Atenolol: Uses, Dosage & Side Effects
A cardioselective beta blocker used to treat high blood pressure, angina pectoris, cardiac arrhythmias, and for secondary prevention after heart attack
Atenolol is a cardioselective beta-1 adrenergic blocker (beta blocker) widely prescribed for the treatment of hypertension (high blood pressure), chronic stable angina pectoris (chest pain), certain cardiac arrhythmias (irregular heartbeats), and for secondary prevention following myocardial infarction (heart attack). Listed on the WHO Model List of Essential Medicines, atenolol works by slowing the heart rate and reducing the force of cardiac contractions, thereby lowering blood pressure and decreasing the heart's oxygen demand. It requires a prescription and should never be stopped abruptly without medical supervision.
Quick Facts: Atenolol
Key Takeaways
- Atenolol is a cardioselective beta-1 blocker that primarily acts on the heart, causing fewer respiratory side effects than non-selective beta blockers, though it is still contraindicated in asthma.
- It is used to treat high blood pressure, angina pectoris, certain arrhythmias, and to prevent further heart attacks after an initial myocardial infarction.
- Never stop taking atenolol suddenly; abrupt withdrawal can cause rebound hypertension, worsening angina, or in rare cases, a heart attack. Your doctor will taper the dose gradually.
- Atenolol can mask symptoms of low blood sugar (hypoglycemia) in people with diabetes; blood glucose should be monitored carefully during treatment.
- Common side effects include cold hands and feet, fatigue, slow heart rate, and digestive disturbances, most of which are mild and manageable.
What Is Atenolol and What Is It Used For?
Atenolol belongs to the class of medications known as beta-adrenergic blocking agents, or beta blockers. More specifically, it is a cardioselective (beta-1 selective) beta blocker, meaning it preferentially blocks beta-1 adrenergic receptors found predominantly in the heart, rather than beta-2 receptors found in the lungs and blood vessels. This cardioselectivity, while not absolute at higher doses, generally translates to fewer respiratory side effects compared to non-selective beta blockers such as propranolol.
First introduced in the 1970s, atenolol has been one of the most widely prescribed beta blockers worldwide and is included on the World Health Organization (WHO) Model List of Essential Medicines. It has a well-established safety profile supported by decades of clinical use and extensive clinical trial data. Atenolol is available as a generic medication in most countries, making it an affordable treatment option for cardiovascular conditions.
The pharmacological action of atenolol centers on its ability to block beta-1 adrenoceptors in the heart. By doing so, it reduces the heart rate (negative chronotropic effect), decreases the force of cardiac muscle contraction (negative inotropic effect), and lowers the rate of electrical conduction through the atrioventricular (AV) node (negative dromotropic effect). These combined actions result in a reduction in cardiac output and systolic blood pressure, as well as decreased myocardial oxygen consumption, which underlies its effectiveness in treating both hypertension and angina.
Atenolol is indicated for several cardiovascular conditions. In hypertension (high blood pressure), it is used either as monotherapy or in combination with other antihypertensive agents such as diuretics or calcium channel blockers to achieve target blood pressure levels. For chronic stable angina pectoris, atenolol reduces the frequency and severity of angina episodes by decreasing the heart's oxygen demand during exertion. In the management of certain cardiac arrhythmias, particularly supraventricular tachycardias, atenolol helps control the heart rate by slowing conduction through the AV node. Additionally, atenolol is used for secondary prevention after myocardial infarction (heart attack), where it has been shown to reduce the risk of reinfarction and cardiovascular mortality.
Atenolol is distinguished from some other beta blockers by its pharmacokinetic properties. It is water-soluble (hydrophilic), which means it does not readily cross the blood-brain barrier. This characteristic may contribute to a lower incidence of central nervous system side effects such as nightmares, sleep disturbances, and depression compared to lipophilic beta blockers like propranolol or metoprolol. Atenolol has a relatively long half-life of approximately 6 to 7 hours, allowing for once-daily dosing in most patients, which improves adherence to treatment regimens.
