Adult Dosing
Hypertension
- Initial: 50 mg PO daily
- Titrate: May increase to 100 mg PO daily after 7-14 days. Max: 100 mg/day. Doses >100 mg/day were not found to be more efficacious than 100 mg/day
Chronic stable angina pectoris
- Initial: 50 mg PO daily
- Titrate: May increase to 100 mg PO daily after 7-14 days, Max: 200 mg/day PO for optimal effect
Post MI cardiovascular event prevention
- 100 mg PO daily or 50 mg PO bid
- Info: Taper dose gradually to D/C
Thyrotoxicosis [Non-FDA Approved]
- 25-50 mg PO daily; Max: 200 mg/day
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
Thyrotoxicosis [Non-FDA Approved]
- 0.5-1 mg/kg/dose PO qd-bid; Max: 2 mg/kg/day [Max 100 mg/day]
[Outline]
Renal Dose Adjustment (Based on CrCl)
- 10-50 mL/min: Decrease dose by 50%; give q48 hours; max dose=50 mg daily
- <10 mL/min: Decrease dose by 50-75%; give q96 hours; max dose=25 mg daily
- Hemodialysis: give dose after dialysis
Hepatic Dose Adjustment:
- Hepatic impairment: Dosage adjustments not defined
- Following the abrupt discontinuation of therapy with beta blockers, severe exacerbation of angina and the occurrence of myocardial infarction and ventricular arrhythmias have been reported in angina patients . If the angina worsens or acute coronary insufficiency develops, it is recommended that drug administration be promptly reinstituted, as least temporarily. Do not discontinue therapy abruptly even in patients treated only for hypertension [US Black Box Warning]
- Concomitant use of calcium channel blockers may cause bradycardia and heart block and increased left ventricular end diastolic pressure. Patients with pre-existing conduction abnormalities or left ventricular dysfunction are particularly susceptible
- It should not be used in patients with bronchospastic disease unless patients do not respond to or cannot tolerate other therapy. Administer beta-2 stimulating agent concomitantly and use lowest possible dose; start smaller doses tid to avoid higher plasma levels
- Do not withdraw therapy prior to surgery in the majority of patients. Take care when using anesthetic agents which may depress the myocardium
- Therapy should be used with caution in diabetic patients if a betablocking agent is required; as it may mask tachycardia occurring with hypoglycemia
- Do not administer in patients with untreated pheochromocytoma
- It may mask signs of hyperthyroidism; avoid abrupt withdrawal due to the risk of precipitating a thyroid storm. Patients suspected of developing thyrotoxicosis should be managed carefully to avoid abrupt withdrawal of therapy, which might precipitate a thyroid storm
Cautions: Use cautiously in
- Renal impairment
- Peripheral vascular disease
- Bronchospastic disease
- Major surgery
- Diabetes mellitus
- Thyroid disorder
- WPW syndrome
- Myasthenia gravis
- Hx of severe anaphylactic reactions
- Elderly patients
Pregnancy Category:D
Breastfeeding: Possibly unsafe. Atenolol is extensively excreted in breastmilk. Therefore other agents may be preferred while nursing a newborn or preterm infant or with high maternal dosages. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 21 January 2011). According to manufacturer data atenolol is excreted in breast milk in a ratio of 1.5-6.8 when compared to the concentration in plasma. Clinically significant bradycardia has been reported in breast fed infants. Therefore caution should be exercised when administering to a nursing woman.
Pricing data from www.DrugStore.com in U.S.A.
- Atenolol 25 MG TABS [Bottle] (RANBAXY PHARMACEUTICALS)
90 mg = $14.99
180 mg = $23.98 - Tenormin 25 MG TABS [Bottle] (ASTRAZENECA)
30 mg = $61.15
90 mg = $159.4 - Atenolol 50 MG TABS [Bottle] (SANDOZ)
90 mg = $17.99
180 mg = $27.97 - Tenormin 100 MG TABS [Bottle] (ASTRAZENECA)
30 mg = $82.98
90 mg = $227.13 - Atenolol 100 MG TABS [Bottle] (SANDOZ)
90 mg = $18.99
180 mg = $35.96 - Tenormin 50 MG TABS [Bottle] (ASTRAZENECA)
30 mg = $61.14
90 mg = $163.78
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
