atenolol / chlorthalidone
Tenoretic (atenolol / chlorthalidone) is used to lower blood pressure in adults. It's a combination of two types of blood pressure medications: a beta blocker (atenolol) and a diuretic (chlorthalidone). The tablet is taken by mouth once daily. Side effects, like dizziness and tiredness, are usually mild and they get better over time. Tenoretic (atenolol / chlorthalidone) is available as a brand-name and generic medication.
What is Tenoretic (atenolol / chlorthalidone)?
What is Tenoretic (atenolol / chlorthalidone) used for?
How Tenoretic (atenolol / chlorthalidone) works
Tenoretic (atenolol / chlorthalidone) is a combination of two different medications that both help lower blood pressure.
- Atenolol is a beta blocker. It works by blocking certain chemicals from attaching to beta receptors on the heart. This slows down your heart rate and lowers your blood pressure.
- Chlorthalidone is a thiazide-like diuretic (water pill). It works in the kidneys and moves extra water and salts into your urine. This helps remove extra water from your body. This then helps lowers blood pressure.
Drug facts
Side effects of Tenoretic (atenolol / chlorthalidone)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness
- Tiredness
- Nausea
- Slow heartbeat
- Dizziness when standing up too quickly
- Stomach irritation or cramps
- Nausea
- Constipation
Less Common Side Effects
- Feeling like the room is spinning
- Lightheadedness
- Diarrhea
- Skin that's more sensitive to the sun
- Muscle spasms
- Dry eye
- Skin rash
Note: The side effects of Tenoretic are similar to those of its two individual medications (atenolol and chlorthalidone).
Tenoretic (atenolol / chlorthalidone) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reaction: trouble breathing; swelling of the tongue, mouth, or throat; hives
- Heart problems: trouble breathing; tiredness; chest pain; irregular heartbeat; can't walk very far before feeling out of breath; swelling in the legs, ankles, or feet;
- Trouble breathing: tightness in the chest, trouble catching your breath, wheezing, cough, dizziness, extreme tiredness
The following Tenoretic (atenolol / chlorthalidone) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Chest pain or discomfort
chills
cold sweats
confusion
dizziness, faintness, or lightheadedness when getting up from lying or sitting position
leg pain
lightheadedness, dizziness, or fainting
slow or irregular heartbeat
unusual tiredness or weakness
Incidence not determined
Black, tarry stools
bleeding gums
blood in urine or stools
feeling that others are watching you or controlling your behavior
feeling that others can hear your thoughts
general feeling of discomfort, illness, or weakness
paleness or cold feeling in fingertips and toes
pinpoint red spots on skin
seeing, hearing, or feeling things that are not there
severe mood or mental changes
skin irritation or rash, including rash that looks like psoriasis
tingling or pain in fingers or toes when exposed to cold
unusual behavior
unusual bleeding or bruising
Get emergency help immediately if any of the following symptoms of overdose occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Discouragement
feeling sad or empty
irritability
lack of appetite
loss of interest or pleasure
tiredness
trouble concentrating
trouble sleeping
Less common
feeling of constant movement of self or surroundings
sensation of spinning
unusual drowsiness, dullness, or feeling of sluggishness
Incidence not determined
Decreased interest in sexual intercourse
disturbed color perception
double vision
hair loss, thinning of hair
halos around lights
headache
inability to have or keep an erection
loss in sexual ability, desire, drive, or performance
loss of vision
night blindness
overbright appearance of lights
pain of penis on erection
tunnel vision
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Tenoretic (atenolol / chlorthalidone)
Pros
- Combines two medications into one pill to help lower blood pressure better
- Only need to take once a day
- Can take with or without food
- Gets rid of extra fluids in your body
Cons
- Might make you urinate more often
- Comes in fixed doses, which makes it hard to adjust the dose if needed
- Not safe if you're pregnant or breastfeeding
- Might cause an allergic reaction if you have a sulfa allergy
Pharmacist tips for Tenoretic (atenolol / chlorthalidone)
- Take Tenoretic (atenolol / chlorthalidone) in the morning or early afternoon. This medication can make you urinate more. So taking it earlier in the day can help you avoid waking up at night often to use the bathroom.
- If you're checking your blood pressure at home, record your measurements. Bring your log to your follow-up appointments so your prescriber can see how well Tenoretic (atenolol / chlorthalidone) is working for you. They can see if you need any changes to your treatment plan to manage your blood pressure better.
- Tenoretic (atenolol / chlorthalidone) might make you feel more tired or out of breath while you're exercising or going about your usual life. This usually gets better as you get used to the medication. But talk to your prescriber if this side effect doesn't seem go away.