What Should You Know Before Taking Atenolol?
Contraindications
There are several conditions where atenolol must not be used. Understanding these absolute contraindications is essential for safe prescribing and use. Do not take atenolol if any of the following apply to you:
- Known hypersensitivity: Allergy to atenolol or any of the inactive ingredients in the formulation.
- Untreated or decompensated heart failure: Atenolol can worsen heart failure that has not been stabilized with appropriate treatment. Signs may include breathlessness and swollen ankles.
- Sick sinus syndrome or second/third-degree AV block: Unless a pacemaker is fitted, atenolol can dangerously slow cardiac conduction.
- Severe bradycardia: A resting heart rate below 50 beats per minute before treatment.
- Severe hypotension: Very low blood pressure that may cause dizziness or fainting.
- Severe peripheral circulatory disorders: Including advanced peripheral arterial disease with critical limb ischemia.
- Cardiogenic shock: A life-threatening condition where the heart cannot pump enough blood to meet the body's needs.
- Untreated pheochromocytoma: A rare adrenal tumor that causes dangerously high blood pressure. Atenolol should only be used after adequate alpha-blocker treatment is established.
- Metabolic acidosis: If your doctor has diagnosed you with excessively acidic blood.
- Asthma or severe bronchospasm: Beta blockers, even cardioselective ones, can trigger life-threatening bronchospasm in asthma patients.
- Concurrent IV use of verapamil or diltiazem: The combination with these calcium channel blockers can cause severe cardiac depression.
Warnings and Precautions
Never discontinue atenolol abruptly, especially if you have ischemic heart disease (coronary artery disease). Sudden withdrawal may lead to rebound hypertension, worsening of angina symptoms, or in rare cases, myocardial infarction. Your doctor will reduce the dose gradually over 1 to 2 weeks.
Atenolol requires careful use and medical consultation in several circumstances. Talk to your doctor or pharmacist before taking atenolol if you have any of the following conditions:
- Respiratory problems: If you experience wheezing or shortness of breath (not related to asthma), atenolol should be used with caution. While cardioselective, it can still affect bronchial beta-2 receptors at higher doses.
- History of severe allergic reactions: Beta blockers may increase the severity of anaphylactic reactions and reduce the response to epinephrine (adrenaline) used to treat them.
- Kidney disease: Atenolol is primarily eliminated by the kidneys. Patients with moderate to severe renal impairment require dose reduction to prevent drug accumulation.
- Prinzmetal's angina: A type of variant angina caused by coronary artery spasm. Beta blockers may worsen this condition.
- Poor peripheral circulation: Atenolol may exacerbate symptoms of peripheral arterial disease or Raynaud's phenomenon.
- Slow heart rate: If your resting heart rate is between 50 and 55 beats per minute, close monitoring is required.
- First-degree heart block: Atenolol may further slow conduction in the heart.
- Diabetes mellitus: Atenolol can mask the typical symptoms of low blood sugar (hypoglycemia), particularly a fast heart rate and tremor. Blood glucose levels should be monitored carefully. The medication may also alter glycemic control.
- Psoriasis: Beta blockers may worsen this skin condition.
- Thyroid disorders (thyrotoxicosis): Atenolol can mask the signs of an overactive thyroid, such as rapid heart rate and tremor. Do not stop atenolol abruptly in patients with thyrotoxicosis, as this may precipitate a thyroid storm.
- Pheochromocytoma under treatment: If you are being treated for this adrenal tumor, an alpha-blocker must be used in addition to atenolol, and blood pressure should be monitored closely.
- Planned surgery: Inform your anesthesiologist that you are taking atenolol, as certain anesthetic agents may interact. Atenolol is generally not stopped before surgery, but the anesthesia team needs to be aware.
- Elderly patients: The dose may need to be adjusted, particularly if kidney function is reduced.
