The drug Atenolol: indications for use and important recommendations regarding treatment. Atenolol: instructions for use Atenolol lethal dose

Atenolol is a "core" drug. Available in tablets. The drug has a cardioselective effect on beta-adrenergic receptors, while no sympathomimetic activity is observed. Most often, the drug is prescribed to reduce systolic or diastolic pressure. However, there are other diseases in which Atenolol is indicated.

Atenolol is characterized by antiarimic, antianginal and hypotensive effects. Lowering blood pressure is achieved by influencing nerve impulses (the sensitivity of baroreceptors on the aortic flexure is impaired, the activity of the hormonal regulator of blood pressure is inhibited, and the minute volume of blood circulation is reduced).

The decrease in heart rate occurs due to the fact that the muscle cells of the heart require less oxygen. The heart rate is normalized due to the elimination of the following number of factors that affect the formation of extraordinary impulse signals:

- high blood pressure;
- the number of ATP molecules that produce signals for adrenaline and glucagon;
- activation of the sympathetic nervous system (this part of the autonomic nervous system is responsible for the excitation of cardiac activity);
- pathological tachycardia.

The drug has practically no effect on the smooth muscles of the bronchi. It also does not disturb carbohydrate metabolism and does not provoke a change in the function of tissues and organs containing beta2-adrenergic receptors (pancreas, striated muscle tissue, uterus).

What helps Atenolol? – testimony

Instructions for use Atenolol indicates that the drug should be prescribed for the following pathological conditions and diseases:

• hypertensive crisis - a serious condition caused by an excessive increase in blood pressure;
• a stable increase in blood pressure above 140 to 90 (arterial hypertension);
• pain in the region of the heart due to acute insufficiency of blood supply to the myocardium;
• damage to the heart muscle (functional or organic) caused by impaired blood supply to the myocardium;
• heart neurosis - a violation of the cardiovascular system associated with a dysfunction of neuroendocrine regulation;
• hyperkinetic cardiac syndrome - a kind of vegetative-vascular dystonia, manifested by high pulse pressure and involuntary muscle tremor;
• Minor's disease - trembling of the hands, facial muscles, voice, eyelids or tongue;
• agitation is a strong psycho-emotional arousal, turning into motor restlessness, often uncontrolled.

Atenolol is also prescribed for the prevention of diseases such as myocardial infarction, arrhythmias of various origins, including those associated with atrial flutter or fibrillation.

Instructions for use Atenolol, dosage

Tablets are taken per os (inside), washed down with water. With high blood pressure, the dosage is prescribed with Atenolol 25 mg per day, if the clinical symptoms have not decreased, then after a week the amount is increased to 50 mg.

In general, the average daily allowable dosage is Atenolol 100 mg.

The amount of the drug, depending on the pathology:

For the treatment of the tachysitolic form of atrial fibrillation, as well as coronary disease, it is recommended to take one 50 mg tablet once a day;
in acute myocardial infarction, when the patient has already received urgent therapeutic measures, 50 mg tablets are prescribed, then after 12 hours the dose of Atenolol is repeated.

With hyperkinetic cardiac syndrome, Atenolol 25 mg is prescribed.

Tablets should be taken once a day, preferably at the same time. The daily dose should not exceed 200 mg, otherwise overdose symptoms may occur.

Atenolol is canceled gradually, in order to avoid the "rebound syndrome" - every 3-4 days the amount is reduced by 25%.

Atenolol contraindications, side effects

• severe palpitations (bradycardia);
• antroventricular blockade (second or third stage);
• acute left ventricular failure;
• decompensated heart failure;
• acute decrease in cardiac function;
• sinoatrial blockade;
• spontaneous angina, in which there is a spasm of blood vessels that feed the heart muscle;
• an increase in heart parameters (size and mass), in medicine called cardiomegaly.

Also, the medication is prohibited for women who are carrying a child or breastfeeding. Drugs that inhibit monoamine oxidase are not compatible with Atenolol, so the patient must be sure to inform the doctor about the use of antidepressants.

Under close medical supervision, tablets are prescribed for people suffering from diabetes mellitus, pheochromocytoma, bronchial asthma, thyrotoxicosis, and renal failure. There are also age recommendations - for children and the elderly, the initial dosage of the drug is prescribed in microdoses.
With improper use of Atenolol, an overdose may occur, manifested by symptoms:

• violation of bronchial patency due to spasm of the airways;
• cyanosis (blue) of the nail plates and nasolabial triangle;
• change in heart rate;
• lowering blood pressure;
• short-term loss of consciousness and dizziness;
• decrease in heart rate.

The above conditions can threaten the life of the patient, therefore, if any symptom occurs while taking Atenolol, you should immediately call for emergency care!

Instructions for use:

pharmachologic effect

Atenolol blocks nerve impulses, which leads to a decrease in the frequency and strength of heart contractions. Atenolol has antihypertensive (reduces blood pressure), antianginal (eliminates symptoms of myocardial ischemia) and antiarrhythmic (eliminates heart rhythm disturbances) action.

During the first days after oral administration of Atenolol, a reactive increase in total peripheral vascular resistance is observed against the background of a decrease in cardiac output. The severity of this action within 1-3 days begins to decline. The hypotensive effect of Atenolol is manifested in the form of a decrease in minute and stroke volume, a decrease in systolic (highest) and diastolic (lowest) blood pressure.

Reviews of Atenolol indicate that the hypotensive effect of the drug lasts 24 hours, and in the case of regular use by the end of the second week, the results stabilize. The antianginal effect of Atenolol is aimed at reducing myocardial oxygen demand by reducing the number of heart contractions. Clinical studies and reviews of Atenolol confirm that the drug reduces mortality among patients who have had myocardial infarction by reducing the frequency of angina attacks and ventricular arrhythmias.

About 50% of the drug dose is absorbed from the gastrointestinal tract after oral administration of Atenolol. Binding to blood proteins - 6-16%. The therapeutic effect of Atenolol can be observed 2-4 hours after oral administration, this effect lasts for about a day. It is practically not metabolized in the liver. Atenolol is excreted by the kidneys and during hemodialysis. In breast milk, through the placental and blood-brain barriers, the drug penetrates in small quantities.

Indications for the use of Atenolol

The appointment of the drug is advisable for:

• ischemic heart disease;
• hypertension and arterial hypertension;
• unstable angina, rest angina, exertional angina;
• hyperkinetic cardiac syndrome, decreased muscle tone at the mitral valve;
• neurocirculatory disorders with hypertensive complications;
• essential tremor, senile tremor, and withdrawal tremor.

According to the instructions, Atenolol can be used for the prevention and treatment of diseases such as:

• myocardial infarction;
• arrhythmias of various etiologies;
• paroxysmal atrial tachycardia, sinus tachycardia, supraventricular and ventricular extrasystoles;
• atrial flutter.

Positive reviews about Atenolol confirm its effectiveness in the complex treatment of hypertrophic obstructive cardiomyopathy and thyrotoxicosis.

Dosage and administration

The drug should be taken before meals, without chewing or crushing, drinking water. The instructions for Atenolol indicate the following recommendations: the initial dose for angina pectoris is 50 mg, the maximum daily dose is 200 mg, the daily maintenance dose is 25 mg once a day. A more complete and detailed dosing regimen is determined by the attending physician individually for each patient.

