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Atenolol

Last reviewed on RxList: 7/30/2020
Atenolol Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

What Is Tenormin (Atenolol)?

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 in generic form in tablets and IV.

What Are Side Effects of Tenormin (Atenolol)?

Common side effects of both preparations of Tenormin include:

  • Dizziness
  • Lightheadedness
  • Tired feeling
  • Nausea
  • Slow heart rate
  • Depression
  • Decreased sex drive
  • Impotence
  • Difficulty having an orgasm
  • Sleep problems (insomnia)
  • Anxiety
  • Nervousness
  • Mild shortness of breath

Serious side effects of Tenormin may include:

Dosage for Tenormin (Atenolol)

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.

What Drugs, Substances, or Supplements Interact with Tenormin (Atenolol)?

Use with calcium channel blockers (CCBs) may precipitate bradycardia. Tenormin may interact with allergy treatments (or if you are undergoing allergy skin-testing), amiodarone, clonidine, digoxin, disopyramide, guanabenz, MAO inhibitors, diabetes medications, heart medications, medicine for asthma or other breathing disorders, cold medicines, stimulant medicines, or diet pills. Tell your doctor all medications and supplements you use.

Tenormin (Atenolol) During Pregnancy and Breastfeeding

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.

Additional Information

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.

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Atenolol Consumer Information

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • new or worsening chest pain;
  • slow or uneven heartbeats;
  • a light-headed feeling, like you might pass out;
  • shortness of breath (even with mild exertion), swelling, rapid weight gain; or
  • a cold feeling in your hands and feet.

Common side effects may include:

  • dizziness;
  • feeling tired; or
  • depressed mood.

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.

Read the entire detailed patient monograph for Atenolol (Atenolol Tablets)

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Atenolol Professional 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.

  Volunteered
(US Studies)
Total - Volunteered and Elicited (Foreign+US Studies)
Atenolol
(n=164) %
Placebo
(n=206) %
Atenolol
(n=399) %
Placebo
(n=407) %
CARDIOVASCULAR
  Bradycardia 3 0 3 0
  Cold Extremities 0 0.5 12 5
  Postural Hypotension 2 1 4 5
  Leg Pain 0 0.5 3 1
CENTRAL NERVOUS SYSTEM/ NEUROMUSCULAR
  Dizziness 4 1 13 6
  Vertigo 2 0.5 2 0.2
   Light-headedness 1 0 3 0.7
  Tiredness 0.6 0.5 26 13
  Fatigue Lethargy 3 1 1 0 6 3 5 0.7
  Drowsiness 0.6 0 2 0.5
  Depression 0.6 0.5 12 9
  Dreaming 0 0 3 1
GASTROINTESTINAL
  Diarrhea 2 0 3 2
  Nausea 4 1 3 1
RESPIRATORY (see WARNINGS)
  Wheeziness 0 0 3 3
  Dyspnea 0.6 1 6 4

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
(n=244)
Conventional Therapy Alone
(n=233)
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.

Hematologic: Agranulocytosis.

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)

Related Resources for Atenolol

Read the Atenolol User Reviews »

© Atenolol Patient Information is supplied by Cerner Multum, Inc. and Atenolol Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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