Pregnancy and Breastfeeding
Atenolol is generally not recommended during pregnancy. Studies have associated its use, particularly during the first trimester, with intrauterine growth restriction (reduced fetal growth and lower birth weight). If you are pregnant or planning to become pregnant, discuss alternative medications with your doctor. Other beta blockers such as labetalol are generally preferred for managing hypertension in pregnancy.
Atenolol crosses the placenta and reaches significant concentrations in the fetal circulation. Clinical studies have reported associations between atenolol use during pregnancy and reduced placental weight, intrauterine growth restriction, and lower neonatal birth weight. The European Medicines Agency (EMA) and most obstetric guidelines recommend avoiding atenolol during pregnancy when safer alternatives are available. Labetalol and methyldopa are generally the preferred antihypertensive agents during pregnancy.
Atenolol is excreted in breast milk at concentrations approximately 1.5 to 6.8 times higher than those in maternal plasma. Although clinical effects on the nursing infant are considered unlikely at therapeutic maternal doses, breastfeeding is generally not recommended during atenolol treatment. If beta-blocker therapy is required during breastfeeding, metoprolol or propranolol may be preferred due to lower milk-to-plasma ratios. Always consult your doctor before taking any medication while breastfeeding.
Driving and Operating Machinery
Atenolol treatment may cause dizziness, fatigue, or lightheadedness, particularly at the start of treatment or after dose increases. These effects can impair your ability to drive or operate machinery safely. It is advisable to wait and see how the medication affects you before engaging in activities that require alertness. If you experience persistent dizziness or tiredness, discuss this with your doctor. Be particularly cautious if you also consume alcohol, as the combination may enhance these effects.
How Does Atenolol Interact with Other Drugs?
Atenolol can interact with a number of other medications in clinically significant ways. Some combinations are contraindicated, while others require dose adjustment or careful monitoring. Always inform your doctor, pharmacist, or nurse about all medications, herbal remedies, and supplements you are taking before starting atenolol treatment.
Major Interactions
| Interacting Drug | Effect | Clinical Advice |
|---|---|---|
| Verapamil, Diltiazem | Concurrent use can cause severe bradycardia, hypotension, heart block, and potentially cardiac arrest due to additive negative effects on heart rate and conduction | Contraindicated. Do not combine with intravenous verapamil or diltiazem. Oral combination only under strict specialist supervision with close monitoring. |
| Clonidine | If clonidine is withdrawn while taking atenolol, severe rebound hypertension can occur. The combination can also cause excessive blood pressure reduction. | If both drugs need to be stopped, discontinue atenolol several days before clonidine. Follow your doctor's tapering instructions carefully. |
| Amiodarone, Disopyramide, Quinidine, Procainamide | Additive effects on heart rate and conduction; increased risk of bradycardia, heart block, and hypotension | Use only under close cardiac monitoring. Your doctor may need to adjust doses of both medications. |
| Floctafenine | Beta blockers may prevent the compensatory cardiovascular responses to hypotension associated with floctafenine-induced anaphylactic reactions | Contraindicated. Do not take floctafenine while on atenolol. |
| Nifedipine | Can cause excessive blood pressure lowering and in rare cases may worsen heart failure | Combination requires careful blood pressure monitoring. Do not combine without medical supervision. |
Minor Interactions
| Interacting Drug | Effect | Clinical Advice |
|---|---|---|
| Digoxin | Additive slowing of the heart rate and AV conduction | Monitor heart rate and ECG. Dose adjustment may be needed. |
| Insulin and oral antidiabetics | Atenolol can mask symptoms of hypoglycemia (low blood sugar), particularly tachycardia and tremor | Monitor blood glucose closely. Diabetes medication may need adjustment. Sweating remains a reliable sign of hypoglycemia. |
| Ibuprofen, Indomethacin (NSAIDs) | NSAIDs may reduce the blood pressure-lowering effect of atenolol | If regular NSAID use is needed, monitor blood pressure and consider alternative pain relief such as paracetamol. |