- Don't forget to use sunscreen whenever you go outside even if it's cloudy. Tenoretic (atenolol / chlorthalidone) can make your skin more sensitive to sunlight. This can raise your risk for sunburns.
- You might need to get blood tests or urine tests while you're taking Tenoretic (atenolol / chlorthalidone). These tests help your prescriber check your kidney health and electrolyte levels. Get your labs done on time so they can make sure it's safe for you to continue taking this medication.
- Tell your prescriber if you've ever had to use a life-saving medication like epinephrine (EpiPen) for an allergic reaction. Tenoretic (atenolol / chlorthalidone) can interact with these medications and make them work less well.
- If you have a planned surgery coming up, tell the surgery team that you're taking Tenoretic (atenolol / chlorthalidone). They'll know to keep a close eye on your heart rate during the surgery to keep you safe.
- Don't stop taking Tenoretic (atenolol / chlorthalidone) suddenly without talking to your prescriber. Stopping the medication too abruptly can be harmful because it can make your blood pressure go up. It can also raise your risk of serious heart problems like chest pain or heart attack. Your prescriber can give your directions on how to stop the medication safely.
More on Tenoretic (atenolol / chlorthalidone) tips
Common questions about Tenoretic
No. Tenoretic isn't an angiotensin-converting enzyme (ACE) inhibitor. Instead, it contains a beta blocker and a thiazide diuretic (water pill). ACE inhibitors, beta blockers, and diuretics all help lower blood pressure. But they work in different ways.
Atenolol, one of the ingredients in Tenoretic, can start to lower heart rate within 1 hour. It reaches its strongest effect on heart rate in about 2 to 4 hours. Heart rate and blood pressure are closely linked. In general, most blood pressure medications take a few hours to lower blood pressure after you take them. But it can take a couple weeks of treatment to see a consistent reduction in blood pressure. Ask your prescriber if you have questions about how long it takes Tenoretic to lower your blood pressure.
Weight gain wasn't a reported side effect of Tenoretic during clinical studies. If you notice weight changes that concern you while taking this medication, talk to your healthcare professional. They can help you find out what's causing it and how to manage it.
The manufacturer doesn't say whether or not you can safely crush Tenoretic. Talk to your prescriber or pharmacist about what to do if you're having trouble swallowing the tablet whole.
It's recommended to avoid alcohol while you're taking Tenoretic. Alcohol can make blood pressure medications work less well. It can also raise your risk for side effects, like dizziness and stomach upset. Talk to a healthcare professional about your drinking habits while taking this medication.
Yes. This medication contains chlorthalidone, which is a diuretic (water pill). Diuretics can make you urinate more. This helps your body get rid of extra fluid (water) to lower your blood pressure. Taking Tenoretic during the day rather than at night can help you avoid waking up often to urinate.
It depends on the Mucinex product. Mucinex is a branded line of products. And each Mucinex product can have different ingredients in them. You can take Mucinex that only has guaifenesin with Tenoretic. It shouldn't affect your blood pressure or the way the medications work. But some Mucinex products contain pseudoephedrine, which can raise blood pressure. Check the label and ask a pharmacist if the ingredients are safe to take with your blood pressure medication.
If you're pregnant, thinking of becoming pregnant, or breastfeeding, talk to your prescriber or obstetrician-gynecologist (OB-GYN). Tenoretic can cause harm to an unborn baby, like growth problems, if taken during pregnancy. It can also pass into breast milk and slow your baby's heart rate if you're breastfeeding. Discuss the risks and benefits with your care team. They can help find safer options to manage blood pressure during pregnancy or while breastfeeding. If you become pregnant while taking Tenoretic, call your prescriber right away.
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Risks and warnings for Tenoretic (atenolol / chlorthalidone)
Tenoretic (atenolol / chlorthalidone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of heart problems after stopping Tenoretic (atenolol / chlorthalidone) suddenly
- Risk factors: Stopping Tenoretic (atenolol / chlorthalidone) suddenly | Coronary artery disease
Don’t stop taking Tenoretic (atenolol / chlorthalidone) suddenly. It can raise your risk of serious heart problems, like chest pain or heart attack.
Get medical help right away if you have chest tightness, chest pain that spreads to your arms and neck, shortness of breath, dizziness, and fatigue. These can be signs of serious heart problems.
If you need to stop taking Tenoretic (atenolol / chlorthalidone) for any reason, talk to your prescriber first. They can help lower your dose safely over about a week or so before stopping completely.
