Atenolol: Difference between revisions

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| generic = Atenolol

| brand = Tenormin

| classes = Beta blocker

| structure =

| ~~intro~~ = ~~Atenolol is a cardioselective~~ (~~beta~~-1-selective) ~~beta blocker~~, ~~used mainly~~ in cardiovascular ~~conditions such as high blood pressure and angina~~.

| classes = [[:Category:Beta blockers|Beta blocker (cardioselective β1)]], [[:Category:Antihypertensives|Antihypertensive]]

| uses = <vote slug="hypertension-use">Hypertension (FDA, though displaced from first-line by JNC8 and contemporary guidelines)</vote>, <vote slug="angina-pectoris-use">Angina pectoris (FDA)</vote>, <vote slug="post-mi-use">Post-myocardial-infarction secondary prevention (FDA)</vote>, <vote slug="atrial-fibrillation-rate-control-use">Atrial fibrillation rate control (off-label)</vote>, <vote slug="supraventricular-tachycardia-use">Supraventricular tachycardia (off-label)</vote>

| starting_dose = 25-50 mg PO once daily; titrate to 100 mg/day

| preparations = Tablets 25, 50, 100 mg

| fda_max = 100-200 mg/day depending on indication

| pill_id =

| routes = Oral

| onset = BP effect within hours; full effect over 1-2 weeks

| duration = 24 hours (once-daily dosing supported by long elimination)

| halflife = 6-9 hours (substantially longer in renal impairment due to renal elimination)<ref name="tenormin-label">FDA Prescribing Information, Tenormin (atenolol), AstraZeneca/various, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/018240s031lbl.pdf</ref>

| bioavailability = ~50% (oral)<ref name="tenormin-label" />

| pregnancy = '''Documented fetal growth restriction with chronic exposure'''; avoid in pregnancy if alternative β-blockers are appropriate. The β-blocker most consistently associated with intrauterine growth concerns<ref name="tenormin-label" />

| legal = [[USLegal:Prescription only|Rx-only]] in US

| mechanism = <vote slug="atenolol-mech-claim">Selective β1-adrenergic receptor antagonist with minimal β2 activity at therapeutic doses, giving lower bronchoconstriction risk than non-selective β-blockers. '''Hydrophilic''' (unlike lipophilic propranolol and metoprolol), so it has very limited CNS penetration, giving much less CNS adverse-effect burden (depression, fatigue, vivid dreams) but correspondingly less migraine prophylactic efficacy compared to lipophilic β-blockers. '''Renally eliminated''', so accumulates in renal impairment and requires dose adjustment by creatinine clearance.</vote> Contemporary hypertension guidelines (JNC8 and onward) have moved atenolol away from first-line antihypertensive use based on trial data showing inferior cardiovascular outcomes versus other antihypertensive classes, particularly in older patients<ref name="tenormin-label" />.

}}

== References ==

[[Category:Beta blockers]]

[[Category:Antihypertensives]]

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