| Epinephrine (Adrenaline) | The response to epinephrine in allergic reactions may be reduced; higher doses may be needed | Patients at risk of anaphylaxis should inform their allergist about beta-blocker use. |
| Baclofen, Diuretics, Vasodilators | Enhanced blood pressure-lowering effect, increasing the risk of hypotension | Blood pressure should be monitored, especially when starting or adjusting doses. |
| Lidocaine | Atenolol may increase lidocaine levels by reducing hepatic blood flow | Monitor for signs of lidocaine toxicity if used concurrently. |
| Tricyclic antidepressants, MAOIs, Phenothiazines | Enhanced hypotensive effect; possible increased risk of orthostatic hypotension | Monitor blood pressure regularly. Rise slowly from sitting or lying positions. |
| Ampicillin | May reduce the absorption of atenolol from the gastrointestinal tract | Clinical significance is usually minor. No dose adjustment typically needed. |
If you are scheduled for surgery, inform your anesthesiologist that you are taking atenolol. Certain anesthetic agents may interact with beta blockers, increasing the risk of hypotension during the procedure. If you are undergoing radiological examination with iodinated contrast media, your doctor should also be informed. Atenolol is generally continued during surgery, but the anesthesia team must be aware to manage your care appropriately.
What Is the Correct Dosage of Atenolol?
Atenolol dosing depends on the condition being treated, the patient's age, kidney function, and individual response to therapy. Your doctor will determine the most appropriate dose for your situation. Always take atenolol exactly as prescribed. Swallow the tablets whole with a glass of water, and try to take them at the same time each day for consistent blood levels.
Adults
Hypertension (High Blood Pressure)
Starting dose: 50 mg once daily
Maintenance dose: 50–100 mg once daily
Note: Full blood pressure-lowering effect is usually seen within 1–2 weeks. The addition of another antihypertensive (e.g., a diuretic) may provide additional benefit if adequate blood pressure control is not achieved.
Angina Pectoris (Chest Pain)
Starting dose: 50 mg once daily
Maintenance dose: 50–100 mg once daily
Note: If taking 100 mg, your doctor may advise splitting this into 50 mg in the morning and 50 mg in the evening for more consistent coverage throughout the day.
Cardiac Arrhythmias (Irregular Heartbeat)
Starting dose: 50 mg once daily
Maintenance dose: 50–100 mg once daily
Note: Heart rate and rhythm should be monitored regularly during treatment.
Secondary Prevention After Myocardial Infarction (Heart Attack)
Dose: 100 mg once daily or 50 mg twice daily
Note: Treatment is usually initiated within 12 hours of the onset of chest pain and continued long-term as directed by your cardiologist.
Children and Adolescents
Atenolol is generally not recommended for use in children and adolescents under 18 years of age. There is limited clinical data on the efficacy and safety of atenolol in the pediatric population. In exceptional cases where a pediatric cardiologist prescribes atenolol for a child, the dose will be individually calculated based on body weight and the specific clinical indication, with close monitoring.
Elderly Patients
Older adults may be more sensitive to the effects of atenolol, particularly if kidney function is reduced. Your doctor may start with a lower dose and increase it gradually. Particular attention should be paid to heart rate, blood pressure, and kidney function during treatment. If you have significant renal impairment, dose reduction is necessary to prevent drug accumulation, as atenolol is primarily excreted by the kidneys.
Kidney Impairment
Since atenolol is primarily eliminated by the kidneys (approximately 85–100% of the absorbed dose is excreted unchanged in the urine), patients with reduced kidney function require dose adjustment. For patients with a creatinine clearance of 15–35 ml/min, the dose should be reduced to a maximum of 50 mg daily. For patients with a creatinine clearance below 15 ml/min, the dose should be further reduced to 25 mg daily or 50 mg every other day. Patients on hemodialysis should take 50 mg after each dialysis session, under hospital supervision.
Missed Dose
If you forget to take a dose of atenolol, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a forgotten dose, as this could cause your heart rate and blood pressure to drop too low.
