Tenormin: Proven Beta-Blocker for Hypertension and Angina Control
Tenormin
| Product dosage: 100mg | |||
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Tenormin (atenolol) is a cardioselective beta-adrenergic blocking agent widely prescribed for the management of hypertension, angina pectoris, and in certain cases, post-myocardial infarction. As a cornerstone in cardiovascular therapeutics, it functions by competitively inhibiting catecholamine-induced stimulation of β1-adrenergic receptors in the heart and vascular smooth muscle, resulting in reduced heart rate, decreased myocardial contractility, and lowered blood pressure. Its hydrophilic properties and relative cardioselectivity offer a distinct pharmacokinetic and safety profile, making it a preferred choice among clinicians for long-term cardiovascular risk management. This product card provides a comprehensive, evidence-based overview for healthcare professionals.
Features
- Active Ingredient: Atenolol (50 mg or 100 mg film-coated tablets)
- Pharmacologic Class: Cardioselective beta-1 adrenergic receptor blocker
- Bioavailability: Approximately 50% (oral administration)
- Half-life: 6–7 hours (permits once-daily dosing in many patients)
- Protein Binding: Low (<5%)
- Metabolism: Minimal hepatic metabolism; primarily excreted renally unchanged
- Onset of Action: Within 1 hour (oral)
- Duration of Action: Up to 24 hours
Benefits
- Effectively lowers systolic and diastolic blood pressure, reducing long-term cardiovascular risk.
- Decreases myocardial oxygen demand, providing prophylactic management of chronic stable angina.
- Reduces heart rate and cardiac output, beneficial in certain arrhythmias and post-infarction settings.
- Cardioselective action at therapeutic doses minimizes bronchoconstriction risk compared to non-selective beta-blockers.
- Once-daily dosing regimen supports patient adherence and consistent therapeutic coverage.
- Well-established safety and efficacy profile backed by decades of clinical use and research.
Common use
Tenormin is indicated for the management of hypertension, either as monotherapy or in combination with other antihypertensive agents. It is also approved for the long-term management of angina pectoris due to coronary atherosclerosis. In certain clinical contexts, it may be used following acute myocardial infarction to reduce cardiovascular mortality and the risk of reinfarction. Off-label uses may include situational tachycardia, migraine prophylaxis, and essential tremor, though these require careful individual risk-benefit assessment.
Dosage and direction
For hypertension: Initial dose is typically 50 mg once daily, which may be increased to 100 mg once daily after 1–2 weeks if adequate response is not achieved. Maximum recommended dose is 100 mg per day.
For angina: Starting dose is 50 mg once daily, with titration to 100 mg once daily if needed.
Dosage must be individualized based on patient response and renal function. In patients with renal impairment (creatinine clearance <35 mL/min), dose adjustment is necessary—typically 50 mg daily or 100 mg every other day.
Administration is oral, with or without food. Tablets should be swallowed whole with water. Abrupt discontinuation should be avoided; taper gradually over 1–2 weeks under medical supervision.
Precautions
Use with caution in patients with compensated heart failure, diabetes (may mask hypoglycemic symptoms), hyperthyroidism, or peripheral vascular disease. May cause bradycardia or hypotension; monitor heart rate and blood pressure regularly. Can exacerbate symptoms in patients with Prinzmetal’s angina. Not recommended during pregnancy unless potential benefit justifies potential risk. Atenolol is excreted in breast milk; use during lactation only if clearly needed. Elderly patients may require lower doses due to reduced renal function.
Contraindications
Tenormin is contraindicated in patients with sinus bradycardia, second- or third-degree heart block, cardiogenic shock, overt cardiac failure, and hypersensitivity to atenolol or any component of the formulation. Should not be used in patients with severe peripheral arterial disorders or pheochromocytoma (unless alpha-blockade is established).
Possible side effect
Common adverse reactions (>1%) include bradycardia, cold extremities, fatigue, dizziness, and depression. Less frequently, patients may experience dyspnea, wheezing, gastrointestinal disturbances, or vivid dreams. Rare but serious side effects include heart block, worsening heart failure, bronchospasm, and severe hypotension. Skin rashes and dry eyes have been reported. Most side effects are dose-dependent and may diminish with continued use or dose reduction.
Drug interaction
Concomitant use with calcium channel blockers (e.g., verapamil, diltiazem) may potentiate bradycardia and AV block. Concurrent administration with clonidine may exacerbate rebound hypertension upon withdrawal. NSAIDs may reduce antihypertensive efficacy. Tenormin may enhance effects of insulin and oral hypoglycemics. Use with digoxin may increase risk of bradycardia. Caution is advised with other centrally acting antihypertensives or drugs that depress myocardial function.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. If it is near the time of the next dose, the missed dose should be skipped and the regular dosing schedule resumed. Doubling the dose is not recommended.
Overdose
Symptoms may include severe bradycardia, heart failure, hypotension, bronchospasm, and hypoglycemia. Management is supportive and symptomatic: atropine for bradycardia, vasopressors for hypotension, glucagon or IV glucose for hypoglycemia, and bronchodilators for bronchospasm. Hemodialysis may be effective due to atenolol’s low protein binding and renal excretion.
Storage
Store at room temperature (15–30°C) in a dry place, protected from light and moisture. Keep out of reach of children. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is intended for healthcare professionals and is not a substitute for clinical judgment. Prescribing should be based on individual patient assessment and in accordance with official prescribing information. Always consult full product labeling before initiation.
Reviews
Tenormin has been extensively studied in clinical trials and real-world settings. Meta-analyses confirm its efficacy in reducing blood pressure and angina frequency. Many clinicians appreciate its predictable pharmacokinetics and once-daily dosing. Some note the need for caution in asthmatics and elderly patients, though its cardioselectivity is often cited as an advantage over non-selective agents. Long-term data support its role in cardiovascular risk reduction when used appropriately.