What is atenolol used for. How does atenolol work to lower blood pressure. What are the common side effects of atenolol. How should atenolol be administered to children. What precautions should be taken when giving atenolol to children.

Understanding Atenolol: A Beta-Blocker for Hypertension

Atenolol is a medication belonging to a class of drugs known as beta-blockers. It is primarily used to treat high blood pressure, also referred to as hypertension. This medicine works by opening up blood vessels and slowing down the heart rate, which in turn helps to lower blood pressure.

For children diagnosed with hypertension, atenolol can be an effective treatment option. However, it’s crucial for parents and caregivers to understand how to properly administer this medication and be aware of potential side effects.

How does atenolol work?

Atenolol functions by blocking the effects of certain natural chemicals in the body, such as epinephrine, on the heart and blood vessels. This action results in:

• Slowing down the heart rate
• Reducing the force of heart contractions
• Decreasing blood pressure
• Improving blood flow through the body

Proper Administration of Atenolol for Children

When it comes to giving atenolol to children, following the prescribed dosage and administration guidelines is crucial for the medication’s effectiveness and the child’s safety.

What forms does atenolol come in?

Atenolol is available in the following forms:

• Tablets: 25 mg, 50 mg, and 100 mg
• Liquid medicine: 25 mg in 5 mL

How often should atenolol be given?

Typically, atenolol is administered once daily. It’s important to give the medication at approximately the same time each day to maintain consistent levels in the body. This routine also helps in remembering to administer the medicine regularly.

How to administer atenolol to children?

The method of administration depends on the form of atenolol prescribed:

1. For tablets:
   • Should be swallowed whole with water, milk, or juice
   • Can be crushed and mixed with a small amount of soft food if necessary
   • Ensure the child swallows the mixture immediately without chewing
2. For liquid medicine:
   • Use a medicine spoon or oral syringe to measure the correct dose
   • Avoid using kitchen teaspoons as they don’t provide accurate measurements

Dosage and Adjustments of Atenolol for Children

The dosage of atenolol for children is carefully determined by healthcare professionals based on various factors including the child’s age, weight, and overall health condition.

How is the initial dose determined?

Doctors typically start with a low dose of atenolol and gradually increase it until the child’s blood pressure reaches the desired level. This approach, known as dose titration, helps minimize side effects while achieving optimal therapeutic benefits.

Can the dosage be adjusted?

Yes, the dosage may be adjusted over time. Regular check-ups and blood pressure monitoring allow healthcare providers to make necessary adjustments to ensure the medication remains effective as the child grows or their condition changes.

Potential Side Effects of Atenolol in Children

While atenolol is generally well-tolerated, it’s important for parents and caregivers to be aware of potential side effects that may occur in children taking this medication.

What are the common side effects of atenolol?

Some of the more frequently reported side effects include:

• Dizziness or lightheadedness
• Fatigue
• Slow heart rate
• Cold hands and feet
• Gastrointestinal disturbances (nausea, diarrhea)

Are there any serious side effects to watch for?

While rare, some side effects require immediate medical attention:

• Shortness of breath or wheezing (potential asthma trigger)
• Severe dizziness or fainting
• Unusually slow or irregular heartbeat
• Signs of low blood sugar (confusion, weakness, excessive sweating)

If any of these serious side effects occur, it’s crucial to seek medical help promptly.

Precautions and Warnings for Atenolol Use in Children

Before starting atenolol treatment, it’s essential to consider certain precautions and potential interactions with other conditions or medications.

What conditions may affect atenolol use?

Atenolol should be used with caution in children with:

• Asthma or other respiratory conditions
• Diabetes
• Heart rhythm disorders
• Kidney problems

Can atenolol interact with other medications?

Yes, atenolol can interact with various medications. It’s crucial to inform healthcare providers about all medications, supplements, and herbal products the child is taking. Some common interactions include:

• Other blood pressure medications
• Certain diabetes medications
• Some antidepressants
• Non-steroidal anti-inflammatory drugs (NSAIDs)

Managing Missed Doses and Overdose Situations

Proper management of missed doses and potential overdose situations is crucial for maintaining the effectiveness and safety of atenolol treatment.

What should be done if a dose is missed?

If a dose of atenolol is missed:

• Give the missed dose as soon as you remember, if it’s at least 12 hours before the next scheduled dose
• Skip the missed dose if it’s close to the time for the next dose
• Never give a double dose to make up for a missed one

How to handle potential overdose situations?

In case of a suspected overdose:

• Contact a healthcare provider or poison control center immediately
• Watch for symptoms like severe dizziness, fainting, or unusually slow heartbeat
• Seek emergency medical attention if symptoms are severe

Long-Term Considerations for Atenolol Treatment in Children

When considering long-term atenolol treatment for children with hypertension, several factors need to be taken into account to ensure optimal management of the condition.

How long does atenolol treatment typically last?

The duration of atenolol treatment can vary depending on the individual child’s condition and response to the medication. In some cases, treatment may be long-term or even lifelong. Regular follow-ups with healthcare providers are essential to assess the ongoing need for the medication.

