Atenolol

byAbdelwahab Ward, BS Pharm, PharmD - last updated
0
TENORMIN...
CLASS: β-Adrenergic Blocker, Cardioselective.
DOSAGE FORM: Tablet 25 mg, 50 mg, 100 mg.

  • Angina pectoris, chronic: 50 mg po daily; titrate to 100-200 mg po daily.
  • HTN: Adults, 50 mg po daily, titrate to 100 mg po daily; Children, 0.5-1 mg/kg/day po in 1-2 divided doses, titrate to 2 mg/kg/d po in 1-2 divided doses (max 100 mg/day).
  • AMI: 25-50 mg po bid (max 100 mg/d in 1-2 divided doses).
  • Cardiac dysrhythmia: Adults, 25-100 mg po daily; Children, 0.3-1.4 mg/kg po daily, titrate to 2 mg/kg po daily.
  • Migraine prophylaxis: 25-100 mg po daily.
  • Marfan syndrome with aortic aneurysm: 25-100 mg/day (max 200 mg/day).
  • Thyrotoxicosis: 25-50 mg po once daily; may titrate up to 200 mg/day in 2 divided doses.
  • Atenolol is a cardioselective β-adrenergic that decreases AV nodal conduction in supraventricular tachycardias and blockade of catecholamine-induced dysrhythmias.

Table (1). Drug Characteristics (Atenolol)
Dose Adjustment Hepatic Not required Absorption F = 50%, food decreases AUC by 20%
Dose Adjustment Renal CrCl 10-30 mL/min, max dose 50 mg po daily; CrCl <10 mL/min, max dose 25 mg po daily Distribution Vd = 50-75 L; 6-16% protein bound
Dialyzable Yes, give 25-50 mg after each dialysis procedure Metabolism Limited hepatic
Pregnancy Category D Elimination Renal 40-50%, fecal 50% (unchanged) with a half-life of 6-7 h
Lactation Avoid Pharmacogenetics None known
Contraindications Hypersensitivity to atenolol, sinus bradycardia, 2nd- or 3rd-degree AV block, overt heart failure or cardiogenic shock Box Warnings Avoid abrupt withdrawal
Briggs Pregnancy Recommendation Human data suggest risk in 2nd and 3rd trimesters
Briggs Breastfeeding Recommendation Limited human data—potential toxicity

REFERENCES

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