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Atenolol Side Effects Center
Medical Editor: Charles Patrick Davis, MD, PhD
Tenormin (atenolol) (and Tenormin IV) is a beta-blocker used mainly for control of hypertension, angina, for management of acute myocardial infarction and occasionally for thyroid storm management. Tenormin is available as generic atenolol in tablets and IV. Side effects of Tenormin may include dizziness, tired feeling, slow heart rate, depression, decreased sex drive, impotence, difficulty having an orgasm, sleep problems (insomnia), anxiety, nervousness, and mild shortness of breath for both preparations. Patients with bronchospastic disease, in general, should not take Tenormin or other beta-blockers.
Tenormin is available in 25, 50 and 100 mg strength tablets; it is also available vials of 5 mg atenolol in ten ml of citrate-buffered solution for intravenous injection. The IV preparation should only be administered by trained personnel. The usual dose for tablets begins at 25 mg once or twice per day and is modified by patient response to the medication. The following information applies to both the tablet and IV forms of atenolol. Serious side effects of Tenormin may include heart arrhythmias, hypotension, pulmonary emboli, chest pain, and bronchospasm. Use with calcium channel blockers (CCBs) may precipitate bradycardia. This medication should be used during pregnancy only when clearly needed. It may harm an unborn baby. This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult the doctor before breastfeeding. Women taking Tenormin should discuss the risks and benefits with their doctor. Safety and effectiveness has not been established in pediatric patients.
Our Tenormin Side Effects Drug Center provide a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What is Patient Information in Detail?
Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.
Atenolol in Detail - Patient Information: Side Effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:
- slow or uneven heartbeats;
- feeling light-headed, fainting;
- feeling short of breath, even with mild exertion;
- swelling of your ankles or feet;
- nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
- depression; or
- cold feeling in your hands and feet.
Less serious side effects may include:
- decreased sex drive, impotence, or difficulty having an orgasm;
- sleep problems (insomnia);
- tired feeling; or
- anxiety, nervousness.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Read the entire detailed patient monograph for Atenolol (Atenolol Tablets)
What is Patient Information Overview?
A concise overview of the drug for the patient or caregiver from First DataBank.
Atenolol Overview - Patient Information: Side Effects
Dizziness, lightheadedness, tiredness, and nausea may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if any of these unlikely but serious side effects occur: very slow heartbeat, severe dizziness, fainting, trouble breathing, blue fingers/toes, mental/mood changes (such as confusion, mood swings, depression).
Although this medication may be used to treat heart failure, some people may rarely develop new or worsening symptoms of heart failure. Tell your doctor right away if you experience any of these unlikely but serious side effects: swelling ankles/feet, severe tiredness, shortness of breath, unexplained/sudden weight gain.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Read the entire patient information overview for Atenolol (Atenolol Tablets)
What is Prescribing information?
The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.
Atenolol FDA Prescribing Information: Side Effects
Most adverse effects have been mild and transient.
The frequency estimates in the following table were derived from controlled studies in hypertensive patients in which adverse reactions were either volunteered by the patient (US studies) or elicited, eg, by checklist (foreign studies). The reported frequency of elicited adverse effects was higher for both TENORMIN and placebo-treated patients than when these reactions were volunteered. Where frequency of adverse effects of TENORMIN and placebo is similar, causal relationship to TENORMIN is uncertain.