Are there any long-term effects of atenolol use in children?

While atenolol is generally considered safe for long-term use, some considerations include:

• Potential effects on growth and development (regular monitoring is important)
• Impact on exercise tolerance and physical activity
• Possible metabolic effects, such as changes in blood sugar levels

Long-term studies on the use of atenolol in children are limited, emphasizing the importance of ongoing medical supervision and periodic reassessment of the treatment plan.

Can lifestyle modifications complement atenolol treatment?

Yes, lifestyle modifications can play a significant role in managing hypertension alongside atenolol treatment. These may include:

• Maintaining a healthy diet low in sodium and rich in fruits and vegetables
• Encouraging regular physical activity appropriate for the child’s age and condition
• Maintaining a healthy weight
• Limiting caffeine intake
• Ensuring adequate sleep and stress management

These lifestyle changes can potentially enhance the effectiveness of atenolol and may even allow for dose reduction over time in some cases.

Monitoring and Follow-Up Care for Children on Atenolol

Regular monitoring and follow-up care are crucial components of managing atenolol treatment in children with hypertension. This ongoing care helps ensure the medication’s effectiveness and allows for timely adjustments if needed.

What type of monitoring is required?

Children on atenolol typically require:

• Regular blood pressure checks
• Periodic blood tests to monitor kidney function and electrolyte levels
• Heart rate monitoring
• Assessment of growth and development
• Evaluation of any side effects or new symptoms

How often should follow-up visits occur?

The frequency of follow-up visits can vary based on the individual child’s needs and response to treatment. Initially, visits may be more frequent, such as every few weeks. As the condition stabilizes, visits may be spaced out to every few months. Your healthcare provider will determine the appropriate schedule.

What should parents monitor at home?

Parents and caregivers play a crucial role in monitoring children on atenolol. They should watch for and report:

• Any new or worsening side effects
• Changes in the child’s energy levels or physical capabilities
• Any signs of asthma or breathing difficulties
• Unusual mood changes or behavioral shifts
• Problems with growth or development

Home blood pressure monitoring may also be recommended in some cases, with guidance from the healthcare provider on how to perform and interpret these measurements.

Educating Children About Their Atenolol Treatment

As children grow and mature, involving them in understanding their condition and treatment becomes increasingly important. This knowledge can help promote adherence to the medication regimen and foster a sense of responsibility for their health.

How can parents explain atenolol treatment to children?

When discussing atenolol treatment with children, consider the following approaches:

• Use age-appropriate language to explain hypertension and how the medication helps
• Emphasize the importance of taking the medication regularly
• Explain potential side effects in a non-frightening manner
• Encourage questions and open communication about their treatment

How can children be involved in managing their treatment?

Depending on their age and maturity level, children can be involved in their treatment in various ways:

• Setting reminders for taking medication
• Keeping a simple log of when they take their medication
• Participating in blood pressure checks at home (under supervision)
• Learning about healthy lifestyle choices that support their treatment

Involving children in their care can help them develop a sense of control and responsibility for their health, which can be beneficial as they transition into adolescence and adulthood.

Transitioning Care as Children Grow Older

As children with hypertension grow into adolescence and young adulthood, their care needs and management strategies may evolve. Planning for this transition is an important aspect of long-term atenolol treatment.

How does atenolol treatment change as children grow?

Several factors may influence changes in atenolol treatment as children grow:

• Dosage adjustments based on weight and body size changes
• Potential switch to adult formulations or different medications
• Reassessment of the need for continued treatment
• Increased focus on self-management skills

What considerations are important for adolescents on atenolol?

As children enter adolescence, additional considerations may include:

• Impact of hormonal changes on blood pressure and medication effectiveness
• Potential interactions with contraceptives or other medications
• Addressing concerns about long-term medication use
• Discussing the impact of lifestyle choices (e.g., alcohol, smoking) on their condition and treatment

Healthcare providers will work closely with adolescents and their families to ensure a smooth transition in care and to address any new concerns or challenges that arise during this period.

Research and Future Directions in Pediatric Hypertension Treatment

The field of pediatric hypertension management, including the use of medications like atenolol, continues to evolve. Ongoing research aims to improve treatment strategies and outcomes for children with high blood pressure.

What are some current areas of research in pediatric hypertension?

Current research topics in pediatric hypertension include:

• Long-term effects of antihypertensive medications in children
• Development of pediatric-specific formulations and dosing strategies
• Genetic factors influencing hypertension and treatment response in children
• Novel approaches to blood pressure monitoring in pediatric populations
• Impact of early intervention on long-term cardiovascular health

How might future developments affect atenolol use in children?

Future developments that could influence atenolol use in pediatric patients may include:

• More targeted therapies based on individual genetic profiles
• Advanced drug delivery systems for improved adherence and reduced side effects
• Integration of technology for better monitoring and management of hypertension
• New guidelines for hypertension diagnosis and treatment in children

As research progresses, treatment strategies for pediatric hypertension, including the use of atenolol, may be refined to provide more personalized and effective care for children with high blood pressure.