Side effects

In reviews of Atenolol, side effects are rarely mentioned, but it should be borne in mind that the body may respond to the use of the drug as follows:

• memory impairment, decreased concentration, increased fatigue, weakness, dizziness;
• depression, hallucinations, anxiety, tremors, seizures;
• violation of visual function, a decrease in the activity of the glands of external secretion;
• heart failure, arrhythmia, bradycardia, hypotension, atrioventricular block, agranulocytosis, thrombocytopenia, chest pain;
• nausea, vomiting, dry mouth, stool disorder, epigastric pain, liver dysfunction;
• laryngospasm, bronchospasm, shortness of breath;
• allergic reactions on the skin;
• impotence, decreased libido, changes in the activity of certain enzymes, decreased body temperature in the extremities, increased levels of bilirubin in the blood.

The use of Atenolol must be stopped gradually to prevent complications, since this drug is characterized by a withdrawal syndrome. It should be borne in mind that the higher the therapeutic dose, the more often and more severely side effects appear. According to reviews of Atenolol, a mild negative reaction of the body to the drug disappears after 2-3 weeks of regular use.

Contraindications to the use of Atenolol

The instructions for Atenolol indicate diseases in which the use of this drug is prohibited, these include:

• cardiogenic shock;
• sinus bradycardia;
• atrioventricular blockade of the first and third degree;
• sinuauricular blockade;
• arterial hypotension;
• acute and chronic heart failure;
• violation of the acid-base balance towards acidosis;
• bronchial asthma.

The appointment of Atenolol is contraindicated in persons with hypersensitivity to the components of the drug,

Under the supervision of a physician, Atenolol is used by pregnant and lactating women, children and the elderly, as well as patients with myasthenia gravis, psoriasis and depression.

Additional Information

Storage of Atenolol should be carried out in a dark and dry place where the air temperature does not exceed 25 0 C.

The shelf life of the drug is 3 years.

All properties and actions of Atenolol Nycomed are similar to the corresponding characteristics of Atenolol. The drug Atenolol Nycomed is available in the form of tablets of 50 or 100 mg. Atenolol Nycomed is manufactured by Nycomed Denmark AnC.

Even a healthy person's home first-aid kit always has a set of medicines necessary for extreme situations. If someone in the family has a “chronicle”, some standard ones: “iodine, peroxide, painkillers, sedatives, yes” - you can’t do it.

In hypertensive patients and concurrently - cores are often at hand - atenolol. When the heart "ran into a frenzy", and even responded with pain, atenolol is a good helper, sometimes irreplaceable.

Atenolol: types, indications, instructions for use

The trade name of the drug and its active substance are the same. Atenolol. This is the first product in the line. Based on this line, later manufacturers of other companies launched the production of a similar pharmaceutical product.

Atenolol is available in a dosage of 0.1 g (tablets) and half of this dose - 0.05 g. In milligrams, these are respectively: 100 and 50.

Appeared on sale and tablets of a different dosage - 25 mg.

Tablets do not consist of the active substance in its pure form. There are always fillers in which these milligrams of the drug are distributed. The first, familiar to the older generation, atenolol contains them only in the core, has no shell, the composition of the drug includes a minimum of additives.

Other companies that took over the production of this drug added a shell. The quantitative (qualitative - too) composition of the chemicals included in the tablet has also been added. The shell contains its components.

The group represented by the drug is beta-blockers.

Pharmacodynamics

Typical action for beta-blockers. Atenolol acts selectively, not on the whole body, but in a directed way: cardioselectively. Its purpose is to act on the heart and the coronary vessels that feed it, to help the circulatory system of the heart cope with the load. Or to remove, and more often - to warn - an attack of angina pectoris.

Taking atenolol on the first day reduces cardiac output. Peripheral vessels react reflexively to this, their resistance increases. The effect is not curative, but not catastrophic. With continued use, the state of the vessels for 24, maximum - 72 hours becomes the same.

Further treatment with atenolol reduces this resistance even in comparison with the former before the first dose. This reduces blood pressure (antihypertensive effect), evens out the rhythm in those suffering from arrhythmia.

It has a medicine and antianginal - relieving ischemic symptoms (pain, shortness of breath) action. Atenolol has no analgesic properties. The pain goes away because its cause is eliminated. This is an important point. Not just a symptom is stopped, a healing process takes place.

The scheme is as follows: the drug gently affects the beta1-adrenergic receptors of the heart and its vessels. This reduces myocardial oxygen demand, even during physical or emotional stress. The flow of oxygen at this time is increased, so the drug acts through the nervous system. The volume of blood circulation per unit of time - a minute (IOC) decreases. This entails a decrease in both blood pressure values ​​- less systolic and diastolic.

The myocardial conduction system receives a smaller excitation signal. This stops tachycardia and various types of extrasystoles. The heart rate slows down, the rhythm of contractions evens out. The heart rate after taking atenolol does not decrease sharply, in about an hour. A sharp change, the transition from tachycardia to almost bradycardia is dangerous for the myocardium. The drug acts - gently, this is also a plus.

As a result, the heart is protected, it does not experience oxygen starvation, there is no overload. Dangerous types of arrhythmias are blocked. The patient's condition is normalizing and stabilizing.

The action of atenolol concerns specifically beta1-adrenergic receptors. There are also beta2-adrenergic receptors in the body.

They govern:

Beta2-adrenergic receptors control metabolic processes (carbohydrate metabolism).

Atenolol in the doses recommended by the instructions for use, prescribed by the doctor, does not interfere with the work of type 2 adrenergic receptors. Exceeding the dosage can also block these receptors, so the maximum is 100 mg, no more should be taken.

Pharmacokinetics

From the gastrointestinal tract, the drug is absorbed quickly, but not completely, about half of the active substance enters the bloodstream. If circumstances require quick action, the tablet is placed under the tongue. There, the mucous membrane has many vessels, and the drug directly enters through them - into the bloodstream.

Traditionally, the use of atenolol is indicated - inside. Sublingual (sublingual) method - only for emergency conditions, when other drugs are not available for some reason.

With oral (internal, through the mouth) application, the desired (maximum) concentration of the drug is reached in the blood two hours after ingestion. Blood proteins partially, up to 15%, bind the active substance. The liver is not involved in the metabolism of atenolol. It is excreted by the kidneys. The drug has already done the necessary work in the body, and it is excreted up to 100% (sometimes less - up to 85%) - in the same, unchanged form.

Indications

Indications for use of atenolol are few, but very important.

Arterial hypertension. With regular use, pressure stabilization occurs gently but reliably. The drug is used at the initial, first, stage of the disease and at the second. It also helps in combination with drugs of other groups in the treatment of the third stage of hypertension.

That is, according to the instructions for use, in which the patient is looking for - at what pressure atenolol helps, it is recommended to use it up to values ​​of 180/110.

But, taken sublingually, put crushed under the tongue, it will help with “over two hundred”. Moreover, it will help - quickly, although they consider it "slow". The release form is important here: without a shell, the medicine will start working immediately.

The method of consumption is also important: being absorbed into the blood from the sublingual vessels, atenolol will act much faster. This property makes uncoated atenolol a valuable assistant in the relief of an attack of coronary artery disease, tachycardia paroxysm and hypertensive crisis. These pathologies can occur simultaneously or separately, the drug is effective in both cases.

Prevention of angina attacks. When the heart is protected, the likelihood of an attack is almost impossible. The myocardium has enough nutrition, its tissues and blood vessels do not experience overload. This is how atenolol works at rest and during exercise.
Tachycardia. By reducing the heart rate, atenolol directly affects tachycardia, removes it, the rhythm returns to normal values.

