atenolol
Atenolol (Tenormin) is a cardioselective beta-blocker that's used to treat high blood pressure and chest pain. It's also used to lower the risk of death after a heart attack. Atenolol (Tenormin) works by slowing down heart rate and making it easier for your heart to pump blood. Atenolol (Tenormin) is taken by mouth, typically once daily. Some common side effects of this medication include dizziness, feeling tired, and having cold hands and feet.
What is Atenolol (Tenormin)?
What is Atenolol (Tenormin) used for?
- High blood pressure
- Chest pain (stable angina)
- Lower risk of death after heart attack
How Atenolol (Tenormin) works
Atenolol (Tenormin) is a cardioselective beta-blocker. It slows down heart rate so your heart doesn't have to work as hard to pump blood through the body. This puts less stress on the blood vessels, which lowers blood pressure. Atenolol (Tenormin) also improves blood flow to the heart, which eases chest pain.
Drug facts
Side effects of Atenolol (Tenormin)
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
- Feeling tired (up to 26%)
- Dizziness (up to 13%)
- Cold hands and feet (up to 12%)
- Feeling depressed (up to 12%)
- Trouble catching your breath (up to 6%)
Note: Side effects were reported by people who took atenolol for high blood pressure
Less Common Side Effects
- Slow heart rate
- Leg pain
- Spinning sensation
- Lightheadedness
- General weakness
- Drowsiness
- Dreaming
- Diarrhea
- Nausea
- Wheezing
Atenolol (Tenormin) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Worsening heart failure: shortness of breath, unusual swelling, tiredness, and sudden weight gain
- Bronchospasm: tightness in the chest, trouble catching your breath, difficulty breathing, wheezing, cough, dizziness, extreme tiredness
More on Atenolol (Tenormin) side effects
The following Atenolol (Tenormin) 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:
More common
Blurred vision
cold hands or feet
confusion
difficult or labored breathing
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
shortness of breath
sweating
tightness in chest
unusual tiredness or weakness
Less common
chest pain or discomfort
chills
cold sweats
dizziness or lightheadedness
fainting
fast heartbeat
leg pain
noisy breathing
slow or irregular heartbeat
sudden shortness of breath or troubled breathing
Rare
Bloody urine
decreased frequency or amount of urine
increased blood pressure
increased thirst
loss of appetite
lower back or side pain
swelling of face, fingers, or lower legs
vomiting
Incidence not determined
Black, tarry stools
bleeding gums
blood in urine or stools
blurred or loss of vision
bone or joint pain
disturbed color perception
double vision
feeling that others are watching you or controlling your behavior
feeling that others can hear your thoughts
feeling, seeing, or hearing things that are not there
halos around lights
night blindness
overbright appearance of lights
paleness or cold feeling in fingertips and toes
pinpoint red or purple spots on skin
severe mood or mental changes
skin irritation or rash, including rash that looks like psoriasis
swollen or painful glands
tingling or pain in fingers or toes when exposed to cold
tunnel vision
unusual behavior
unusual bleeding or bruising
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
coma
cool, pale skin
dilated neck veins
extreme fatigue
headache
increased hunger
irregular breathing
nervousness
nightmares
seizures
shakiness
slurred speech
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
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
trouble concentrating
trouble sleeping
Less common
dream activity
feeling of constant movement of self or surroundings
sensation of spinning
sleepiness
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 Atenolol (Tenormin)
Pros
- A first-choice treatment to prevent chest pains (angina)
- Lower risk of wheezing and breathing problems compared to non-selective beta blockers
- Available as a lower-cost generic medication
Cons
- Can hide some symptoms of low blood sugar
- Not recommended during pregnancy or breastfeeding
- Stopping treatment suddenly can raise the risk of heart attack and stroke
Pharmacist tips for Atenolol (Tenormin)
- Atenolol (Tenormin) can cause dizziness, which could lead to falls. Make sure to sit or lie down if you feel dizzy to prevent accidental injuries. Don't drive a car or operate machinery until you know how atenolol (Tenormin) affects you.
- If you're taking atenolol (Tenormin) for your blood pressure, you can track how well it's working by checking your blood pressure regularly at home. Write down your blood pressure readings, and bring them to your appointments with your provider so you can discuss how well atenolol (Tenormin) is working for you.
- Don't take atenolol (Tenormin) if you're pregnant since it can cause low blood sugar or slow heart rate to the unborn baby. If you're pregnant or thinking of getting pregnant during treatment, contact your provider right away. Your provider might prescribe you a different medication that's safer during pregnancy or suggest lifestyle changes.
- Consider avoiding alcohol while taking atenolol (Tenormin) because taking the two together can make you more drowsy and dizzy. If you drink alcohol regularly and it's difficult to stop completely, talk with your provider about what's a safer amount to drink.
- If you have diabetes, be careful taking atenolol (Tenormin), since this medication can hide symptoms of low blood sugar, except for sweating and dizziness.