Atenolol for hypertension | Medicines for Children

Atenolol for hypertension

This leaflet is about the use of atenolol for high blood pressure (which is also called hypertension).

This leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Atenolol can trigger asthma. You must tell your doctor if your child has ever had asthma or wheezy chest episodes, before giving atenolol.

Do not stop giving atenolol suddenly, as this may cause your child’s blood pressure to rise dangerously high.

Name of drug

Atenolol
Brand names: Tenormin®

Why is it important for my child to take this medicine?

High blood pressure (hypertension) can lead to damage to internal organs. Atenolol is a medicine called a beta blocker. It opens up blood vessels and slows the heart so that it pumps less forcefully, which help to lower the blood pressure.

What is atenolol available as?

• Tablets: 25 mg, 50 mg, 100 mg
• Liquid medicine: 25 mg in 5 mL

When should I give atenolol?

Atenolol is usually given once each day.
If your child is taking more than one medicine to reduce their blood pressure, your doctor may suggest that they take the different medicines at different times of the day. Your doctor will help you plan this.
Give the medicine at about the same time each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of atenolol (the dose) that is right for your child. The dose will be shown on the medicine label.
Your doctor will start the medicine at a low dose then gradually increase it until your child’s blood pressure is at the right level.

It is important that you follow your doctor’s instructions about how much to give.

How should I give it?

Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablet. You can crush the tablet and mix it with a small amount of soft food such as yogurt, jam or mashed potato. Make sure your child swallows it straight away, without chewing.

Liquid medicine: Measure out the right amount using a medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.

 

When should the medicine start working?

Your child’s blood pressure will start to come down after a few days, although you will not see any difference in your child.

What if my child is sick (vomits)?

• If your child is sick less than 30 minutes after having a dose of atenolol, give them the same dose again.
• If your child is sick more than 30 minutes after having a dose of atenolol, you do not need to give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your GP, pharmacist or hospital. They will decide what to do based on your child’s condition and the specific medicine involved

What if I forget to give it?

Give the missed dose when you remember during the day, as long as this is at least 12 hours before the next dose is due. You do not need to wake up a sleeping child to give a missed dose.

Never give a double dose of atenolol.

What if I give too much?

It may be dangerous to give an extra dose of atenolol because it may make your child’s blood pressure too low.

If you think you may have given your child too much atenolol, contact your doctor, as they may want to check your child’s blood pressure and blood sugar level.

If your child feels faint or dizzy, cold and sweaty, or has a weak or rapid heart rate (they may feel as though their heart is racing or fluttering), or they begin to breathe quickly, contact your doctor or take your child to hospital straight away.

Have the medicine container or packaging with you, even if it is empty. This will be useful to the doctor. Have the medicine packaging with you if you telephone for advice.

Are there any possible side-effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Side-effects you must do something about

If your child is short of breath or wheezy after taking atenolol, take them to hospital or call an ambulance straight away, as it may have triggered an asthma attack.

Other side-effects you need to know about

• Your child may feel dizzy or light-headed when they stand up, or may faint. Encourage them to stand up slowly, and to sit or lie down if they feel dizzy or light-headed. If this happens often, contact your doctor to check your child’s blood pressure and blood sugar level, as it may be too low.
• Your child may say that their heart is beating slowly.
• Your child’s hands and feet may feel cold. This is nothing to worry about. If their hands and feet hurt, contact your doctor for advice.
• Your child may feel sick or be sick (vomit) when they first start taking atenolol. Giving the medicine with some food may help. If this is still a problem after a week, contact your doctor for advice.
• Your child may feel physically tired and they may have difficulty getting to sleep or nightmares.

There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://www.mhra.gov.uk/yellowcard.
More information on side-effects can be found in the following leaflet http://www.medicinesforchildren.org.uk/side-effects-childrens-medicines

Can other medicines be given at the same time as atenolol?

• You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
• Atenolol should not be taken with some other medicines that you get on prescription. Tell your doctor and pharmacist about any other medicines your child is taking before starting atenolol.
• Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Is there anything else I need to know about atenolol?

Atenolol can sometimes worsen asthma. You must tell your doctor if your child has ever had asthma or wheezy chest episodes.

Atenolol can slow the heart rate, and therefore, some types of slow heart rhythm disorders can get worse. You must tell your doctor if your child has any heart or heart rhythm problems.

• Your doctor will check your child’s blood pressure and pulse rate regularly while taking atenolol.

General advice about medicines

• Try to give the medicine at about the same times each day, to help you remember.
• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

• Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
• Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
• Make sure that children cannot see or reach the medicine.
• Keep the medicine in the container it came in.

Who to contact for more information

Your doctor, pharmacist or nurse will be able to give you more information about atenolol and about other medicines used to treat high blood pressure.

