Atenolol Side Effects

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Physicians have been prescribing a drug class called beta blockers for decades to manage high blood pressure and arrhythmias and reduce cardiac mortality. Atenolol is one of the members of this particular drug class that millions of people use daily to control their cardiovascular function. Despite being sold in millions due to a highly effective mechanism of action, even a prescription medication like atenolol can lead to certain unwanted side effects in the body. Those new to this medication and those taking it for some time must remember these side effects and try their best to prevent them for a healthier, high-quality life.

Indications of Using Atenolol

Available under the brand name called Tenormin, atenolol is a prescription-only medication used to manage various cardiovascular issues. Experts may prescribe atenolol to an individual to:

  • Decrease high blood pressure or hypertension
  • Reduce chest pain or angina
  • Reduce the amount of work the heart muscles have to do to circulate blood throughout the body following a heart attack.

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Available in tablet form, atenolol belongs to a drug class called beta blockers. This drug class includes plenty of medications that share a similar mechanism and are used to manage the same conditions. These drugs produce their respective benefits by targeting beta receptors found on the cells that make up the heart. When the adrenaline hormone activates a beta receptor, it responds by increasing the heart rate and blood pressure. Beta-blockers work by blocking the effect of adrenaline on these beta receptors in the heart and blood vessels. As a result, the blood vessels and heart muscles relax, and the blood pressure and heart rate drop.

Remember that beta blockers like atenolol do not permanently change blood pressure but only manage its relevant symptoms. These medications are also available in generic forms that cost less and may not require a prescription in some cases. However, caution must be observed while taking atenolol or a similar drug without indication may lead to certain side effects.

Atenolol Side Effects Profile Explained

Atenolol can cause mild to severe side effects in different people. Some of its most common side effects include the following:

  • Cold hands and feet
  • Diarrhea or constipation
  • Headache
  • Dizziness
  • Dips in blood pressure
  • Reduced sex drive or impotence
  • Unexplained tiredness
  • Shortness of breath
  • Leg pain

As long as these side effects are mild, they are likely to go away on their own within a few days to weeks. However, if their severity increases, talking to a pharmacist or doctor is imperative. Sometimes, regular use of atenolol may cause serious side effects for which emergency help may be needed. Some of these side effects include the following:

  • Allergic reaction, characterized by fever, a large red rash, labored breathing, swelling of tongue, throat, and lips, and swelling in feet, hands, or ankles
  • Depressive episodes, characterized by excessive fatigue, poor concentration, hopelessness, anxious thoughts, and suicidal tendencies
  • Unusual weight gain leading to swelling of ankles, arms, or feet

Atenolol Combinational Side Effects: Possible Drug Interactions

Atenolol can interact with many other herbs, vitamins, and medications an individual may take simultaneously. An interaction is when a substance changes the way the work of another substance may prevent it from working well. To avoid possible atenolol interactions, a doctor may manage all medications an individual takes. To ensure this, always inform your healthcare provider of all medications, prescription, and non-prescription, with complete honesty.

Following are some examples of the medications that may possibly interact with atenolol:

Mental Health Medications

Monoamine oxidase inhibitors (MAOIs) and reserpine can significantly enhance the effects of atenolol when taken together, resulting in a slowed heart rate and lightheadedness. MAOIs may even interact with atenolol for up to two weeks after the last dose. Some examples of these medicines include selegiline, isocarboxazid, and phenelzine.

Heart Rhythm Control Drugs

Taking rhythm control drugs like digoxin, disopyramide, and amiodarone with atenolol may slow down the heart too much.

Calcium Channel Blockers

Like atenolol, calcium channel blockers also help people manage high blood pressure along with other heart issues. Combined with atenolol, these medications can interfere with normal heart contractions, slowing them down. Some examples of calcium channel blockers include the following:

  • amlodipine
  • felodipine
  • diltiazem
  • isradipine
  • nifedipine
  • nisoldipine
  • nimodipine
  • verapamil

Alpha Blockers

Alpha-blockers work by reducing blood pressure, and their combination with atenolol can exacerbate these reductions. Some examples of alpha-blockers include prazosin, clonidine, and methyldopa.

Pain Control Drugs

Medications, such as indomethacin, can interact with atenolol to reduce its blood pressure-lowering effects.

Atenolol Warnings & Risks: What to Keep in Mind

Atenolol is easily available in the market but comes with several boxed warnings that every user should keep in mind before making it a part of daily life. The Food and Drug Administration issues these warnings and helps people understand how this drug may be dangerous. Following are some most common atenolol warnings to keep in mind:

Sudden Cessation Warning

Do not stop taking atenolol suddenly, as it may lead to a jump in blood pressure, severe chest pain, or even a heart attack. Stopping this medication on your own is highly discouraged, and medical advice must be sought if you no longer wish to take it. A doctor will closely work with you to gradually reduce your dose to avoid risky side effects.

Asthma/Chronic Obstructive Pulmonary Disease (COPD) Warning

At high doses, atenolol and other beta-blockers can exacerbate the symptoms of COPD and asthma. This happens because the medication blocks certain beta receptor types in the breathing pipes. This blockage narrows down the windpipe and other parts of the lungs, making breathing difficult.