There is such a type of rhythm disturbance: paroxysmal tachycardia. With this disease, even against the background of habitual bradycardia, paroxysms (attacks) of tachycardia may occur. Conventional treatment is difficult: beta-blockers slow down the rhythm, and in the patient it is initially rare.

But at the time of the attack, it is atenolol that can help if taken sublingually. The action will be fast, but short-lived. Which is what you need, because prolonged drugs are dangerous: after an attack, a normal slow rhythm will be established. To cut it even more is impossible. Therefore, oral (inside) use is not suitable. Only under the tongue.

Extrasystole. The special value of atenolol is that the medicine, the price of which remains symbolic - a little more than 10 rubles - saves lives. It prevents heart rhythm disturbances. Not only tachycardia - extrasystole. Supraventricular and life-threatening: ventricular.

If erratic extrasystoles occur in a patient who does not constantly take atenolol, and there is a medicine, you must take it. Also sublingual. This is important for those who do not tolerate antiarrhythmics of other groups and composition.

Drug intolerance has become common. With good tolerability of atenolol, it can save life to those who are considered more effective means "do not go."

Contraindications

individual sensitivity. Intolerance to the drug or sensitivity to its components. The latter began to be observed more often with the appearance of atenolol analogues.

The active substance itself is accepted by the body without problems, but the fillers, or the chemical elements included in the shell, can easily provoke an allergy.

Each firm that undertakes to produce a medicine tries to introduce its own “brand touch”, a new component. It is claimed that this is an improvement, protection, additional therapeutic effect. This is not always the case. Patients, fairly “stuffed with chemistry” of drugs, often cannot absorb this new improved one without an allergic reaction.

Atenolol nycomed - an analogue of the primary form - has the same indications for use as atenolol (for hypertension, tachycardia and other indications). The active substance is one, atenolol. It is generally accepted that produced by a reputable company, atenolol nycomed is devoid of some of the side effects. He has a shell - will protect the stomach. And she will make the effect of the drug softer.

Look at the original instructions for atenolol nycomed: for use, it is a complete analogue of just atenolol. But the sensitivity of the body can vary, as well as the composition of excipients.

The medicine itself (of any firms and names: atenolol, atenolol belupo or nycomed) and drug analogues have a harsh effect on the gastrointestinal tract. It is enough to take it sublingually once - it will become clear how much. A crushed preparation that has fallen on the tongue or buccal mucosa causes a burn. It is clear that this happens with the gastrointestinal mucosa in any part of it. The shell will dissolve, atenolol injures the mucosa.

Additional substances of the shells are different. In a simple atenolol shell company "Ozone" contains titanium oxide, and polyvinyl alcohol, other chemical elements (opadray, macrogol).

The instructions for atenolol nycomed indicate: the shell, among others, contains propylene glycol, hypromellose. These additions will not harm someone, they will even help. And someone may not be able to tolerate just one component, reacting with an allergic reaction.

Additives and brands have greatly increased the cost of the drug, the price of atenolol nycomed is 6-10 times higher than its predecessor. Production in Germany seems to the consumer to be better than domestic medicine. The Russian manufacturer (Zhigulevsk) only doubled the price for the same 30 coated tablets. The name remained the same.

Belupo atenolol has similar instructions for use, it is the same drug, only produced in Croatia. There are representative offices of this pharmaceutical company in Russia. Some additives repeat the German ones, there are also pharmaceutical finds: carnauba wax, disodium edetate dihydrate.

It is worth paying attention to the fact: medicines in the shell are definitely not helpers in an emergency situation. Note: initially, atenolol was not intended for force majeure.

If you think about it: what are atenolol tablets prescribed for? From pressure and prophylactically for angina pectoris. But still, you can use a simple domestic, with a minimum of fillers, cheap atenolol and as an ambulance. And the more expensive "sparing" forms - it is impossible. Only prevention is their task. The shell will “slow down” and can make an already dangerous condition worse.

Bradycardia. The rhythm is pathologically slowed down, it is impossible to reduce the heart rate, which makes atenolol. Landmark contraindications: heart rate less than 60. The exception is described above: “Indications. Tachycardia".

SSSU. The weakness of the pacemaker - the sinus node, or its dysfunction does not tolerate the intervention of beta-blockers. The contractions of the heart in this pathology are chaotic, the effect of atenolol cannot be predicted.

Decompensated or acute CHF. The drug increases the left gastric load and diastolic blood pressure at the beginning of treatment, it is dangerous in these cases. The left ventricle of the heart is already overloaded in hypertensive patients, and therefore it is compensatory enlarged.

The heart does not fully relax: the pressure at the moment of supposed relaxation (diastole) is significantly increased. To enhance this effect with atenolol, even for a short time, is a risk. With constant intake, oxygen deficiency of the myocardium will occur.

Cardiomegaly (bull heart). Myocardial muscles increase, grow decrepit, other methods of assistance are used here. Conduction is impaired, it is not advisable to act on it with beta-blockers, you can cause severe - to irreparable - consequences.

Low blood pressure (hypotension). Especially if with a heart attack - it's dangerous. Even if there is no heart attack, it can happen. Low pressure, with weakness of the vessels of patients with arterial hypertension or cores, will not provide sufficient blood flow to nourish the myocardium and brain. The likelihood of vascular accidents increases.

Reception of MAO inhibitors. Combination with atenolol is unacceptable. This combination is fraught with severe orthostatic hypotension.

Do not take the drug and with:

Under supervision, with caution if installed:

Pregnant and elderly - special care when using. Assign according to vital indications, carefully monitoring the condition.

Application and dosage

Once a day, before meals. The minimum starting dose is 50 mg. Usual therapeutic with normal tolerance - 100 mg. Conclusions about the effectiveness - after two weeks. 100 mg - maximum, if there are kidney problems, reduce the dosage by half.

Side effects

drug interaction

Dangerous to combine with:

special instructions

It is regularly necessary to control when taking atenolol:

You can not cancel the medicine abruptly, this will worsen the condition, the symptoms may increase:

1. hypertension;

Before operations with anesthesia, the medicine will be canceled earlier. Pause - two days, then only anesthesia.

The interval between the administration of verapamil and the intake of Atenolol is 48 hours.

Analogues

Analogues of atenolol, its absolute twins, are even the same instructions for use, only prices differ, sometimes names, and reviews of cardiologists and patients. Here are the analogues:

Prescription release.

Atenolol is a complex cardiovascular drug that helps to effectively cope with arterial hypertension, as well as coronary heart disease.

This medication has pronounced hypotensive (reducing high blood pressure), antiarrhythmic, as well as antianginal actions.

Regular use of Atenolol contributes to a significant decrease in the frequency and strength of heart contractions, while quickly normalizing the pulse.

As a rule, with long-term use of this drug, the risk of possible development of severe cardiovascular diseases (myocardial infarction, stroke, etc.) is significantly reduced, while mortality among many patients is significantly reduced.

After internal administration, the main hypotensive effect appears after 1-2 hours and lasts more than 20-24 hours.

The main indications for the use of Atenolol:

• arterial hypertension;
• angina pectoris (pain in the heart area);
• prevention of myocardial infarction, various disorders of cardiac activity or stroke;
• complex treatment of senile tremor.

Attention: before starting the use of Atenolol, it is recommended to consult with a qualified general practitioner!

The drug is produced in the form of soluble tablets for oral administration.

The course of treatment and the dose of the drug is determined by the attending physician absolutely individually for each patient, depending on the severity of the course of a particular disease.

The initial daily dose of Atenolol in the complex treatment of angina pectoris is 2 tons (50 mg), while the maintenance dose should not exceed more than 1 tons (25 mg).