Overdose
Atenolol overdose is a medical emergency. Contact your local emergency services or go to the nearest emergency department immediately. Take the medication packaging with you so that medical staff know what has been taken.
Overdose with atenolol can cause severe cardiovascular depression. Symptoms may include a dangerously slow heart rate (severe bradycardia), very low blood pressure (hypotension), dizziness, fainting, breathing difficulties (bronchospasm), and in severe cases, acute heart failure and cardiogenic shock. Seizures and loss of consciousness may also occur in massive overdoses.
Hospital treatment of atenolol overdose typically involves intravenous atropine to increase heart rate, intravenous fluids and vasopressors to support blood pressure, intravenous glucagon as a specific antidote for beta-blocker toxicity, and temporary cardiac pacing if necessary. Atenolol can be partially removed by hemodialysis due to its low protein binding and water solubility.
What Are the Side Effects of Atenolol?
Like all medications, atenolol can cause side effects, although not everyone experiences them. Most side effects are mild and often improve as your body adjusts to the medication over the first few weeks of treatment. If side effects are persistent or troublesome, speak to your doctor, as a dose adjustment or switch to a different medication may be appropriate. The following section classifies potential side effects by frequency, based on international pharmacovigilance data.
Stop taking atenolol and call emergency services immediately if you experience: swelling of the face, lips, tongue, or throat; difficulty breathing or swallowing; severe dizziness or fainting; wheezing or worsening breathing problems; severe chest pain; or a very slow or irregular heartbeat with symptoms.
Common
- Cold hands and feet: Due to reduced peripheral blood circulation; wear warm gloves and socks
- Slow heart rate (bradycardia): This is expected and usually not harmful, but tell your doctor if it concerns you
- Digestive disturbances: Including diarrhea, constipation, nausea, vomiting, and indigestion
- Fatigue and tiredness: Usually mild and improves after the first weeks of treatment
- Sweating: Increased perspiration, particularly during physical activity
Uncommon
- Sleep disturbances: Difficulty falling or staying asleep
- Raised liver enzymes (transaminases): Detected on blood tests; usually reversible
Rare
- Heart block: Irregular heartbeat with dizziness, fatigue, or fainting
- Worsening heart failure: Shortness of breath or swollen ankles
- Bronchospasm: Wheezing or difficulty breathing, especially in those with a history of airway disease
- Raynaud's phenomenon: Numbness or spasms in fingers followed by warmth and pain
- Tingling or numbness: In hands and feet (paraesthesia)
- Worsening claudication: Increased leg pain when walking due to poor circulation
- Low blood pressure (hypotension): Dizziness on standing
- Headache and dizziness
- Mood changes: Confusion, anxiety, or depression
- Nightmares
- Personality changes (psychosis) or hallucinations: Very rare, more common with lipophilic beta blockers
- Dry mouth
- Hair loss (alopecia)
- Dry eyes: Reduced tear production
- Skin rash or flushing
- Worsening of psoriasis: Dry, scaly skin patches
- Visual disturbances
- Easy bruising: Purpura or thrombocytopenia
- Erectile dysfunction (impotence)
- Jaundice: Yellowing of the skin or whites of the eyes
- Blood changes: Your doctor may periodically check blood counts
Frequency Not Known
- Allergic reactions (hypersensitivity): Including itching, rash, and in severe cases, anaphylaxis with swelling of the face or throat and difficulty breathing
- Lupus-like syndrome: An autoimmune reaction affecting the skin and joints
- Depression
- Masking of thyrotoxicosis symptoms: Including rapid heart rate and tremor
- Masking of hypoglycemia symptoms: In diabetic patients, particularly tachycardia and palpitations
If you experience any unexpected symptoms while taking atenolol, even if they are not listed here, report them to your doctor or pharmacist. You can also report suspected side effects directly to your national pharmacovigilance authority (for example, the MHRA Yellow Card scheme in the UK, the FDA MedWatch program in the US, or the EMA EudraVigilance system in Europe). Reporting side effects contributes to the ongoing monitoring of medication safety.