|Total - Volunteered and Elicited (Foreign+US Studies)|
|CENTRAL NERVOUS SYSTEM/ NEUROMUSCULAR|
|Fatigue Lethargy||3 1||1 0||6 3||5 0.7|
|RESPIRATORY (see WARNINGS)|
Acute Myocardial Infarction
In a series of investigations in the treatment of acute myocardial infarction, bradycardia and hypotension occurred more commonly, as expected for any beta blocker, in atenololtreated patients than in control patients. However, these usually responded to atropine and/or to withholding further dosage of atenolol. The incidence of heart failure was not increased by atenolol. Inotropic agents were infrequently used. The reported frequency of these and other events occurring during these investigations is given in the following table. In a study of 477 patients, the following adverse events were reported during either intravenous and/or oral atenolol administration:
|Conventional Therapy Plus Atenolol
|Conventional Therapy Alone
|Bradycardia||43 (18%)||24 (10%)|
|Hypotension||60 (25%)||34 (15%)|
|Bronchospasm||3 (1.2%)||2 (0.9%)|
|Heart Failure||46 (19%)||56 (24%)|
|Heart Block||11 (4.5%)||10 (4.3%)|
|BBB + Major|
|Axis Deviation||16 (6.6%)||28 (12%)|
|Supraventricular Tachycardia||28 (11.5%)||45 (19%)|
|Atrial Fibrillation||12 (5%)||29 (11%)|
|Atrial Flutter||4 (1.6%)||7 (3%)|
|Ventricular Tachycardia||39 (16%)||52 (22%)|
|Cardiac Reinfarction||0 (0%)||6 (2.6%)|
|Total Cardiac Arrests||4 (1.6%)||16 (6.9%)|
|Nonfatal Cardiac Arrests||4 (1.6%)||12 (5.1%)|
|Deaths||7 (2.9%)||16 (6.9%)|
|Cardiogenic Shock||1 (0.4%)||4 (1.7%)|
|Development of Ventricular|
|Septal Defect||0 (0%)||2 (0.9%)|
|Development of Mitral|
|Regurgitation||0 (0%)||2 (0.9%)|
|Renal Failure||1 (0.4%)||0 (0%)|
|Pulmonary Emboli||3 (1.2%)||0 (0%)|
In the subsequent International Study of Infarct Survival (ISIS-1) including over 16,000 patients of whom 8,037 were randomized to receive TENORMIN treatment, the dosage of intravenous and subsequent oral TENORMIN was either discontinued or reduced for the following reasons:
|Reasons for Reduced Dosage|
|IV Atenolol Reduced Dose ( < 5 mg)*||Oral Partial Dose|
|Hypotension/Bradycardia||105 (1.3%)||1168 (14.5%)|
|Cardiogenic Shock||4 (.04%)||35 (.44%)|
|Reinfarction||0 (0%)||5 (.06%)|
|Cardiac Arrest||5 (.06%)||28 (.34%)|
|Heart Block ( > first degree)||5 (.06%)||143 (1.7%)|
|Cardiac Failure||1 (.01%)||233 (2.9%)|
|Arrhythmias||3 (.04%)||22 (.27%)|
|Bronchospasm||1 (.01%)||50 (.62%)|
|*Full dosage was 10 mg and some patients received less than 10 mg but more than 5 mg.|
During postmarketing experience with TENORMIN, the following have been reported in temporal relationship to the use of the drug: elevated liver enzymes and/or bilirubin, hallucinations, headache, impotence, Peyronie's disease, postural hypotension which may be associated with syncope, psoriasiform rash or exacerbation of psoriasis, psychoses, purpura, reversible alopecia, thrombocytopenia, visual disturbance, sick sinus syndrome, and dry mouth. TENORMIN, like other beta blockers, has been associated with the development of antinuclear antibodies (ANA), lupus syndrome, and Raynaud's phenomenon.
Potential Adverse Effects
In addition, a variety of adverse effects have been reported with other beta-adrenergic blocking agents, and may be considered potential adverse effects of TENORMIN.
Allergic: Fever, combined with aching and sore throat, laryngospasm, and respiratory distress.
Central Nervous System: Reversible mental depression progressing to catatonia; an acute reversible syndrome characterized by disorientation of time and place; short-term memory loss; emotional lability with slightly clouded sensorium; and, decreased performance on neuropsychometrics.
Gastrointestinal: Mesenteric arterial thrombosis, ischemic colitis.
Other: Erythematous rash.
Miscellaneous: There have been reports of skin rashes and/or dry eyes associated with the use of beta-adrenergic blocking drugs. The reported incidence is small, and in most cases, the symptoms have cleared when treatment was withdrawn. Discontinuance of the drug should be considered if any such reaction is not otherwise explicable. Patients should be closely monitored following cessation of therapy. (See DOSAGE AND ADMINISTRATION.)
The oculomucocutaneous syndrome associated with the beta blocker practolol has not been reported with TENORMIN. Furthermore, a number of patients who had previously demonstrated established practolol reactions were transferred to TENORMIN therapy with subsequent resolution or quiescence of the reaction.
Read the entire FDA prescribing information for Atenolol (Atenolol Tablets)
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Report Problems to the Food and Drug Administration
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