Risk of heart failure
- Risk factors: Congestive heart failure
In some cases, Tenoretic (atenolol / chlorthalidone) might raise the risk of heart failure. This is because beta blockers (like the atenolol in Tenoretic) can slow down your heart. This can cause your heart muscle to pump less often. If you already have heart failure, your healthcare professional (HCP) will only prescribe this medication if they believe the benefits outweigh the risks. They might follow up with you more often during treatment.
Talk to your HCP if you notice signs of heart failure. Watch for swelling in your feet or ankles, fast or irregular pulse, or shortness of breath when you lie down.
Risk of heart block when taken with calcium channel blockers
- Risk factors: Taking calcium channel blockers | Currently have or have had heart rhythm problems or other heart problems
Let your prescriber know if you're taking any calcium channel blockers, like verapamil or diltiazem (Cardizem). Taking these medications with Tenoretic (atenolol / chlorthalidone) can slow your heartbeat or cause heart block, which can be dangerous. Share a list of all your medications with your prescriber so they can help check for interactions.
Caution use in people with breathing problems
- Risk factors: History of asthma | History of chronic obstructive pulmonary disease (COPD) | History of lung problems
Tell your prescriber if you have any breathing problems, like asthma. Beta blocker medications, like Tenoretic (atenolol / chlorthalidone), can cause the airways in your lungs to tighten. This can make it harder to breathe for people with lung problems.
Tenoretic (atenolol / chlorthalidone) has a lower chance of causing breathing problems than some other beta blockers because atenolol mainly affects the heart. But you should still be aware of this risk. Keep a rescue inhaler nearby in case you have sudden trouble breathing if you have lung problems.
Kidney problems
- Risk factors: History of kidney problems
Your body gets rid of Tenoretic (atenolol / chlorthalidone) using your kidneys. If your kidneys aren't working well, more medication can build up in your body and lead to side effects. Additionally, Tenoretic (atenolol / chlorthalidone) can sometimes cause certain waste products to build up.
Let your HCP know if you have a history of kidney problems. They might check your kidney function more often. In some cases, they might need to adjust your dose of Tenoretic (atenolol / chlorthalidone) to keep you safe.
Changes in fluids and electrolytes in the body
- Risk factors: History of kidney or liver problems | Dehydration
Tenoretic (atenolol / chlorthalidone) can make your body lose fluids. It can also cause changes to the levels of your electrolytes, like potassium, sodium, and chloride. Your risk might be higher if you have kidney problems. And if you have liver problems, small changes in fluid and electrolyte levels can raise your risk for liver complications.
Tell your care team if you have dry mouth, weakness, muscle cramps, tiredness, fast or irregular heart rate, nausea, or vomiting. These can be signs of abnormal electrolyte levels. Your HCP might have you get regular blood work to check your electrolyte levels while taking Tenoretic (atenolol / chlorthalidone).
Hidden symptoms of low blood sugar
- Risk factors: Diabetes | Fasting (e.g., related to getting surgery, not eating regularly, vomiting)
There's a risk that the atenolol in Tenoretic can make it harder for you to notice signs of low blood sugar. Some signs, such as fast heartbeat, tremors, and irritability, might not be as noticeable. Sweating might be the only sign you have warning you of low blood sugar levels. This is especially important people with diabetes to know. Speak with your HCP about when and how to check your blood sugar if you start Tenoretic (atenolol / chlorthalidone).
Hidden symptoms of overactive thyroid
- Risk factors: Hyperthyroidism
If you have hyperthyroidism (too much thyroid hormone), talk to your HCP before stopping Tenoretic (atenolol / chlorthalidone). This medication can hide signs of hyperthyroidism, like a fast heart rate. Suddenly stopping the medication can worsen symptoms of hyperthyroidism. It can also lead to a serious condition called a "thyroid storm," which can cause high fever and rapid heartbeat.
Possible gout
- Risk factors: History of gout
The chlorthalidone component of Tenoretic can raise the uric acid levels in your body. This can sometimes lead to gout. Make sure to tell your prescriber if you've had a history of gout before starting this medication. They can tell you what signs to look out for, such as swollen, red, and painful joints.
Risk of harm to baby
- Risk factors: Pregnant | Breastfeeding
Taking Tenoretic (atenolol / chlorthalidone) during pregnancy or while breastfeeding can possibly harm your baby. If you're pregnant, thinking of becoming pregnant, or breastfeeding, talk to your prescriber or obstetrician-gynecologist (OB-GYN) about the risks and benefits. They can help find a safer option for you.