How Should You Store Atenolol?
Proper storage of atenolol helps ensure the medication remains effective and safe throughout its shelf life. Follow these general guidelines:
- Temperature: Store at room temperature. No special temperature requirements apply, but avoid extreme heat or cold. Do not store in the bathroom where humidity is high.
- Packaging: Keep tablets in their original blister pack or container until ready to take. This protects them from moisture and light.
- Child safety: Keep all medicines securely out of the sight and reach of children. Atenolol overdose in children can be particularly dangerous.
- Expiry date: Do not use atenolol after the expiry date stated on the packaging. The expiry date refers to the last day of that month.
- Disposal: Do not dispose of medications via household waste or down drains. Return unused or expired medicines to your pharmacy for safe disposal to protect the environment.
What Does Atenolol Contain?
All atenolol formulations contain atenolol as the active pharmaceutical ingredient. The inactive ingredients (excipients) serve important roles in tablet manufacture, including binding, disintegration, lubrication, and ensuring uniform drug release.
Tablet Composition
Active substance: Atenolol 25 mg, 50 mg, or 100 mg per tablet.
Inactive ingredients (excipients): Heavy magnesium carbonate, maize starch (corn starch), sodium lauryl sulfate, gelatin, magnesium stearate (E572), microcrystalline cellulose, and talc. These excipients are commonly used in pharmaceutical manufacturing and are generally well tolerated.
Tablet Appearance
Atenolol tablets are typically white, round, flat tablets with bevelled edges. Different strengths are identified by markings on the tablet surface, and all strengths generally have a score line allowing the tablet to be divided into two equal halves if a lower dose is required. The specific appearance may vary between manufacturers.
Tablets are packaged in blister packs (PVC/PVDC/aluminium) in common pack sizes of 14, 20, 28, 30, or 90 tablets, or in HDPE containers with polypropylene caps for larger quantities. Not all pack sizes may be available in all countries.
If you have known allergies to any specific excipients, always check the full ingredient list on the product packaging or patient information leaflet before taking any atenolol product. Your pharmacist can help you identify suitable formulations from different manufacturers.
Frequently Asked Questions About Atenolol
Atenolol is a cardioselective beta blocker prescribed for four main indications: high blood pressure (hypertension), chronic stable angina pectoris (chest pain caused by reduced blood supply to the heart), certain cardiac arrhythmias (irregular heartbeats, particularly supraventricular tachycardias), and secondary prevention after a myocardial infarction (heart attack) to reduce the risk of further cardiac events. It works by slowing the heart rate and reducing the force of heart contractions, thereby lowering blood pressure and decreasing the heart's oxygen demand.
No, you should never stop taking atenolol abruptly without consulting your doctor. Sudden withdrawal of a beta blocker can lead to a dangerous rebound effect, including a rapid increase in blood pressure (rebound hypertension), worsening of angina symptoms, and in rare but serious cases, a heart attack. This risk is particularly high in patients with ischemic heart disease (coronary artery disease). Your doctor will gradually reduce the dose over one to two weeks to safely discontinue the medication. If you need to stop atenolol for any reason, always follow your doctor's tapering instructions.
Beta blockers, including atenolol, have been associated with modest weight gain in some patients, though this is not universally experienced. The mechanism is not fully understood but may relate to a slight reduction in metabolic rate and decreased energy expenditure during physical activity. Studies suggest that the average weight gain with beta blockers is approximately 1 to 3.5 kg over the first few months of treatment. If you notice significant or concerning weight changes, discuss this with your doctor. Maintaining a balanced diet and regular physical activity (as tolerated and approved by your doctor) can help mitigate this effect.