Atenolol for veterinary use

Questions?
Call 1-877-357-9661

by Barbara Forney, VMD

Overview

Therapeutic Class

Beta Adrenergic Blocker

Species

Dogs and cats

May Be Prescribed by Veterinarians for:

Cardiac arrhythmias and hypertension

FDA Status

Atenolol is commercially available as Tenormin® (25mg/50mg/100mg tablets)

Search for Available Dosage Forms

Basic Information

Atenolol is a beta adrenergic blocker that is used in veterinary medicine to treat supraventricular tachyarrhythmia, premature ventricular contractions (PVC’s), and systemic hypertension. Beta blockers improve cardiac performance indirectly by reducing the heart rate; prolonging diastole, which allows more time for ventricular and coronary arterial filling.

The effects of atenolol on the cardiovascular system include decreased sinus heart-rate, slowed AV conduction, decreased cardiac output and oxygen demand, and decreased blood pressure. Beta-blockers may be cardioprotective in early cases of hypertrophic cardiomyopathy because they reduce myocardial oxygen demand. Atenolol is most commonly used with other cardiac anti-arrhythmic drugs.
The bioavailability of atenolol is higher in dogs (80%) and cats (90%) than in humans. Atenolol undergoes minimal hepatic metabolism and is eliminated in the urine and to a lesser extent in the feces.

Dogs and cats

Dogs: Atenolol is used in dogs to treat arrhythmias, hypertension, obstructive heart disease, subvalvular aortic stenosis, and pulmonic stenosis. Atenolol may be used with other drugs, such as calcium channel blockers and ACEI drugs, in the treatment of systemic hypertension. When atenolol is used to treat atrial fibrillation in dogs, it is frequently used with digoxin.

Cats: Atenolol is used in cats to treat hypertrophic cardiomyopathy (HCM), left ventricular outflow tract obstruction, and hypertension secondary to hyperthyroidism.

• When beta blockers are used to treat HCM, they are not started until after the cat has been stabilized with diuretics. Some veterinarians will use atenolol as a first-line drug for cats with HCM when they are asymptomatic and early in the disease process.
• Atenolol is used in cats to treat left ventricular outflow tract obstruction. It is superior to diltiazem in terms of both its side effect profile and its ability to slow the heart rate, which reduces obstruction and decreases murmurs.
• Atenolol is used to treat cats with hypertension secondary to hyperthyroidism. It may be given during the initial therapy with methimazole. Other forms of hyperthyroidism in the cat may not be as responsive to atenolol.

Side Effects

• Side effects occur more frequently in older animals and those that are unstable due to cardiac disease.
• The most common side effects include bradycardia, conduction disturbances, hypotension, depression, loss of appetite, and diarrhea.

Precautions

• Beta blockers such as atenolol should not be used in animals that are hypotensive or bradycardic. They should not be used in animals with peripheral vascular disease or arterial thromboembolism.
• Beta blockers, such as atenolol, should not be used in patients with congestive heart failure until the animal is stabilized (usually with diuretics and ACEI’s).
• Beta blockers should be used with additional caution in animals with sinus node dysfunction, renal dysfunction, and diabetes.
• Older cats, particularly those with renal problems, may need additional monitoring.
• Atenolol therapy should not be started prior to surgery due to potential drug interactions with anesthetic agents.
• Atenolol crosses the placenta and is found in maternal milk.
• Therapy with atenolol or other beta blockers should not be withdrawn abruptly. The dose should be tapered gradually.

Drug Interactions

• Atenolol may block the effects of sympathomimetic drugs, such as metaproterenol, terbutaline, epinephrine, and phenylpropanolamine. These drugs may also decrease the effects of atenolol. Atenolol inhibits isoproterenol induced tachycardia.
• Anesthetic drugs that depress myocardial function may have an additive effect when used with atenolol.
• Atenolol may increase the hypotensive properties of drugs such as phenothiazines and reserpine. Drugs such as furosemide and hydralazine may increase the hypotensive potential of atenolol.
• Concurrent use of atenolol and clonidine may increase the likelihood of rebound hypertension when clonidine therapy is discontinued.

Overdose

• Clinical signs associated with overdose are based on the drug’s cardiodepressant effects. These include bradycardia, changes in conduction or rhythm, hypotension, lethargy, and coma. Monitoring and support of cardiovascular status should be instituted. Fluids and presser agents may be necessary.
• If oral overdose is recognized promptly and the animal is conscious and stable, GI emptying protocols should be instituted and activated charcoal should be administered.

About the Author

Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master’s degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.

She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.

Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.

The information contained on this site is general in nature and is intended for use as an informational aid. It does not cover all possible uses, actions, precautions, side effects, or interactions of the products shown, nor is the information intended as medical advice or diagnosis for individual health problems or for making an evaluation as to the risks and benefits of using a particular product. You should consult your doctor about diagnosis and treatment of any health problems. Information and statements have not been evaluated by the Food and Drug Administration (“FDA”), nor has the FDA approved the products to diagnose, cure or prevent disease.