Tenoretic (atenolol / chlorthalidone) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50mg/25mg | 90 tablets | $36.12 | $0.40 |
| 100mg/25mg | 90 tablets | $42.51 | $0.47 |
Typical dosage for Tenoretic (atenolol / chlorthalidone)
The typical starting dose is 50 mg/25 mg (atenolol/chlorthalidone) by mouth once daily. Your prescriber might raise your dose slowly over time if you need more help with managing your blood pressure.
The maximum recommended dose is 100 mg/25 mg (atenolol/chlorthalidone) once daily.
Your dose might differ if you have kidney problems.
Interactions between Tenoretic (atenolol / chlorthalidone) and other drugs
More on Tenoretic (atenolol / chlorthalidone) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aceclofenac
- Acemetacin
- Acetyldigoxin
- Albuterol
- Amtolmetin Guacil
- Arsenic Trioxide
- Aspirin
- Bepridil
- Bromfenac
- Bufexamac
- Celecoxib
- Ceritinib
- Choline Salicylate
- Clonidine
- Clonixin
- Crizotinib
- Deslanoside
- Desmopressin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Digitalis
- Digitoxin
- Digoxin
- Diltiazem
- Dipyrone
- Dofetilide
- Dronedarone
- Droperidol
- Droxicam
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoldopam
- Fenoprofen
- Fepradinol
- Feprazone
- Fingolimod
- Flecainide
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Formoterol
- Ibuprofen
- Indacaterol
- Indomethacin
- Iohexol
- Ketanserin
- Ketoprofen
- Ketorolac
- Lacosamide
- Levalbuterol
- Levomethadyl
- Lithium
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Metildigoxin
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Olodaterol
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenylbutazone
- Piketoprofen
- Piroxicam
- Ponesimod
- Proglumetacin
- Propyphenazone
- Proquazone
- Rivastigmine
- Rofecoxib
- Salicylic Acid
- Salmeterol
- Salsalate
- Siponimod
- Sodium Salicylate
- Sotalol
- Sulindac
- Tenoxicam
- Terbutaline
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Valdecoxib
- Verapamil
- Vilanterol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Aceclofenac
- Acemetacin
- Acetyldigoxin
- Albiglutide
- Alfuzosin
- Alogliptin
- Aminolevulinic Acid
- Amtolmetin Guacil
- Arbutamine
- Aspirin
- Bromfenac
- Bufexamac
- Bunazosin
- Canagliflozin
- Celecoxib
- Chlorpropamide
- Choline Salicylate
- Clonixin
- Dapagliflozin
- Deslanoside
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Digitoxin
- Digoxin
- Dipyrone
- Disopyramide
- Doxazosin
- Droxicam
- Dulaglutide
- Empagliflozin
- Ertugliflozin
- Etodolac
- Etofenamate
- Etoricoxib
- Exenatide
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Glimepiride
- Glipizide
- Glyburide
- Gossypol
- Ibuprofen
- Indomethacin
- Insulin Aspart, Recombinant
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Human Inhaled
- Insulin Human Isophane (NPH)
- Insulin Human Regular
- Insulin Lispro, Recombinant
- Ketoprofen
- Ketorolac
- Licorice
- Linagliptin
- Liraglutide
- Lixisenatide
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Metformin
- Metildigoxin
- Mibefradil
- Miglitol
- Morniflumate
- Moxisylyte
- Nabumetone
- Naproxen
- Nateglinide
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenoxybenzamine
- Phentolamine
- Phenylbutazone
- Piketoprofen
- Pioglitazone
- Piroxicam
- Pramlintide
- Pranoprofen
- Prazosin
- Proglumetacin
- Propyphenazone
- Proquazone
- Quinidine
- Repaglinide
- Rofecoxib
- Rosiglitazone
- Salicylic Acid
- Salsalate
- Saxagliptin
- Sitagliptin
- Sodium Salicylate
- St John's Wort
- Sulindac
- Tamsulosin
- Tenoxicam
- Terazosin
- Tiaprofenic Acid
- Tolazamide
- Tolbutamide
- Tolfenamic Acid
- Tolmetin
- Trimazosin
- Urapidil
- Valdecoxib
- Vildagliptin
- Warfarin
How much does Tenoretic (atenolol / chlorthalidone) cost?
Tenoretic (atenolol / chlorthalidone) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Tenoretic (atenolol / chlorthalidone) will not be safe for you to take.
- Slow heart rate
- Second- or third-degree heart block
- Cardiac shock
- Certain cases of heart failure
- Untreated pheochromocytoma
- Not making urine (not urinating)
- Allergy to sulfa-containing medications
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