Contraindications to the use of Atenolol

• severe arterial hypotension (very low pressure);
• cardiogenic shock;
• children's age up to 12 years;
• sinus bradycardia (decreased heart rate);
• bronchial asthma;
• hypersensitivity (increased sensitivity of the body to the main active ingredients of the drug);
• acute or chronic form of heart failure;
• pregnancy and lactation (breastfeeding).

Side effects of Atenolol

• dizziness;
• pain in the abdomen;
• nausea or vomiting (noted with a significant overdose of the drug);
• local allergic reactions on the skin (urticaria, increased skin itching);
• dry mouth;
• increased anxiety or irritability;
• general weakness;
• memory loss.

With the development of any adverse reactions after prolonged use of Atenolol, it is recommended to consult with your doctor!

In this article, we looked at what Atenolol helps from, as well as how to take it correctly.

Contains an active ingredient atenolol(in 1 tablet 25, 50 or 100 mg of this substance).

Release form

Produced in tablet form.

pharmachologic effect

Cardioselective beta-1-blocker.

Pharmacodynamics and pharmacokinetics

The drug has antiarrhythmic, antianginal, hypotensive effects. It has negative dromotropic, chronotropic, inotropic and bathmotropic effects.

Hypotensive effect achieved by affecting the nervous system, reducing the sensitivity of baroreceptors on the aortic arch, reducing the activity renin-angiotensin system, decreasing the IOC.

The drug reduces systolic and diastolic blood pressure, reduces the IOC, SV.

The drug does not affect the tone of peripheral arteries in therapeutic doses.

Antianginal effect It is provided by a decrease in the demand of myocardial cardiomyocytes for oxygen, which leads to a decrease in heart rate. The drug reduces the pulse at rest and during physical activity.

Antiarrhythmic effect provided by the elimination of factors of arrhythmogenicity (arterial hypertension, an increase in the content of cAMP, an increase in the activity of the sympathetic department of the nervous system, tachycardia), slowing atrioventricular conduction, a decrease in the rate of spontaneous excitation of the ectopic and sinus pacemaker.

When taking Atenolol, the survival rate of patients who have had a myocardial infarction increases significantly.

The drug does not cause a weakening of the bronchodilating effect of isoproterenol.

Indications for the use of Atenolol

What are the pills for?

The medicine is prescribed for hypertensive crisis, arterial hypertension, angina pectoris, ischemic heart disease, neurocirculatory dystonia, hyperkinetic cardiac syndrome of functional origin, with withdrawal symptoms, tremor, essential tremor, agitation.

The drug is recommended for use in the prevention of rhythm disturbances, myocardial infarction, ventricular extrasystole, sinus tachycardia, atrial flutter, atrial fibrillation, ventricular tachycardia.

The drug is prescribed for migraine, thyrotoxicosis, pheochromocytoma.

Indications for the use of Atenolol Nycomed are similar.

Contraindications

The drug is not used for severe bradycardia, atrioventricular blockade of 2-3 degrees, cardiogenic shock, decompensated form of CHF, acute heart failure, SA-blockade, with Prinzmetal's angina, intolerance to the active ingredient, cardiomegaly, breastfeeding, taking MAO inhibitors.

With emphysema, allergies, metabolic acidosis, diabetes mellitus, hypoglycemia, pheochromocytoma, bronchial asthma, thyrotoxicosis, myasthenia gravis, liver failure, pregnancy, psoriasis, depression, children and the elderly, with Raynaud's syndrome, the drug is used with caution.

Side effects

Sense organs: conjunctivitis, visual disturbances, dry eyes, decreased production of lacrimal fluid, soreness in the eyes.

Nervous system: depression, insomnia, headaches, dizziness, weakness, asthenia, drowsiness, depression, paresthesia in limbs, impaired concentration, short-term memory loss, convulsions, myasthenia gravis.

Cardiovascular system: pain behind the sternum, vasculitis, coldness of the lower extremities, angiospasm, orthostatic hypotension, CHF, weakening of myocardial contractility, arrhythmia, atrioventricular blockade, palpitations, bradycardia, myocardial conduction disturbances.

Digestive system: changes in taste perception, epigastric pain, nausea, vomiting, dry mouth, stool disorders: constipation, diarrhea.

Respiratory system: bronchospasm, laryngospasm, shortness of breath, nasal congestion.

Endocrine system: hypothyroid state, hyperglycemia, hypoglycemia.

Skin: reversible alopecia, psoriasis-like skin rashes, increased sweating, exacerbation of psoriasis symptoms, hyperemia of the skin.

There is also back pain, bradycardia, decreased potency, weakened libido, arthralgia, intrauterine growth retardation.

The severity of side effects directly depends on the dose of the drug.

Application instruction of Atenolol (Way and dosage)

Tablets are taken orally, washed down with liquid, not chewed.

The initial dosage is 25-50 mg per day, after a week, if necessary, the amount of the drug is increased by 50 mg, the average daily dosage is 100 mg.

With tachysystolic disorders, with IHD, Atenolol is prescribed 1 time per day, 50 mg.

Acute myocardial infarction with stable hemodynamic parameters: intravenous infusion, then taking a 50 mg tablet 10 minutes later, repeating the dose 12 hours later.

With cardiac hyperkinetic syndrome, 25 mg per day is indicated.

The drug acts during the day, more than 1 time per day, the drug is not used. It is not recommended to prescribe more than 200 mg per day. Cancellation of the drug is carried out gradually, every 3 days - ¼ dose.

Instructions for use Atenolol Nycomed is similar.

Overdose

Manifested bronchospasm, cyanosis of the nail plates, convulsions, shortness of breath, arrhythmia, fainting, drop in blood pressure, dizziness, severe bradycardia.

An emergency gastric lavage is required.

In violation of atrioventricular conduction, with bradycardia, atropine, epinephrine is administered intravenously, or a temporary pacemaker is installed.

With a sharp drop in blood pressure, the patient is given trendelenburg position.

In the absence of signs of pulmonary edema, plasma-substituting solutions are administered intravenously; in case of inefficiency, they are administered dobutamine, epinephrine, dopamine.

With convulsive syndrome, intravenous infusion of diazepam is indicated. Dialysis effective.

Interaction

In patients taking Atenolol, allergen extracts for skin tests, as well as allergens for immunotherapy significantly increase the risk of developing severe systemic allergic reactions, anaphylaxis. Risk anaphylactic reactions increases with intravenous administration of radiopaque drugs.

A drop in blood pressure and a cardiodepressant effect have been observed with intravenous infusion of phenytoin, as well as with the use of drugs for inhalation general anesthesia. The drug is able to mask the signs of a developing hypoglycemia with the simultaneous use of oral hypoglycemic agents, insulin.

Atenolol reduces the clearance of xanthines, Lidocaine. Estrogens, glucocorticosteroids, NSAIDs, BMCC, guanfacine, reserpine, methyldopa, cardiac glycosides, amiodarone, Diltiazem, Verapamil and many antiarrhythmic drugs increase the likelihood of developing atrioventricular block, bradycardia, cardiac arrest, worsening heart failure.

Hydralazine, sympatholytics, clonidine, diuretics, antihypertensives, BMCC can significantly lower blood pressure.

Atenolol prolongs the action of coumarins, non-depolarizing muscle relaxants. Antipsychotics, sedatives, hypnotics, ethanol, tetracyclic and tricyclic antidepressants increase the inhibitory effect on the central nervous system.