- Don't stop taking this medication suddenly unless your provider tells you to. Stopping atenolol (Tenormin) all of a sudden cause your blood pressure to go up, which can raise the risk of heart attack and stroke. If you want to stop this medication, your provider can lower your dose slowly over time.
Common questions about Atenolol (Tenormin)
Studies show that atenolol (Tenormin) can start to lower exercise tachycardia (fast heart rate from exercise) within an hour after your dose. And you'll see a more noticeable effect on heart rate around 2 to 4 hours after a dose. But if you're taking atenolol (Tenormin) for blood pressure you might not see the full effects of this medication until about 1 to 2 weeks after you start. To make sure atenolol (Tenormin) is working well for you, your provider might ask you to check your heart rate and blood pressure regularly while taking this medication. Keep in mind that it might take a few weeks for your provider to find a dose that works for you. Make sure to follow the titration schedule as directed by your provider.
If you need to stop taking atenolol (Tenormin) for any reason, let your provider know. Don't suddenly stop atenolol (Tenormin) because this not only raises your risk of high blood pressure and chest pain, but also your risk of having a heart attack. Your provider can help you stop atenolol (Tenormin) safely by lowering your dose slowly over time.
It can take between 1 to 2 days for most of atenolol (Tenormin) to leave your body. But it can take much longer for older adults and people with kidney problems. Keep in mind that this time frame is estimated based on the half-life of atenolol (Tenormin). It can also be affected by your health conditions and genetics, so it can be different for each individual person. Talk with your provider if you have more questions about how long atenolol (Tenormin) stays in your system.
Atenolol (Tenormin) is only FDA-approved to be taken once daily for high blood pressure and chest pain. If you're taking atenolol (Tenormin) after a heart attack, your provider might ask you to take it twice daily for a short period of time. Don't stop, start, or change how your take your blood pressure or heart medications on your own without first speaking to your provider.
The maximum dose of atenolol (Tenormin) is different depending on what medical condition you're taking it to treat. For example, the maximum dose of atenolol (Tenormin) to treat high blood pressure is 100 mg once daily. On the other hand, the maximum dosage for chest pain is 200 mg of atenolol (Tenormin) once daily. In either condition, your provider will typically start you at 50 mg once daily and raise your dose every few weeks until your blood pressure or chest pain is controlled. Don't adjust the dose of atenolol (Tenormin) without talking to your provider.
Even though it's not common, atenolol (Tenormin) might cause some weight gain as a side effect. This is because beta blockers, such as atenolol (Tenormin), have been shown to slow down metabolism, which can lead to weight gain. In addition, beta blockers can also cause you to be more tired, which can make it harder for you to exercise. To minimize weight gain, try to stick with an exercise routine that works for you. Talk with your provider if you have more questions about atenolol (Tenormin) and weight gain.
According to the American Psychiatric Association, atenolol (Tenormin) can be prescribed off-label for performance-only social anxiety, such as public speaking. The typical dose is to take 50 mg to 150 mg by mouth 1-2 hours before an event that causes anxiety. Keep in mind that atenolol (Tenormin) doesn't work against generalized social anxiety. Ask your provider if atenolol (Tenormin) is appropriate for you.
Atenolol (Tenormin) and metoprolol tartrate (Lopressor) are both cardioselective beta-blockers that can help lower blood pressure, ease chest pain, and to lower the risk of death after a heart attack. One main difference is that atenolol (Tenormin) is typically taken once daily, whereas metoprolol tartrate (Lopressor) is taken twice daily. But metoprolol does come in an extended-release version called metoprolol succinate (Toprol XL) that's taken once daily. Talk with your provider if you have more questions about the differences between atenolol and metoprolol.
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Risks and warnings for Atenolol (Tenormin)
Atenolol (Tenormin) 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.
Worsening chest pain, heart attacks, and irregular heartbeat
- Risk factors: Stopping atenolol (Tenormin) suddenly | History of coronary artery disease (CAD)
Don’t stop taking atenolol (Tenormin) suddenly since it can worsen your chest pain, heart attack, or irregular heartbeat. If you need to stop taking this medication for any reason, let your provider know. They can work with you to lower your dose safely over time. While your dose is being lowered, make sure to limit physical activity as much as possible to lower the stress on your heart. Watch out for symptoms of heart attack (e.g., chest pain and tightness, pain that spreads to arms and neck, trouble breathing, lightheadedness, and fatigue) and irregular heartbeat (e.g., chest pain, fast heartbeat, dizziness, nausea). Get medical attention right away if you have any of these symptoms.
Heart failure
- Risk factors: Heart failure | Sudden heart attack
Atenolol (Tenormin) might lead to heart failure or worsen heart failure in people who already have it. This is because atenolol (Tenormin) can slow down your heart, which leads to your heart muscle not pumping as often. In people with a history of heart problems, this can cause their heart to not work as well, leading to heart failure. People with heart failure shouldn't take atenolol (Tenormin) if their heart failure symptoms aren’t well-managed. Discuss with your provider before starting atenolol (Tenormin) if you have a history of heart failure. Let your provider know right away if you experience symptoms such as trouble breathing, tiredness, swelling in your body, or sudden weight gain. Your provider might ask you to stop this medication if you have symptoms of heart failure.