Wedgewood Pharmacy compounded veterinary preparations are not intended for use in food and food-producing animals.

 

Tenormin (Atenolol) Drug / Medicine Information

Atenolol

Consumer Medicine Information

What is in this leaflet

This leaflet answers some common questions about TENORMIN. It does not contain all
the available information. It does not take the place of talking to your doctor or
pharmacist.

All medicines have benefits and risks. Your doctor has weighed the risks of you taking
TENORMIN against the benefits they expect it will have for you.

If you have any concerns about taking this medicine, ask your doctor or pharmacist.

Keep this leaflet with the medicine.

You may need to read it again.

What TENORMIN is used for

TENORMIN belongs to a group of medicines called beta-blockers.

It works by affecting the body’s response to certain nerve impulses, especially in
the heart. As a result, it decreases the heart’s need for blood and oxygen and therefore
reduces the amount of work the heart has to do. It widens the blood vessels in the
body, causing blood pressure to fall. It also helps the heart to beat more regularly.

TENORMIN is used to:

lower high blood pressure, which is called hypertension

prevent angina

treat irregular heart rhythm or beat called arrhythmias

treat heart attacks, or reduce your risk of heart complications following a heart
attack

TENORMIN may be either used alone or in combination with other medicines to treat
your condition.

Hypertension:

All people have blood pressure. This pressure helps to push blood all around your
body. Your blood pressure changes during the day, depending on how busy you are or
how you are feeling.

You have hypertension (high blood pressure) when your blood pressure stays higher
than is needed, even when you are calm and relaxed.

Regular blood pressure checks are the only way of knowing that you have hypertension.
There are usually no symptoms of hypertension and you may feel fine. If hypertension
is not treated, serious health problems such as stroke, heart disease and kidney failure
may occur.

TENORMIN helps to lower your blood pressure.

Angina:

Angina is a discomfort or pain felt in your chest. The pain may also be felt down
your arms or neck and sometimes your shoulders and back. This may be caused by not
enough oxygen or blood reaching areas of your heart. Angina pain is often brought
on by exercise or stress.

TENORMIN is used to prevent angina. It is not used to relieve a sudden attack of angina.

Irregular heart beat (arrhythmia):

A number of factors such as some heart diseases, an over active thyroid gland or chemical
imbalances may cause your heart to have an irregular heart beat or rhythm.

TENORMIN helps restore your heart’s normal rhythm.

Reducing heart complications after heart attack:

After a heart attack, you may have complications such as an irregular heart beat or
an increased chance of having another heart attack.

TENORMIN helps to prevent these complications from occurring.

Ask your doctor if you have any questions about why TENORMIN has been prescribed for
you.

Your doctor may have prescribed TENORMIN for another reason.

TENORMIN is not recommended for use in children, as there have been no studies of
its effects in children.

There is no evidence that TENORMIN is addictive.

This medicine is only available with a doctor’s prescription.

Before you take TENORMIN

When you must not take it

Do not take TENORMIN if:

1. you have or have had asthma (difficulty in breathing, wheezing and coughing), bronchitis
or other lung problems in the past.

2. you have the following conditions:

a history of allergic problems, including hayfever. Symptoms of an allergy may include:
rash, itching, watery eyes or sneezing.

a very slow heart beat (less than 45-50 beats/minute)

a severe blood vessel disorder causing poor circulation in the arms and legs

certain other heart conditions

phaeochromocytoma (a rare tumour of the adrenal gland) which is not being treated
with other medicines

low blood pressure (hypotension)

too much acid in your blood (metabolic acidosis)

certain anaesthetics for medical dental procedures

emergency treatment for shock or severely low blood pressure

4. you have an allergy to atenolol, the active ingredient in TENORMIN or any of the ingredients
listed at the end of this leaflet, or to any other beta-blocker medicine.

Some of the symptoms of an allergic reaction may include shortness of breath, wheezing
or difficulty breathing; swelling of the face, lips, tongue or other parts of the
body; rash, itching or hives on the skin or you may feel faint.

5. you are pregnant, intend to become pregnant, are breast feeding or intend to breast
feed.

Your doctor will discuss the possible risks and benefits of using TENORMIN during
pregnancy and breast feeding. TENORMIN passes into breast milk and may therefore affect
the breast-fed baby.

If you are not sure whether any of these apply to you, check with your doctor.

Do not use TENORMIN if the expiry date (EXP) printed on the pack has passed.

Do not use TENORMIN if the package is torn or shows signs of tampering.

If it has expired or is damaged, return it to your pharmacist for disposal.

If you are not sure whether you should start taking TENORMIN, talk to your doctor
or pharmacist.

Before you start to take it

Tell your doctor if:

1. you have any allergies to:

any other medicine, including eye drops, or other beta-blocker medicines

any other substances, such as foods, preservatives or dyes

insect stings

TENORMIN may make allergies worse or make them harder to treat.

