Atenolol; Uses, Dosage, Side Effects, Interactions, Pregnancy

Atenolol; Uses, Dosage, Side Effects, Interactions, Pregnancy

Atenolol is a synthetic isopropylamino-propanol derivative used as an antihypertensive, hypotensive and antiarrhythmic Atenolol acts as a peripheral, cardioselective beta blocker specific for beta-1 adrenergic receptors, without intrinsic sympathomimetic effects. It reduces exercise heart rates and delays atrioventricular conduction, with overall oxygen requirements decreasing.

Atenolol is a cardioselective beta-blocker that is widely used in the treatment of hypertension and angina pectoris. Atenolol has been linked to rare cases of drug-induced liver injury, some of which have been fatal.

Atenolol is a selective β1 receptor antagonist, cardioselective beta-adrenergic blocker possessing properties and potency similar to propranolol, but without a negative inotropic effect. The drug belonging to the group of beta blockers (sometimes written β-blockers), a class of drugs used primarily in cardiovascular diseases.

Mechanism of Action of Atenolol

Like metoprolol, atenolol competes with sympathomimetic neurotransmitters such as catecholamines for binding at beta(1)-adrenergic receptors in the heart and vascular smooth muscle, inhibiting sympathetic stimulation. This results in a reduction in resting heart rate, cardiac output, systolic and diastolic blood pressure, and reflex orthostatic hypotension. Higher doses of atenolol also competitively block beta(2)-adrenergic responses in the bronchial and vascular smooth muscles. Although it is similar to metoprolol, atenolol differs from pindolol and propranolol in that it does not have intrinsic sympathomimetic properties or membrane-stabilizing activity. Atenolol is used alone or with chlorthalidone in the management of hypertension and edema.

Indications of Atenolol

  • Long-term management of patients with angina
  • Control high blood pressure.
  • Relieve chest pain (angina pectoris stable or unstable).
  • Control an irregular heartbeat.
  • Protect the heart in the early treatment after a heart attack.
  • Angina pectoris
  • Heart failure, unspecified
  • High blood pressure (Hypertension)
  • Myocardial infarction (MI)
  • Secondary prevention myocardial infarction
  • Ventricular tachyarrhythmias
  • Supraventricular tachyarrhythmias
  • Long QT syndrome,
  • Acute myocardial infarction,
  • Ventricular tachycardia,
  • Symptoms of alcohol withdrawal.
  • Anxiety
  • Alcohol Withdrawal
  • Angina Pectoris Prophylaxis
  • Esophageal Variceal Hemorrhage Prophylaxis
  • Heart Attack
  • Mitral Valve Prolapse

Contra-Indications of Atenolol

  • Depression
  • Complete Heart Block
  • Second Degree Atrioventricular Heart Block
  • Sinus Bradycardia
  • Occasional Numbness
  • Prickling
  • or Tingling of Fingers and Toes
  • Asthma
  • Severe Chronic Obstructed Lung Disease
  • Severe Renal Impairment
  • Psoriasis
  • Blood Circulation Failure due to Serious Heart Condition
  • Abnormal Liver Function Tests
  • Pregnancy
  • Anaphylactic Shock due to Allergy Shots
  • Acutely Decompensated HF Requiring Parenteral Inotropic Therapy
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Dosage of Atenolol

Strengths: 25 mg; 50 mg; 100 mg; & 0.5 mg/mL

Angina pectoris

  • The initial dose for hypertension is 50 mg, given as one tablet a day, with the full effect seen in one to two weeks.
  • For angina, the initial dose is 50 mg, given as one tablet a day. But if an optimal response is not achieved in one week, the dosage is increased to 100 mg, given as one tablet a day.


  • Initial dose: 50 mg orally once a day
  • Maintenance dose: 50 to 100 mg orally once a day
  • Maximum dose: 100 mg per day

Angina Pectoris Prophylaxis

  • Initial dose: 50 mg orally once a day
  • Increase to 100 mg orally once a day after 1 week if optimal response not achieved
  • Maintenance dose: 50 to 200 mg orally once a day
  • Maximum dose: 200 mg per day

Angina Pectoris

  • Initial dose: 50 mg orally once a day
  • Increase to 100 mg orally once a day after 1 week if optimal response not achieved
  • Maintenance dose: 50 to 200 mg orally once a day
  • Maximum dose: 200 mg per day

Myocardial Infarction

  • 50 mg orally twice a day or 100 mg orally once a day

Side Effects of Atenolol

The most common

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Drug Interactions of Atenolol

Atenolol may interact with following drugs, supplements, & may change the efficacy of drugs

Pregnancy & Lactation of Atenolol

FDA Pregnancy Category D


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There have not been adequate studies on the use of atenolol by pregnant women; however, studies have shown that atenolol does cross the placenta. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.


This medication passes into breast milk. If you are a breastfeeding mother and are taking atenolol, it may affect your baby. Talk to your doctor about whether you should continue breastfeeding.


The safety and effectiveness of using this medication have not been established for children.




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