II. Indications
III. Mechanism
- See Beta Adrenergic ReceptorAntagonist
- Selective Beta Antagonist that primarily inhibits B1 activity by blocking B1 Receptors
- Reduces Myocardial Contractility, Blood Pressure, myocardial oxygen demand
- Also Antiarrhythmic and slows ventricular response in Atrial Fibrillation
- Contrast with non-selective Beta Blockers (e.g. Propranolol)
- Non-selective Beta Blockers also act at B2 Receptors (bronchoconstriction) and B3 Receptors (block lipolysis)
IV. Adverse Effects
- See Beta Blocker
V. Drug Interactions
- See Beta Blocker
- Apple juice or orange juice
- May reduce Atenolol absorption
- Separate dose from juice by at least 4 hours
VI. Dosing: Adults
- Start: 25-50 mg orally daily
- Despite daily dosing, duration of activity is not a a full 24 hours
- Consider dividing dosing into twice daily (e.g. 50 mg twice daily)
- Target: 50-100 mg orally daily (may divide dose twice daily)
- Maximum dose: 100 mg (50 mg if GFR <35 ml/min, 25 mg if GFR <15 ml/min)
VII. Efficacy
- Not as effective as other Beta Blockers in cardiovascular disease prevention (especially with Hypertension present)
- Consider Metoprolol, Bisoprolol, Carvedilol or Nadolol instead
- Carlberg (2004) Lancet 364:1684-9 [PubMed]
VIII. Safety
- Pregnancy Category D
- Avoid in Lactation
- Risk of Hypoglycemia in newborns
IX. Metabolism
- Bioavailability 50%
- Not lipophilic
- Renal excretion
X. Resources
XI. References
- (2019) Presc Lett, Resource #350503, Comparison of Oral Beta Blockers
- (2020) Med Lett Drugs Ther 62(1598): 73-80
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 66-7
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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Related Studies
atenolol (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
ATENOLOL 100 MG TABLET | Generic | $0.05 each |
ATENOLOL 25 MG TABLET | Generic | $0.03 each |
ATENOLOL 50 MG TABLET | Generic | $0.03 each |
ATENOLOL-CHLORTHALIDONE 100-25 | Generic | $0.39 each |
ATENOLOL-CHLORTHALIDONE 50-25 | Generic | $0.33 each |
Ontology: Atenolol (C0004147)
Definition (MSH) | A cardioselective beta-1 adrenergic blocker possessing properties and potency similar to PROPRANOLOL, but without a negative inotropic effect. |
Definition (CHV) | a drug that treats rapid heart rate and high blood pressure |
Definition (NCI) | 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. (NCI04) |
Definition (CSP) | l-p-carbamoylmethylphenoxy-3-isopropylamino -2-propanol, is a peripheral beta blocker used as an antihypertensive; propranolol, by contrast, also has CNS effects. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D001262 |
SnomedCT | 391790005, 387506000, 87652004 |
LNC | LP16037-1, MTHU015491 |
English | Atenolol, Benzeneacetamide, 4-(2-hydroxy-3-((1-methylethyl)amino)propoxy)-, atenolol, ATENOLOL, atenolol (medication), Atenolol [Chemical/Ingredient], Atenolol - chemical (substance), Atenolol - chemical, Atenolol (product), Atenolol (substance) |
Swedish | Atenolol |
Czech | atenolol |
Finnish | Atenololi |
Russian | ATENOLOL, ICI 66082, АТЕНОЛОЛ |
Japanese | アテノロール |
Croatian | ATENOLOL |
Polish | Atenolol |
Spanish | atenolol (producto), atenolol (sustancia), atenolol, Atenolol |
French | Aténolol |
German | Atenolol |
Italian | Atenololo |
Portuguese | Atenolol |
Ontology: Tenormin (C0592168)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D001262 |
English | Tenormin, tenormine, tenormin, Tenormine |