2. you have or have had a history of any of the following conditions:

heart problems

diabetes

an over active thyroid gland called hyperthyroidism.

kidney problems

circulation problems

If you have not told your doctor about any of the above, tell them before you take
TENORMIN.

Taking other medicines

Tell your doctor if you are taking any other medicines, including any that you buy
without a prescription from your pharmacy, supermarket or health food shop.

Some medicines and TENORMIN may interfere with each other. These include:

other beta-blocker medicines

medicines used to treat high blood pressure or angina

medicine used to treat heart problems

insulin and tablets used to treat diabetes

medicines used to treat arthritis, pain, or inflammation

If any of these medicines and TENORMIN are taken together, it may affect how each
of them work. You may need to take different amounts of your medicine, or you may
need to take different medicines.

Your doctor and pharmacist have more information on medicines to be careful with or
to avoid while taking TENORMIN.

If you have not told your doctor about any of these things, tell them before you take
any TENORMIN.

 

How to take TENORMIN

Follow all directions given to you by your doctor or pharmacist carefully.

They may differ from the information contained in this leaflet.

If you do not understand the instructions on the pack, ask your doctor or pharmacist
for help.

How much to take

Hypertension:

The usual dose is from 50mg (1 tablet) up to 200mg (4 tablets) of TENORMIN daily.

If your dose is 100mg or less, take it once a day. If you need to take more than 100mg
(2 tablets), take half of your TENORMIN in the morning and the other half in the evening.

Angina or Irregular Heart Beat:

The usual dose is from 50mg (1 tablet) up to 100mg (2 tablets) taken as a single dose
or half the dose in the morning and half at night.

Heart attack:

The usual dose is 50mg (1 tablet) of TENORMIN daily.

Certain people such as the elderly or those with kidney problems, may require a lower
dose.

When to take it

It does not matter if you take your TENORMIN before or after food.

Swallow TENORMIN with a glass of water, during or immediately after a meal.

Take your tablet at the same time everyday.

Taking your tablets at the same time each day will have the best effect. It will
also help you remember when to take the tablets.

How long to take it

Take TENORMIN everyday. Continue taking TENORMIN until your doctor advises you to
stop.

TENORMIN helps treat your condition, but does not cure it.

Do not stop taking TENORMIN without checking with your doctor.

Your doctor may want you to gradually reduce the amount of TENORMIN you are taking.
This should take place over a period of about 2 weeks before stopping completely.
Do not stop suddenly as this may worsen your condition.

Make sure you keep enough TENORMIN to last over weekends and holidays. 

If you forget to take it

If it is less than six hours from when you missed your dose, take it as soon as you
remember, and then go back to taking your tablets at the same time you would normally.

If it is more than six hours since your last dose, skip the dose you missed and take
your next dose when you would normally.

Do not take a double dose of TENORMIN to make up for the dose that you missed.

If you have trouble remembering to take your medicine, ask your pharmacist for some
hints.

If you take too much (overdose)

Immediately telephone your doctor or the Poisons Information Centre (telephone 13
11 26), or go to Accident and Emergency at your nearest hospital, if you think that
you or anyone else may have taken too much TENORMIN. Do this even if there are no
signs of discomfort or poisoning. You may need urgent medical attention.

If you take too much TENORMIN, you may feel faint or dizzy or you may find it difficult
to breathe.

While you are taking TENORMIN

Things you must do

Attend all of your doctor’s appointments so that your progress can be checked.

Tell any doctors, dentists and pharmacists who are treating you that you are taking
TENORMIN.

If you are about to be started on any new medicines, tell your doctor, dentist or
pharmacist that you are taking TENORMIN.

Tell your doctor immediately if you become pregnant while taking TENORMIN.

Tell your doctor immediately if you have an allergic reaction to any foods, medicines
or insect stings.

TENORMIN can cause allergic reactions to be worse and harder to treat.

If you have diabetes, check your blood sugar level regularly and report any changes
to your doctor.

TENORMIN may affect your diabetes. It may hide the symptoms of low blood sugar levels,
such as a fast heart beat. It may also take longer for your blood sugar level to get
back to normal even if you follow the usual treatment for diabetes. Your diabetic
medicines may have to be changed or the doses adjusted.

If you continue to have angina attacks, or have more of them whilst taking TENORMIN,
tell your doctor.

TENORMIN is used to help prevent angina, so your angina attacks should become less
severe and occur less often.

If you feel light-headed, dizzy or faint when getting out of bed or standing up, get
up slowly.

You may feel light-headed or dizzy after taking TENORMIN. This is because your blood
pressure is falling suddenly.

If this problem gets worse or continues, talk to your doctor.

To help your body get used to the change in blood pressure, you may find the following
hints useful:

Stand up slowly when getting up from a chair or bed. This will allow your body get
used to the change in position and blood pressure.

If you feel dizzy, sit or lie down until you feel better.

If you feel faint, sit down and put your head between your knees.

Drink lots of water when exercising and during hot weather when taking TENORMIN, especially
if you sweat a lot.

