careful medical monitoring is necessary in:
Patients with asthma or a history of obstructive airways disease.
Diabetics with highly unstable blood glucose concentrations.
Patients following an absolute diet for prolonged periods of time and those subject to great physical exertion.
Patients with pheochromocytoma (tumour of the adrenal medulla; prior alpha-blocker therapy is indicated).
Patients with impaired kidney function
Only use if clearly needed in patients with a history of severe hypersensitivity reactions and those receiving specific hyposensitisation therapies (because of the risk of exaggerated anaphylactic reactions); patients with a history or family history of psoriasis.
The application of atenolol could cause positive results in doping tests.
Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
The use of atenolol in women who are, or may become, pregnant requires that the anticipated benefit be weighed against the possible risks, particularly in the first and second trimesters. Atenolol is not recommended in nursing mother.
Patients should be aware of how they react to drug before driving or operating machinery.
Storage
Store at temperature below 30°C, protect from light.