The simultaneous appointment of MAO inhibitors is unacceptable because of the risk of hypotension. Violation of the peripheral circulation is noted when using drugs with non-hydrogenated ergot alkaloids.

Terms of sale

Requires a prescription.

Storage conditions

In a dry place inaccessible to children at a temperature not exceeding 30 degrees Celsius.

Best before date

No more than three years.

special instructions

Taking the drug should be accompanied by regular measurement of blood pressure, determining the pulse, sugar levels in persons with diabetes.

Elderly patients are shown periodic monitoring of the state of the renal system. The doctor needs to instruct the patient and teach how to measure heart rate correctly. In 20% of patients with angina pectoris, adrenergic blockers do not give the desired effect due to severe coronary atherosclerosis with a low threshold of ischemia, impaired subendocardial blood flow.

In patients with nicotine dependence, the effectiveness of the drug Atenolol is significantly lower than in patients who do not smoke. Against the background of therapy, a decrease in the production of lacrimal fluid is possible, which should be warned in patients who wear contact lenses.

The drug may mask the clinical picture of thyrotoxicosis (tachycardia). Abrupt discontinuation of the drug in patients with thyrotoxicosis is unacceptable due to the risk of increasing the severity of the symptoms of the disease. Atenolol is able to mask tachycardia during hypoglycemia. The drug is canceled a few days before the planned general anesthesia with ether or chloroform. Otherwise, the patient is selected for a drug for general anesthesia, which has a minimal inotropic effect.

Intravenous administration of atropine eliminates reciprocal activation of the vagus nerve. The drug can be prescribed to patients with bronchospastic pathology with ineffectiveness or intolerance to other antihypertensive drugs with strict adherence to the dosing regimen.

With the development of arterial hypotension in the elderly, increasing bradycardia, ventricular arrhythmias, bronchospasm, severe disorders in the liver and kidneys, the dosage of the drug is reduced or the therapy is completely stopped. With the development of depression, the drug is replaced. Abrupt cancellation can cause myocardial infarction, a severe form of arrhythmia. Cancellation of the drug is carried out by a gradual decrease in dosage within two weeks.

Before determining the level of normetanephrine, catecholamines, titers of antinuclear bodies, vanillylmandelic acid, Atenolol is canceled. The drug affects the management of vehicles.

Recipe in Latin:

Rp: Atenololi 0.05

D.t. d. No. 30 in tab. S. 1 tablet 1 time per day.

During pregnancy

Used with caution. When lactation is contraindicated.

When breastfeeding, carrying a pregnancy, the appointment of a medication is justified in case of vital necessity.

Analogues of Atenolol Coincidence in the ATX code of the 4th level:

Analogues of Atenolol are means: Atenobene, Atenova, Atenol, Tenolol.

Reviews about Atenolol

The drug is effective in hypertension and arrhythmia, is quite inexpensive. However, side effects are common, such as hallucinations and decreased blood sugar levels. Reviews about Atenolol Nycomed are generally better than about drugs produced by other manufacturers.

Reviews during pregnancy are generally positive, drug users generally did not notice side effects. However, it should be remembered that according to the results of clinical studies, such side effects on the fetus are very possible.

Atenolol price, where to buy

Price Atenolol 25 mg, 30 tablets - 17 rubles.

50 mg, 30 pcs - 21 rubles.

• Internet pharmacies in RussiaRussia
• Internet pharmacies of UkraineUkraine
• Internet pharmacies of KazakhstanKazakhstan

WER.RU

Atenolol tablets 50 mg 30 pcs Pliva Hrvatska

Atenolol tablets 25 mg 30 pcs. Ozon LLC

ZdravZone

Atenolol 25mg No. 30 tablets/ozone/Ozone OOO

Atenolol-Belupo 25mg No. 30 tablets Belupo d.d.

Atenolol-Belupo 100mg No. 14 tablets Belupo d.d.

Atenolol-Belupo 100mg No. 28 tablets Belupo d.d.

Atenolol compositum-sandoz 50mg + 12.5mg №30 tab p/o

Pharmacy IFK

AtenololNycomed Danmark Asp, Denmark

AtenololRenewal of PFK CJSC, Russia

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Pharmacy24

AtenololMonfarm (Ukraine, Monastery)

Atenolol tablets 100mg №20Astrapharm (Ukraine, Cherry)

Atenolol tablets 50mg No. 20Astrapharm (Ukraine, Cherry)

Atenolol tablets 50mg №20Zdorovye (Ukraine, Kharkiv)

PaniApteka

Atenolol tab. 100mg №20Monfarm

Atenolol tab. 100mg №20Monfarm

Atenolol tab. 100mg №20Monfarm

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BIOSPHERE

Atenolol-rationopharm 25 mg No. 30 tabl.p.o.

Atenolol-rationopharm 25 mg No. 50 tabl.p.o.

Atenolol-AKOS 50 mg No. 30 tab. Sintez OJSC (Russia)

Atenolol 50 mg No. 30 tab. p.o. Balkanpharma-Dupnitza AD (Bulgaria)

Atenolol-AKOS 100 mg No. 30 tab. Sintez OJSC (Russia)

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NOTE! Information about medicines on the site is a general reference, collected from publicly available sources and cannot serve as a basis for making a decision on the use of medicines in the course of treatment. Before medicine use Atenolol surely consult with the attending physician.

Atenolol is a medicine for hypertension and heart disease, belongs to the group of beta-blockers. It is prescribed to lower blood pressure, reduce the frequency of attacks of pain in the heart and weaken them. Atenolol is also used to prevent and treat myocardial infarction. He has other indications for use: panic attacks, increased activity of the thyroid gland, uncontrolled emotional arousal. However, atenolol is now largely obsolete. It often causes side effects, provokes diabetes, does not sufficiently reduce the risk of heart attack, almost does not protect against stroke. Discuss with your doctor if you should switch from him to some more modern beta blocker. Read the details below.

Atenolol: instructions for use

Read the article "

Pressure pills: questions and answers

• How to manage blood pressure, blood sugar and cholesterol at the same time
• The pressure pills prescribed by the doctor used to help well, but now they have begun to act weaker. Why?
• What to do if the pressure does not reduce even the strongest pills
• What to do if hypertension drugs lower blood pressure too much
• High blood pressure, hypertensive crisis - features of treatment in young, middle and old age

Read about the treatment of cardiovascular diseases:

Watch also a video about the treatment of coronary artery disease and angina pectoris

Learn how to take control of heart failure

Prices for the drug Atenolol from different manufacturers in an online pharmacy, with delivery in Moscow and Russia

The use of atenolol

Atenolol is a medicine for hypertension and cardiovascular diseases. This drug blocks the heart from the action of adrenaline and other hormones that speed up the heart rate. Other beta blockers work the same way. As a result, the pulse slows down, blood pressure drops, and the amount of blood that the heart pumps with each beat decreases. Since the workload on the heart is reduced, the risk of a first and recurrent heart attack is reduced for the patient. Most often, atenolol is prescribed to control hypertension, reduce heart pain, and to prevent and treat heart attacks.

They give fewer side effects, better protect against heart attack and stroke.

arterial hypertension

Atenolol and other drugs are only part of a complex of measures for the treatment of hypertension and cardiovascular diseases. Pay attention to your diet, exercise, yoga and other relaxation techniques. Don't rely on pills alone. High blood pressure often causes no outward symptoms until the patient has a sudden heart attack or stroke. Therefore, take your hypertension medication even on days when you feel well.