If you do not drink enough water while taking TENORMIN, you may feel faint, light-headed
or sick. The recommended healthy minimum water intake is 6-8 glasses a day.

If you are having surgery (even at the dentist), tell your doctor or dentist that
you are taking TENORMIN.

TENORMIN may affect some of the medicines used during surgery.

If you have to have any medical tests while you are taking TENORMIN, tell your doctor.

TENORMIN may affect the results of some tests.

Things you must not do

Do not stop taking TENORMIN or change the dose without checking with your doctor.

Do not take any new medicines with TENORMIN, unless your doctor has told you to.

Do not use TENORMIN to treat any other complaint unless your doctor tells you to.

Do not give TENORMIN to anyone else, even if their symptoms seem similar or they have
the same condition as you.

Things to be careful of

Take care driving or operating machinery until you know how TENORMIN affects you.

TENORMIN may cause dizziness, fatigue, light-headedness or faintness in some people.

Make sure you know how you react to TENORMIN before you drive a car, operate machinery
or do anything else that could be dangerous if you are dizzy or lightheaded.

Be careful not to over exercise when you first start taking TENORMIN.

It helps prevent angina resulting from physical activity and exercise. You may be
tempted to exercise too much. Talk to your doctor about how much exercise you can
do.

Dress warmly during cold weather, especially if you will be outside for a long time
(for example, when playing or watching sport in winter).

TENORMIN, like other beta-blocker medicines, may make you more sensitive to cold temperatures,
especially if you have circulation problems. Beta-blockers tend to decrease blood
circulation in the skin, fingers and toes.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you
are taking TENORMIN.

If you get any side effects, do not stop taking TENORMIN without first talking to
your doctor.

All medicines can have side effects. Sometimes they are serious, most of the time
they are not. You may need medical treatment if you get some of the side effects.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor if you notice any of the following and they worry you:

stomach upsets such as diarrhoea, constipation, abdominal pain or heartburn (indigestion)

dry mouth, change in taste sensation

dizziness, headache or buzzing or ringing in the ears

slow or irregular heart beat

dry eyes, problems with vision

runny or blocked nose

difficulty sleeping, nightmares

skin reactions (e.g. rash, itching, worsening of psoriasis)

cold fingers and toes

increased hair loss

tingling, ‘pins and needles’ or walking unsteadily

sexual problems

These side effects are usually mild.

Tell your doctor immediately if you notice any of the following:

confusion or disorientation

depression or mood changes or a worsening of these

unusual thoughts, hallucinations (seeing, feeling or hearing things that are not there)

light-headedness or fainting which may be due to low blood pressure

yellowing of the skin and/or eyes (jaundice)

These are serious side effects. You may need urgent medical attention. Serious side
effects are rare.

If any of the following happen, tell your doctor immediately, or go to Accident and
Emergency at your nearest hospital:

wheezing, chest tightness or difficulty breathing

unexplained bruising

swelling of the face, lips or throat

These are very serious side effects and you may need urgent medical attention or hospitalisation.
These side effects are rare.

Other side effects not listed here may occur in some patients. Tell your doctor or
pharmacist if you notice anything that is making you feel unwell.

Do not be alarmed by this list of possible side effects.

You may not experience any of them.

After taking TENORMIN

Storage

Keep your tablets in a cool, dry place where the temperature stays below 25°C. Protect
from light.

Keep your tablets in the pack until it is time to take them.

If you take TENORMIN out of the pack it will not keep well.

Do not store it or any other medicine in the bathroom or near a sink. Do not leave
it in the car or on a window sill.

Heat and dampness can destroy some medicines.

Keep this medicine where children cannot reach it.

A locked cupboard at least one-and-a-half metres above the ground is a good place
to store medicines.

Disposal

If your doctor tells you to stop taking TENORMIN, or the tablets have passed their
expiry date, ask your pharmacist what to do with any that are left over.

Product description

What TENORMIN looks like

TENORMIN 50 mg tablets are white, round, biconvex, film coated, tablets marked with
50 on one side and bisected on the other.

TENORMIN tablets come in calendar packs containing 30 tablets.

Tablet Ingredients

Each TENORMIN tablet contains atenolol 50 mg as the active ingredient.

Plus the following inactive ingredients:

magnesium stearate

magnesium carbonate hydrate

maize starch

sodium lauryl sulfate

gelatin

hypromellose

glycerol

titanium dioxide

TENORMIN does not contain lactose, sucrose, gluten, tartrazine or any other azo dyes.

Sponsor

AstraZeneca Pty Ltd

ABN 54 009 682 311

66 Talavera Road

MACQUARIE PARK NSW 2113

Telephone: 1800 805 342

 

Australian Registration Number:

TENORMIN 50 mg tablets –

AUST R 287200

 

This leaflet was prepared in October 2017.

 

TENORMIN is a trade mark of the AstraZeneca group of companies.