Risk of difficulty breathing
- Risk factors: Chronic obstructive pulmonary disease (COPD) | Asthma
Atenolol (Tenormin) can cause the vessels in your lung to tighten. This can make breathing difficult, especially in people with breathing problems, like asthma. This problem is very rare with atenolol (Tenormin) because it's a cardioselective beta-blocker, meaning it targets your heart rather than your lungs. To be safe, make sure your provider knows about your full medical history before starting this medication. Your provider will start you on the lowest dose possible that works well for you.
Greater risk during surgery
- Risk factor: Major surgery requiring anesthesia
If you're planning to undergo a major surgery requiring anesthesia, tell your surgeon that you are taking atenolol (Tenormin). Beta-blockers, such as atenolol (Tenormin), might raise the risk of side effects from anesthesia. If you've been taking it for a while, your surgeon might not ask you to stop it, but they'll need to monitor your heart closely during your procedure.
Hiding symptoms of low blood sugar
- Risk factors: Diabetes
Taking atenolol (Tenormin) can make it difficult for you to identify some symptoms of low blood sugar, such as fast heart beat or tremors. If you’re taking blood sugar medications, you might not be able to rely on all the typical symptoms of low blood sugar to warn you of a dangerous drop in your sugar levels. Watch out for sweating and dizziness, which aren't affected by atenolol (Tenormin), to identify low blood sugar episodes. If you have diabetes, speak with your provider about how often to monitor your blood sugar once you start atenolol (Tenormin).
Hiding symptoms of overactive thyroid
- Risk factor: Hyperthyroidism
If you have hyperthyroidism (overactive thyroid), talk to your provider before stopping atenolol (Tenormin). This is because atenolol (Tenormin) lowers your heart rate, which makes it harder to notice heart-related symptoms that are caused by hyperthyroidism. In some people, stopping this medication suddenly might lead to a condition called a "thyroid storm,” which include symptoms such as a high temperature, rapid heartbeat, and fainting. Get medical attention right away if you have these symptoms.
Risk of heart block (medication interaction)
You should avoid taking atenolol (Tenormin) with certain calcium channel blockers (CCBs), like diltiazem (Cardizem) or verapamil. Doing so can raise the risk of dangerously low heart rate and heart block.
Risk of harm to unborn and breastfed babies
- Risk factors: Currently in second trimester of pregnancy | Breastfed baby
Atenolol (Tenormin) can cause slow heart rate and low blood sugar to your breastfed baby or unborn baby if it's taken after second trimester of pregnancy. Speak to your provider about the risks and benefits of atenolol (Tenormin) if you're pregnant or breastfeeding. Ask them whether there are safer alternatives.
Atenolol (Tenormin) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 25mg | 30 tablets | $4.00 | $0.13 |
| 50mg | 90 tablets | $10.00 | $0.11 |
| 100mg | 90 tablets | $10.00 | $0.11 |
Typical dosage for Atenolol (Tenormin)
High blood pressure
- Adults: The typical starting dose is 50 mg by mouth once daily. Your provider will raise your dose every few weeks if you need to lower your blood pressure more. The maximum recommended dose is 100 mg once daily.
Chest pain (angina)
- Adults: The typical starting dose is 50 mg by mouth once daily. Your provider will raise your dose within a week if you need better control of your chest pain. The usual maintenance dose is 100 mg once daily. The maximum dose is 200 mg once daily.
After a heart attack
- Adults: Atenolol (Tenormin) is usually given as an injection into the veins (IV) in a hospital setting by a trained provider after a heart attack. Afterwards, the typical dose is 100 mg by mouth once daily, or 50 mg by mouth twice daily as directed by the provider.
Your dose might differ if you have kidney problems.
More on Atenolol (Tenormin) dosage
Interactions between Atenolol (Tenormin) and other drugs
More on Atenolol (Tenormin) 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.
- Albuterol
- Ceritinib
- Clonidine
- Crizotinib
- Diltiazem
- Dronedarone
- Fenoldopam
- Fingolimod
- Formoterol
- Indacaterol
- Iohexol
- Lacosamide
- Levalbuterol
- Olodaterol
- Ponesimod
- Rivastigmine
- Salmeterol
- Siponimod
- Terbutaline
- 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
- 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
- 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
- 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
How much does Atenolol (Tenormin) cost?
Atenolol (Tenormin) 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 Atenolol (Tenormin) will not be safe for you to take.
- Low heart rate (less than 60 beats/minute)
- Heart problems (e.g., first-degree heart block, cardiac shock)
- Heart failure
What are alternatives to Atenolol (Tenormin)?
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