Diabetes Warning

Atenolol and other beta-blockers may mask the critical signs of low blood sugar, such as an elevated heart rate or shakiness. Without these signals, it may become hard for a person to realize a dip in their blood sugar which may prove life-threatening for them.

Poor Circulation Warning

People with poor circulation in hands and feet may particularly experience side effects when they use atenolol or other drugs of a similar class. This medication reduces blood pressure which may further decrease the amount of blood that reaches their hands and feet.

Combining Atenolol and Alcohol

Alcohol remains the most common legal beverage across the world, with a tendency to cause effects comparable to those experienced by taking illicit substances. Therefore, experts warn people against combining it with prescription medications and other substances with similar mechanisms of action and overall results. Atenolol is one of these medications that is not safe to combine with alcohol. People who drink while taking atenolol or any other beta-blocker may experience a sudden drop in blood pressure to the extent that it sets off the following symptoms:

  • Dizziness
  • Headache
  • Lightheadedness
  • Inability to concentration
  • Fainting
  • Nausea
  • Rapid heart rate

While these symptoms may not be so bothersome for people at rest, those engaging in risky activities, such as driving or operating machinery, may risk irreversible damage and even death.

Atenolol Withdrawal: What to Expect

Around 5 percent of the general population is likely to experience the symptoms of atenolol withdrawal. These symptoms are more likely to occur in people taking the drug to manage their angina. The duration of these symptoms may be shorter than other drugs of a similar class, such as propranolol.

Below are two examples of what an atenolol withdrawal can trigger in two different categories of patients.

Patients with Cardiovascular Disease

When a person using beta-blockers, such as atenolol, to manage their cardiovascular disease suddenly stops using it, they experience a temporary but sharp upsurge in adrenergic activity. This activity may worsen their angina, stroke, and heart attack symptoms, sometimes to the extent that it may cause death.

Patients with Hypertension

Hypertensive patients, i.e., people with high blood pressure, may take beta blockers to control their symptoms. Withdrawing from this medication suddenly may lead to a condition called sinus tachycardia, where a person experiences a rapid heartbeat. They may also experience palpitations, increased sweating, malaise, and a dangerous increase in blood pressure.

How to Stop Taking Atenolol Safely?

Experts strictly warn not to stop taking atenolol on your own without weaning it off properly. If the medication is causing side effects or you wish to stop using it for other reasons, the best way is to speak with a doctor. The doctor will analyze the circumstances and put together a plan that helps you safely decrease the dosage until you can get off the medication without any risks. On the contrary, stopping abruptly may lead to serious consequences and may possibly exacerbate the condition you were managing with atenolol.

The exact reductions in atenolol dosages may be specific to certain individuals; therefore, it may be impossible to predict the schedule for the possible wean-off for each individual. Consult your physician and seek their advice before you stop atenolol. Withdrawal from the drug must only take place under the careful supervision of a physician as they monitor you for any symptoms of angina, high blood pressure, or any other condition the medication was treating. Moreover, they will also provide you with specific instructions on stopping taking atenolol safely with minimal risks.

Because atenolol is a long-term medication that most people use continually, its tapering schedule has to be longer. In most cases, it is spread to at least two weeks or more, where a doctor carefully reduces the dosage every few days. The physician will provide users with tailored instructions on dosage changes and follow up with them frequently. In case a person has unusual side effects, such as palpitations, increased pulse rate, or shooting blood pressure, they must immediately get back to their physician.

An example of how a physician may plan the discontinuation of atenolol includes decreasing the current dosage by 25 milligrams every four days until the user completely weans off. The doctor may also advise people tapering off atenolol to limit their physical activities as they withdraw to avoid any exacerbation of the existing heart issues.


What is the safe dose of atenolol to take without experiencing side effects?

The daily atenolol dosage and frequency of use may vary from one person to another depending on several personal factors, such as the following:

  • Your age
  • The condition you are treating with atenolol
  • How you react to the first dose reduction
  • Any other co-existing medical conditions
  • The severity of the underlying condition

Should I be taking Atenolol or not?

People with the following issues must avoid taking this drug to prevent experiencing any atenolol side effects:

  • Asthma
  • Low blood sugar
  • Kidney disease
  • Pregnant females or those planning to become pregnant
  • Diabetes
  • Uncontrolled heart block or heart failure
  • Raynaud’s disease
  • Breastfeeding mothers

Should I avoid any specific drinks or foods to avoid atenolol side effects?

There are no specific drinks or foods that can initiate or exacerbate atenolol side effects. However, some experts believe that combining atenolol and alcohol may be dangerous.

Is it safe for me to drive while I am taking Atenolol?

Atenolol carries the tendency to make some people feel tired or dizzy. Hence, if you are beginning therapy with atenolol, give yourself time to see how the medication affects you before engaging in risky tasks, such as driving or operating heavy machinery.

How long does atenolol stay in the body?

The duration for which atenolol stays in the body may vary from one person to another. The half-life of this medication is around six to seven hours which means that it requires up to seven hours to halve its levels in the bloodstream. However, because most drugs take a couple of half-lives to leave the system completely, atenolol may stay in for 24 to 48 hours before the body completely clears it. Remember that the antihypertensive effect due to atenolol only stays in action for up to 24 hours.

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