Atenolol is typically prescribed for the treatment of hypertension and angina pectoris, with the usual starting dose for adults being 25 mg to 50 mg taken orally once daily. Based on the patient's response and tolerability, the dose may be gradually increased up to a maximum of 100 mg per day for hypertension.

For angina pectoris, the typical starting dose is often 50 mg taken orally once daily, which can also be adjusted to a maximum of 100 mg as needed.

If you miss a dose of atenolol and remember it within a few hours, take it as soon as you remember. However, if it is nearly time for your next scheduled dose, you should skip the missed dose and continue with your regular regimen, without taking a double dose to compensate for the missed one.

To maintain the effectiveness of atenolol, it's important to take it consistently at the same time each day. If you miss multiple doses or have questions about missed doses, you should consult your healthcare provider for further advice. Following these instructions will help ensure effective management of hypertension and angina with atenolol.

Always use this medication exactly as your clinician has told you. Check with our clinical team or your GP or pharmacist if you are not sure.

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Atenolol is a selective beta-1 adrenergic blocker commonly used to manage hypertension and angina pectoris. While it is generally well-tolerated, it can have various side effects. Here is a detailed overview of the potential side effects associated with atenolol, excluding allergic reactions:

Common Side Effects

1. Fatigue: Patients may experience a general sense of tiredness or a lack of energy while taking atenolol.

2. Dizziness or Lightheadedness: Some individuals may feel dizzy, especially when moving from a sitting or lying position to standing (orthostatic hypotension).

3. Bradycardia: Atenolol can cause a slowed heart rate, which might lead to feelings of fatigue or faintness.

4. Cold Extremities: Patients may notice cold hands and feet due to reduced peripheral circulation.

5. Nausea: Gastrointestinal disturbances may occur, including feelings of nausea or upset stomach.

Less Common Side Effects

1. Depression: Some patients have reported feelings of depression or mood changes while on atenolol treatment.

2. Sleep Disturbances: Insomnia or vivid dreams may occur in some individuals taking the medication.

3. Impotence: Sexual dysfunction, including difficulties achieving or maintaining an erection, may affect some men taking atenolol.

4. Shortness of Breath: Although uncommon, some individuals may experience respiratory issues, particularly those with underlying respiratory conditions like asthma.

Rare Side Effects

1. Heart Block: Atenolol can lead to varying degrees of heart block, which can affect the heart's electrical conduction system and potentially be life-threatening.

2. Hypotension: Abnormally low blood pressure may occur, particularly when starting treatment or after dosage increases.

3. Liver Function Changes: In rare cases, liver function may be affected, leading to elevated liver enzymes.

4. Raynaud’s Phenomenon: Atenolol can exacerbate conditions like Raynaud’s phenomenon, leading to reduced blood flow to the fingers and toes, causing color changes and discomfort.

Important Considerations

Withdrawal Symptoms: Abrupt discontinuation of atenolol can result in a rebound increase in heart rate and blood pressure, which is why it should be tapered off under medical supervision.

Monitoring: Regular follow-up appointments are essential to monitor heart rate, blood pressure, and potential side effects, particularly when the dosage is adjusted.

For full information on side effects and correct use, see the patient information leaflet. If any side effects concern you, or you are experiencing any of the side effects mentioned in the patient information leaflet whilst taking this medication, please contact our clinical team or speak to your GP.

Cautions

1. Cardiovascular Conditions: Atenolol should be used with caution in patients with a history of heart block, bradycardia, or severe heart failure, as it may exacerbate these conditions. Patients with ischemic heart disease should also be monitored closely, especially during dose adjustments.

2. Respiratory Conditions: Individuals with asthma or chronic obstructive pulmonary disease (COPD) should use atenolol cautiously, as beta-blockers can potentially cause bronchoconstriction, particularly non-selective beta-blockers, although atenolol is selective for beta-1 receptors.

3. Diabetes: Atenolol may mask the symptoms of hypoglycemia (low blood sugar) in diabetic patients, such as rapid heartbeat and tremors, which can delay recognition and treatment of low blood sugar episodes.

4. Hypotension: Patients with a history of low blood pressure or those taking other antihypertensives should be started on atenolol cautiously to prevent further lowering of blood pressure.

5. Renal Impairment: Atenolol is primarily excreted by the kidneys, so caution should be exercised in patients with renal impairment, as dosage adjustments may be necessary to avoid accumulation and toxicity.

6. Withdrawal Symptoms: Sudden discontinuation of atenolol can lead to rebound hypertension or angina. To prevent this, atenolol should be tapered slowly under the supervision of a healthcare provider if discontinuation is necessary.

Warnings

1. Pregnancy and Lactation: Atenolol is classified as a pregnancy category D medication. It should be used during pregnancy only if the benefits outweigh the risks, as it may cause fetal harm. Patients should consult their healthcare provider if they are pregnant, plan to become pregnant, or are breastfeeding.

2. Bradycardia: Atenolol can cause symptomatic bradycardia (slow heart rate), which may require discontinuation of the medication or dosage adjustment if significant.

3. Mental Health Conditions: Atenolol may cause or exacerbate symptoms of depression or anxiety in some patients; monitoring and evaluation are recommended in patients with a history of mental health disorders.

4. Interactions with Other Medications: Atenolol may interact with other medications, including other antihypertensives, certain anti-arrhythmics, and nonsteroidal anti-inflammatory drugs (NSAIDs). Patients should inform their healthcare provider about all medications they are taking.

Get emergency medical help if you have signs of an allergic reaction to this medication. These include:

• Hives
• Dizziness
• Fast or pounding heartbeats
• Wheezing
• Difficult breathing
• Swelling of your face, lips, tongue, or throat.

It is important that you let us know which prescription, over-the-counter medicines and recreational drugs you are currently taking. You must also tell us about any other medical conditions that you currently have (or had in the past). This will help us ensure the prescribed medication is safe and appropriate for you to take.

For full information on warnings, medication interactions and contraindications, refer to the Patient Information Leaflet. Please read all packaging and the Patient Information Leaflet before taking any new medicine and inform our clinical team or your GP of medicines you are taking or intend to take.