Atenolol is generally not recommended during pregnancy. Clinical studies have linked atenolol use during pregnancy, particularly when started in the first trimester, with intrauterine growth restriction and lower birth weight. The drug crosses the placenta and can affect the fetal cardiovascular system. If you are pregnant, planning to become pregnant, or discover you are pregnant while taking atenolol, contact your doctor promptly. Alternative antihypertensive medications such as labetalol or methyldopa are generally considered safer options during pregnancy and are recommended by most obstetric guidelines.
Atenolol does not typically cause significant changes in blood sugar levels itself. However, it can mask the common warning signs of low blood sugar (hypoglycemia), particularly a rapid heart rate (tachycardia), palpitations, and tremor. This is an important consideration for patients with diabetes, as they may not recognize when their blood sugar drops dangerously low. Sweating, however, remains a reliable indicator of hypoglycemia during beta-blocker therapy. Patients with diabetes should monitor their blood glucose levels more frequently, especially when starting atenolol or adjusting the dose. Your doctor may need to modify your diabetes treatment accordingly.
Both atenolol and metoprolol are cardioselective beta-1 blockers, but they differ in several important ways. Atenolol is hydrophilic (water-soluble) and does not readily cross the blood-brain barrier, potentially causing fewer CNS side effects like nightmares and depression. Metoprolol is lipophilic (fat-soluble) and penetrates the brain more easily. Atenolol has a longer half-life (6–7 hours) allowing once-daily dosing, while immediate-release metoprolol requires twice-daily dosing (though extended-release metoprolol succinate is once-daily). Atenolol is primarily excreted by the kidneys and requires dose adjustment in renal impairment, while metoprolol is metabolized by the liver (CYP2D6 enzyme). Metoprolol succinate has stronger clinical evidence for use in chronic heart failure (from the MERIT-HF trial), while atenolol does not have this indication.
References
This article is based on current international medical guidelines, regulatory documents, and peer-reviewed research. All sources meet evidence level 1A standards.
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List. Geneva: WHO; 2023. Atenolol is listed as an essential cardiovascular medicine.
- European Medicines Agency (EMA). Atenolol – Summary of Product Characteristics. EMA/CHMP; 2024. Comprehensive regulatory document covering indications, dosing, contraindications, and safety data.
- Joint Formulary Committee. British National Formulary (BNF) – Atenolol Monograph. London: BMJ Group and Pharmaceutical Press; 2024. Evidence-based prescribing reference for UK healthcare professionals.
- Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal. 2018;39(33):3021-3104. doi:10.1093/eurheartj/ehy339
- National Institute for Health and Care Excellence (NICE). Hypertension in adults: diagnosis and management (NG136). NICE; 2022. Updated guidelines on the role of beta blockers in hypertension management.
- ISIS-1 (First International Study of Infarct Survival) Collaborative Group. Randomised trial of intravenous atenolol among 16 027 cases of suspected acute myocardial infarction: ISIS-1. The Lancet. 1986;328(8498):57-66. doi:10.1016/S0140-6736(86)91607-5
- Wiysonge CS, Bradley HA, Volmink J, Mayosi BM, Opie LH. Beta-blockers for hypertension. Cochrane Database of Systematic Reviews. 2017;(1):CD002003. doi:10.1002/14651858.CD002003.pub5
- U.S. Food and Drug Administration (FDA). Atenolol (Tenormin) Prescribing Information. FDA; 2023. Approved labeling with complete prescribing information.
- Mancia G, Kreutz R, Brunström M, et al. 2023 ESH Guidelines for the management of arterial hypertension. Journal of Hypertension. 2023;41(12):1874-2071. doi:10.1097/HJH.0000000000003480
- Cruickshank JM. The Role of Beta-Blockers in the Treatment of Hypertension. Advances in Experimental Medicine and Biology. 2017;956:149-166. doi:10.1007/5584_2016_36
Editorial Team
This article has been written and reviewed by the iMedic medical editorial team according to our strict editorial standards. Our team consists of licensed physicians, pharmacists, and medical researchers with expertise in cardiology, clinical pharmacology, and cardiovascular medicine.
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