In 2004, the authoritative British medical journal Lancet published an article "Atenolol in hypertension: is it a wise choice?" by Carlberg B., Samuelsson O., Lindholm L.H. Translation of the title into Russian: "Prescribing atenolol for hypertension: is it a wise choice?". According to 14 large studies, atenolol is less effective for hypertension than other beta-blockers, as well as diuretics and ACE inhibitors. This article made a lot of noise. Since then, until now, her conclusions have never been refuted.

Disadvantages of atenolol:

1. Prevents heart attack and heart failure worse than most other hypertension medications.
2. Virtually no protection against stroke.
3. Older people help worse than other drugs.
4. Causes unpleasant side effects more often than newer 3rd generation beta-blockers.
5. Harmfully affects the metabolism - increases the concentration of glucose, triglycerides and bad cholesterol in the blood.
6. For obese patients, it increases the risk of developing type 2 diabetes.
7. In patients with type 2 diabetes mellitus aggravates its course, complications develop faster.
8. Newer beta-blockers work all day long, but atenolol does not.

Based on all of the above, if you are taking atenolol for hypertension, then discuss with your doctor if you should switch to another drug instead.

Detailed articles about drugs:

Patients - do not prescribe beta-blockers yourself! This should only be done by a doctor. If you get the wrong dosage, there can be severe side effects.

Results of the ASCOT study

In 2005, the results of the ASCOT (Anglo–Scandian Cardiac Outcomes Trial) study were published. This can be translated into Russian as the Anglo-Scandinavian study of the risk of cardiovascular accidents depending on the drugs used. As you know, the goal of treating hypertension is not only to lower blood pressure, but also to prevent complications - in the first place, heart attack and stroke. The planners of the ASCOT study wanted to compare the efficacy of two treatment options for hypertension:

• atenolol + diuretic drug bendroflumethiazide;
• combination of perindopril and amlodipine.

Almost 20,000 hypertensive patients who had additional risk factors for cardiovascular disease took part in the study. Patients were divided into two groups, identical in terms of mean age, blood pressure and other characteristics. The patients included in the first group were prescribed atenolol and bendroflumethiazide. Patients who were assigned by lot to the second group - perindopril and amlodipine. Treatment was started with the minimum dosages of drugs, if necessary, they were gradually increased. The course of the study was carefully monitored to ensure that the results were reliable.

The ASCOT study showed that atenolol is not the best choice for hypertension and cardiovascular disease. Because it impairs metabolism, although it lowers blood pressure. However, this does not mean that all beta-blockers can be written off. Modern drugs remain on the list of recommended. They are prescribed for hypertension, if the patient has a high risk of heart attack.

Patients were followed up for an average of 5.5 years. However, the study had to be terminated early because the benefits of perindopril and amlodipine were evident. Indicators of "upper" and "lower" blood pressure in both groups of patients differed slightly.

However, in patients who were lucky enough to enter the perindopril and amlodipine group, the treatment results were much better. They had 33% fewer deaths from cardiovascular disease, 29% fewer strokes, and 41% fewer new cases of diabetes. The reason is that taking atenolol worsens the levels of glucose, cholesterol and triglycerides in the blood. And this, in turn, increases the risk of heart attack, stroke, type 2 diabetes and other complications. Perindopril and indapamide are metabolically neutral drugs. They lower blood pressure and at the same time do not have a harmful effect on metabolism.

The ASCOT results made a lot of noise. Because it was a major international study. Hundreds of doctors and almost 20,000 patients participated in it. It was carefully planned and carefully carried out, so it was impossible to find fault with the reliability of the results. In subsequent years, the frequency of prescribing atenolol for hypertension and cardiovascular diseases decreased. They began to produce perindopril and amlodipine in one tablet - a combination medicine called Prestans, as well as its inexpensive analogues.

Special categories of patients

In overweight people, atenolol increases the risk of developing type 2 diabetes. In people who already have diabetes, the course of the disease worsens and complications develop more quickly. This has been proven in several large studies. See, for example, the article "The place of beta-blockers in the treatment of obese patients with hypertension." Author - Korneeva O.N., magazine "Doctor", No. 11/2011. Atenolol worsens the results of blood tests for sugar, glycated hemoglobin, cholesterol and triglycerides. Physicians who still prescribe this drug to obese and diabetic people are to be blamed.

Atenolol impairs airway patency in patients with cardiovascular disease and concomitant chronic obstructive pulmonary disease. Source - the article "Beta-blockers - the possibility of optimizing the treatment of chronic heart failure in an outpatient setting", authors - E. S. Zhubrina and F. T. Ageev, journal "Attending Doctor", No. 03/2013. At the same time, the newer cardio-selective beta-blockers bisoprolol and nebivolol do not reduce bronchial patency and even improve the quality of life of patients.

How to take this drug

Follow the regimen of taking atenolol prescribed by your doctor. Do not exceed or lower doses unless there is an allergy or other serious side effect. Take your tablets every day at the same time. Drink them with water. Do not stop taking on your own. Otherwise, a sharp jump in blood pressure may occur. Be smart about putting yourself at unnecessary risk of heart attack and stroke.

No more shortness of breath, headaches, pressure surges and other symptoms of HYPERTENSION! Our readers for the treatment of pressure are already using this method.

To learn more…

To monitor the effect of the medicine, you need to measure the pressure with a tonometer several times a week, and preferably every day at the same time. Follow the rules to get accurate results. For more information, read the article “Blood pressure measurement: a step-by-step technique”. Visit your doctor regularly. It is advisable to keep a diary of blood pressure measurements, and then discuss their results with your doctor.

Important information for patients

Tell your doctor if you have any of the following:

• bronchial asthma, emphysema, bronchitis;
• diabetes mellitus type 1 or 2;
• low blood pressure (hypotension);
• heart problems - AV block, sick sinus syndrome, bradycardia (low heart rate), congestive heart failure;
• depression;
• liver disease;
• kidney failure;
• increased or decreased thyroid function;
• myasthenia gravis;
• pheochromocytoma;
• circulatory disorders in the legs, intermittent claudication.

Some of these diseases are contraindications to the appointment of atenolol, others require dosage adjustment.

If you forget to take your medicine, take it as soon as you remember, but only if your next dose is less than 8 hours away. If you need to take your next dose soon, don't take the missed dose at all so that it doesn't turn out to be too much. An overdose of atenolol can be deadly. If it happens, you need emergency medical help.

If you are being treated with atenolol, do not stop taking it on your own. Discuss this issue with your doctor first. Because if you suddenly stop taking the medicine, then the pressure can jump sharply. This is fraught with a heart attack or stroke. If you are going to have surgery, you will most likely need to stop taking atenolol a few days before. Make sure the surgeon is aware of all medications you are taking.

The side effects of atenolol can make you less alert and lethargic. Keep this in mind if you are going to drive a car or perform other activities that require high concentration. It is undesirable to drink alcohol during treatment with atenolol and other beta-blockers. Because the inhibitory effect of alcohol can increase the side effects of the drug.

If you have bradycardia - a very low heart rate - then you should not take atenolol. If you have an allergy, then tell your doctor to prescribe some other medicine.

Reviews

In reviews, people write that atenolol helps them well with hypertension and cardiac arrhythmia, but causes significant side effects. And indeed it is. Information on medical websites and forums corresponds to the real situation. Atenolol today is a morally obsolete drug. It causes weakness, dizziness, and digestive problems more often than modern third-generation beta-blockers. It also impairs metabolism, provokes diabetes, poorly protects against heart attack and stroke. But patients do not feel this and therefore do not indicate in their reviews.

Kristina Listanova

As prescribed by the doctor, I take atenolol nycomed for palpitations and panic attacks. I drink low doses - in the morning and in the evening, 12.5 mg. Tablets help, but sometimes I feel their side effects - weakness, dry mouth, constipation. I know that the drug is harmful to the metabolism, but I'm still afraid to refuse it. I'm worried that panic attacks will start again.

The author of this review can try magnesium tablets with vitamin B6 to calm the nerves, as well as psychotherapy. Perhaps, thanks to these measures, it will finally be possible to stop taking “chemical” drugs.

Dmitry Zarechkin

The doctor prescribed me atenolol 25 mg (? 50 mg tablets) twice a day for hypertension and also amlodipine. Both of these drugs - instead of another regimen, according to which I used to take pressure medications. For a month everything was more or less normal, and then the pressure increased again. Recently there was a hypertensive crisis, an ambulance had to be called, I almost had a stroke. I just can't find good medicines to control hypertension.

You can control hypertension only when you change your lifestyle, and do not rely only on pills. Eat whole foods, not junk. Spend more time outdoors and exercise. Learn to avoid scandals at work and in the family.

Yuri Duganets

The doctor said that atenolol was a harmful drug and prescribed a non-bilet instead. I checked on the Internet - indeed, it increases blood sugar, bad cholesterol, weakens potency. I bought a non-ticket in a pharmacy, tried to take 5 mg per day, but in a few days I was convinced that it was less effective. My blood pressure began to rise, so I had to go back to atenolol.

The doctor is doing the right thing when he tries to switch the patient from atenolol to a more modern beta-blocker. Yes, the non-ticket works more smoothly. It needs to be taken for 2-4 weeks before a lasting effect develops. But it does not impair metabolism, it gives better protection against a heart attack. Discuss with your doctor if you should take a beta-blocker in combination with other medications for a quick and powerful effect.

Frequently Asked Questions and Answers

What other hypertension medicines is atenolol compatible with?

Atenolol is compatible with diuretics, ACE inhibitors, angiotensin II receptor blockers, calcium antagonists (calcium channel blockers). These are all the main groups (classes) of drugs for hypertension. In the instructions, read which group the drug you are interested in belongs to, and you will see whether atenolol is compatible with it or not. It is not compatible with other beta blockers! Do not take anaprilin (propranolol), concor (bisoprolol), nebilet (nebivolol), etc. at the same time.

Does this drug impair male potency?

Yes! This was proven by the results of "blind" studies in which patients did not know which drug they were taking. Atenolol at doses of 50–100 mg/day significantly impairs the ability of men to maintain an erection. It really weakens potency. This is a strong argument to switch from atenolol to one of the newer beta blockers. Read the article “How to treat hypertension so as not to weaken potency” for more details.

What to do if atenolol does not lower blood pressure enough? What other tablets can be taken?

If you do not switch to a healthy lifestyle, then no pills will really help. Even the most powerful combination drugs, at best, will delay a heart attack or stroke by several years. Change your diet, the level of physical activity, learn to avoid scandals in the family and at work. It is also advisable to take natural remedies in addition to medications. With a high probability, thanks to this, you will be able to completely abandon the “chemistry”.

Proven effective and cost-effective blood pressure supplements:

• Magnesium + Vitamin B6 from Source Naturals;
• Taurine from Jarrow Formulas;
• Fish oil from Now Foods.

Read more about the technique in the article "Treatment of hypertension without drugs". How to order hypertension supplements from the USA - download instructions. Get your blood pressure back to normal without the harmful side effects that Noliprel and other "chemical" pills cause. Improve heart function. Become calmer, get rid of anxiety, sleep like a baby at night. Magnesium with vitamin B6 works wonders for hypertension. You will have excellent health, to the envy of your peers.

Is this medicine suitable for treating hypertension in the elderly?

Atenolol is not a good choice for treating hypertension in the elderly. It lowers blood pressure, but at the same time reduces mortality worse than other drugs. There are many modern pressure medications that are more effective for older people. Study the article “What drugs for hypertension are prescribed for elderly patients”, and then discuss with your doctor what is better to replace atenolol.

Doctors give me atenolol for hypertension during pregnancy, in addition to dopegyt. I'm afraid to take it so as not to harm the child.

The doctor prescribed you dopegyt and other medicines not because of a good life, but because the benefits of "chemistry" outweigh the possible risks. If you do not try to bring high blood pressure under control, then the outcome of pregnancy can be sad not only for the fetus, but also for the mother. So take your medication. This is the lesser of the evils in your situation. Read also the article "High blood pressure in pregnant women and its treatment."

conclusions

The article considers atenolol - a medicine for hypertension and cardiovascular diseases. Conveniently presented all the information about this drug that patients and doctors need. Did you know:

• is it possible to take atenolol during pregnancy;
• does this drug impair male potency;
• how it affects metabolism in diabetic patients;
• whether it is suitable for the elderly.

In most cases, it is better to take not atenolol for hypertension, but one of the newer third-generation beta-blockers. However, do not self-medicate, discuss this issue with your doctor. Information on medical websites is not a substitute for professional medical advice. If you have any questions about the treatment of hypertension with atenolol - ask in the comments, the site administration quickly responds.

Atenolol is a very popular medical drug used to treat heart disease.

It has a general antianginal, as well as antiarrhythmic and hypotensive effect on the body. It is especially valued for its ability to reduce heart rate, reduce myocardial excitability or contractility, and also minimize myocardial oxygen demand.

On this page you will find all the information about Atenolol: full instructions for use for this drug, average prices in pharmacies, complete and incomplete analogues of the drug, as well as reviews of people who have already used Atenolol. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

Beta1-blocker.

Terms of dispensing from pharmacies

Released by prescription.

Prices

How much does Atenolol cost? The average price in pharmacies is at the level of 25 rubles.

Release form and composition

The drug Atenolol is available in tablet form from 14 to 100 pieces in one package.

• Contains in its composition the active ingredient atenolol (in 1 tablet 25, 50 or 100 mg of this substance).
• Additional elements: calcium hydrogen phosphate, propyl parahydroxybenzoate, sodium carboxymethyl starch, starch, silicon dioxide, methyl parahydroxybenzoate, magnesium stearate, talc.

Pharmacological effect

The drug blocks nerve impulses, which causes a decrease in the frequency and strength of heart contractions. Many reviews of Atenolol also confirm such pharmacological properties as lowering blood pressure (hypotensive effect), eliminating heart rhythm disturbances (antiarrhythmic effect), and eliminating symptoms of myocardial ischemia (antanginal effect).

During the first day after taking the drug, there is a reactive increase in the total peripheral resistance of blood vessels against the background of a decrease in cardiac output. But within a few days, the severity of this action begins to decline. The hypotensive effect is manifested by a decrease in minute and stroke volume, the highest and lowest blood pressure due to the action of the active substance of the drug.

Betaxolol, Talinolol) belong to the group of pharmacological agents with a selective (selective) beta-1-adrenergic blocking effect. They represent the second generation of beta-blockers.

At the cellular and subcellular levels, these pharmacological agents bind to beta-1-adrenergic receptors and close them from the influence of catecholamines (norepinephrine, adrenaline).

Since beta-1-adrenergic receptors are predominantly located in the heart muscle, Atenolol analogs of the drug are called cardioselective beta-blockers.

Этo вeсьмa сyщecтвeннo, пoтoмy чтo в тeрaпeвтичeских дoзaх oни прaктичecки нe влияют на бeта-aдрeнoрецептoры дрyгих oргaнов, следовательно, имеют мeньшe пoбoчных эффектoв и лyчшe пeрeнoсятся пo срaвнeнию с неселективными бета-адреноблокирующими лекарственными препаратами (например, Попранололом).

Atenolol and analogues of the drug differ in the following pharmacological characteristics:

1. decrease in the strength of heart contractions (negative inotropic action);
2. decrease in contractions of the heart muscle (negative chronotropic action);
3. inhibition of excitability and conduction of the myocardium;
4. a decrease in secretion in the juxtaglomerular cells of the kidneys and the release of the vasoconstrictor agent renin into the blood;
5. mediated through the central nervous system inhibition of sympathetic tone;
6. decreased sensitivity of baroreceptors in the aortic arch.

Due to a decrease in the strength and frequency of heart contractions, the volume of blood ejected into the aorta decreases. Since the baroreceptors of the aortic arch are depressed, a decrease in cardiac output does not lead to a response reflex narrowing of the arteries.

At the same time, renin release decreases, which is especially important for people with an increased level of activity of the renin-angiotensin system. Both systolic and diastolic blood pressure decrease. This is the mechanism of the hypotensive effect.

Atenolol tablets

The antianginal effect of Atenolol and its analogues is also determined by their negative chronotropic effect. It is important that these drugs slow down cardiac contractions both at rest and during exercise.

With a decrease in the heart rate, diastole lengthens, during which the myocardium is better supplied with blood through the coronary vessels. Inhibition of sympathetic tone also contributes to the development of antianginal action.

Antiarrhythmic action is determined, first of all, by inhibition of excitability and conduction of the heart muscle. The rate of excitation of pacemakers decreases, the conduction of impulses through the atrioventricular node slows down. Also, a consequence of the negative chronotropic effect is the elimination of such a powerful arrhythmogenic factor as tachycardia.

Pharmacokinetics

In the understanding of the pharmacologist, analogues are drugs of the same pharmacological group, but containing in their composition active substances that are more or less different in chemical structure. This is how analogs differ from generic drugs.

Analogues of Atenolol among themselves have many similarities in pharmacodynamics, clinical effect, etc., but due to the difference in the chemical structure of the active substance, they usually differ somewhat in pharmacokinetic characteristics.

For example, from 50 to 60% of the dose of atenolol taken before meals is absorbed in the digestive tract fairly quickly. Atenolol is almost not metabolized in the liver. Thus, its bioavailability is from 40 to 50%. The maximum concentration in the blood is reached within 2-4 hours after ingestion, the action lasts up to 24 hours.

The half-life (6 - 9 hours) increases in the elderly and patients with impaired renal function. In the latter case, the accumulation of the drug in the body and, as a result, an overdose is possible, which is why doses should be selected by the doctor based on the value of creatinine clearance.

Penetrates through the placental barrier, which adversely affects the development of the fetus (bradycardia and hypoglycemia in the fetus and, as a result, developmental delay).

The medicine also passes into breast milk. 85-100% Atenolol is excreted by glomerular filtration in the kidneys unchanged.

What is better Atenolol or Metoprolol? Metoprolol is absorbed in the gastrointestinal tract not only quickly, but also much more effectively: 95% versus 50-60%. But Metoprolol is actively metabolized in the liver, and, as a result, its bioavailability at the first dose does not differ in bioavailability.

Metoprolol tablets

But with a course of admission, the bioavailability of Metoprolol increases significantly (up to 70%). In addition, two metabolites of metoprolol formed in the liver also have beta-blocking properties. The action comes a little faster (the maximum concentration in the blood is reached after 1.5-2 hours).

The elimination half-life when taken orally is 3.5-7 hours; hence the need to appoint it inside twice during the day. Only about 5% is excreted from the body by the kidneys unchanged, therefore, in patients with impaired renal excretory function, dose adjustment is not required.

In the case of metoprolol, it is more important to take into account the functional state of the liver. Metoprolol overcomes the blood-brain and placental barriers, enters the mother's milk.

Bisoprolol tablets

Is it better to take Atenolol or Bisoprolol? Bisoprolol is absorbed in the digestive tract by 80-90% (regardless of food intake). Metabolized in the liver (as metoprolol).

The time to reach the maximum concentration in the blood and the half-life are similar to those of Atenolol. 50% of the drug is excreted by the kidneys unchanged.

In clinical practice, differences in the pharmacokinetic parameters of analogue drugs must certainly determine the tactics and dosing regimen.

Indications for use

Any analogue of Atenolol has the following indications for use:

1. arterial hypertension(first of all, hypertension);
2. rhythm disturbances: sinus tachycardia; paroxysmal atrial tachycardia; atrial fibrillation; atrial flutter; supraventricular and ventricular extrasystoles; supraventricular and ventricular tachyarrhythmia);
3. ischemic heart disease: angina pectoris, angina pectoris, unstable angina pectoris (except for angina pectoris Prinsmetal); acute phase of myocardial infarction under the condition of stable hemodynamic parameters; complex prevention of myocardial infarction.

The drug is sometimes used in geriatric and narcological practice for the relief of neurological manifestations.

Bisoprolol is usually not prescribed for rhythm disturbances, as well as (the active substance of Concor is bisoprolol in the form of fumaric acid salts). So, the answer to the question of which is better Atenolol or Concor depends on the form of the disease and the individual characteristics of the patient.

Absolute contraindications

Reception of cardioselective beta-blockers is contraindicated in the presence of pathologies such as:

1. angina of Prinzmetal;
2. bronchial asthma;
3. acidosis;
4. cardiomegaly;
5. acute heart failure;
6. synoaypicular blockade;
7. decompensated chronic heart failure;
8. low blood pressure (systolic less than 100 mmHg);
9. lactation period;
10. acute heart failure, as well as cardiogenic shock (especially severe heart failure with myocardial infarction);
11. atrioventricular blockade of the second and third degree. Pronounced bradycardia (less than 40 contractions of the heart in 1 min);
12. while taking monooxidase inhibitors;
13. individual intolerance;
14. age up to 18 years.

About side effects

The cardioselectivity of Atenolol and its analogues is not absolute, but dose-dependent.

These drugs also affect the beta-adrenergic receptors of all organs and systems of the body, which leads to clinical manifestations in the form of unwanted side effects. In this case, the selectivity decreases with increasing dose.

Since the localization of beta-adrenergic receptors is ubiquitous in the body, undesirable side effects are manifested by almost all organs. Both Atenolol and its analogues do not differ in the set of possible side effects.

Beta-blockers do not differ in the set of undesirable combinations with drugs from other groups, since this set is also determined by pharmacodynamics, which is the same for the drugs under consideration.

Cancellation of the drug

The withdrawal syndrome occurs when you abruptly stop taking beta-blockers and is expressed by tachycardia; an increase in angina attacks; rise in blood pressure; possible death of the patient.

Therefore, the dose of beta-blockers is reduced gradually over two weeks.

Related videos

Overview of tablets Atenolol, Nebivolol, Talinolol, Papazol, Papaverine, and other medications that reduce blood pressure:

So, we found out how to replace Atenolol with hypertension. These are Metoprolol, Bisoporlol (also Concor), which belong to the same pharmacological group, have the same mechanism of action and pharmacodynamic effects and are used in the treatment of arterial hypertension and coronary heart disease. Some difference in the spectrum of indications and the dosing regimen characteristic of each of these drugs (frequency of administration, connection with food intake, dose adjustment depending on kidney or liver function, etc.) is explained by slight differences in pharmacokinetic parameters. But the clinical efficacy of all the drugs considered has been time-tested and is beyond doubt.