Doc ID-001066877 v3.0

Atenolol | PeaceHealth

Drug Information

Common brand names:

Tenormin

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions:
Beneficial
Adverse
Check

Replenish Depleted Nutrients

• Zinc

  Atenolol has been reported to decrease the levels of zinc in blood serum. The clinical significance of that finding is not certain.

  The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Potential Negative Interaction

• Pleurisy Root

  As pleurisy root and other plants in the Aesclepius species contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as atenolol.

  The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

• Potassium

  Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells, leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia. People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (for example, bananas), unless directed to do so by their doctor.

  The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

CVCA Cardiac Care for Pets

Atenolol | CVCA Cardiac Care for PetsAtenolol | CVCA Cardiac Care for Pets

Home » Drug Handouts » Atenolol

What is Atenolol?

Atenolol is classified as a beta blocker. Its main purpose is to block receptors on the heart that respond to stress or excitement. This type of drug helps control heart rate, decreases the incidence of certain arrhythmias, and is commonly used as a treatment for feline hypertrophic cardiomyopathy. It has overall effects on improving oxygen use by the heart muscle.

Uses/Indications

• Feline hypertrophic cardiomyopathy
• Canine subvalvular aortic stenosis (SAS)
• Ventricular premature beats and ventricular tachycardia
• Atrial premature beats and supraventricular tachycardia
• Systemic hypertension (high blood pressure)
• Hyperthyroidism

Adverse Effects

Please contact CVCA should any of these symptoms be noted

• Low heart rate resulting in signs of low blood pressure such as lethargy, depression, and weakness
• Must be used with caution in patients with decreased heart muscle strength and/or congestive heart failure, as symptoms may be worsened
• Needs to be used with caution in patients with airway disease or asthma
• May have some effect on blood sugar control in diabetic patients
• Cannot be stopped suddenly, as this can result in a rebound rapid heart rate. Patients need to be weaned off this class of drug

Client Information

• Can be given with food
• Can be given with other medications to treat heart disease when instructed by CVCA
• Dosing is usually once or twice daily by mouth. When giving this medication once daily, morning dosing is preferred especially in cats
• Can be given in pill form or reformulated into a flavored liquid
• Do not skip doses or stop giving this medication as heart rate could quickly rise again
• Please contact CVCA if your pet requires anesthesia, as dose adjustments may be necessary

Interactions with Other Drugs

• Increased risk for low heart rate or hypotension when combined with other drugs (acepromazine, amlodipine, diltiazem, enalapril/ benazepril)
• The doctors at CVCA have already taken this into account, however, please feel free to contact us to discuss any concurrent medications your pet may be prescribed

Dosage Forms

• Atenolol tablets – 25mg, 50mg, 100mg pill sizes
• Name Brand: Tenormin®

©2021, CVCA – Cardiac Care for Pets. All Rights Reserved.

Definition of Atenolol by Merriam-Webster

aten·​o·​lol

| \ ə-ˈte-nə-ˌlȯl

, -ˌlōl \

: a beta blocker C₁₄H₂₂N₂O₃ used in the treatment of hypertension

Poems & Tips From Other Journals

Am Fam Physician. 2005 Mar 15;71(6):1177-1178.

Study Question: Does atenolol reduce cardiovascular morbidity and mortality in patients with hypertension?

Setting: Various (meta-analysis)

Study Design: Systematic review

Synopsis: The authors of this briefly described systematic review evaluated the effect of atenolol on cardiovascular morbidity and mortality in patients with hypertension. However, the search strategy may have prematurely restricted the field, causing the authors to miss potentially relevant studies. Their search strategy allowed them to include only studies of atenolol versus placebo and five other studies that compared atenolol with other drugs. More than 23,000 patients who were evaluated for an average of 4.6 years were involved in these studies.

Compared with placebo, atenolol lowered systolic blood pressure by approximately 10 mm Hg and diastolic blood pressure by 6 mm Hg. Atenolol and the other drugs, however, had approximately the same effect on lowering blood pressure. In the placebo-controlled trials, atenolol had no effect on all-cause mortality, cardiovascular mortality, myocardial infarction, or stroke. In the studies using other drugs, one study—the Losartan Intervention For Endpoint (LIFE) reduction in hypertension study—included as many patients as the rest combined. The authors analyzed the studies with and without the LIFE data. When the LIFE study was included, no significant differences in all-cause mortality, cardiovascular mortality, myocardial infarction, or stroke were evident. When the LIFE data were not included, atenolol increased all-cause mortality (number needed to treat to harm [NNH] = 110 for 4.6 years; 95 percent confidence interval [CI], 59 to 798) and stroke (NNH = 79 for 4.6 years; 95 percent CI, 51 to 176).

The authors included several studies, including the LIFE trial, with questionable designs. One study was unblinded, two studies recruited patients with transient ischemic stroke or minor stroke, and one included only patients with left ventricular hypertrophy. Although most of the patients had hypertension, those studies were inappropriate to include as prevention trials. If these studies are excluded from the analysis, the authors’ point that the data supporting the use of atenolol are limited is well taken.

Bottom Line: If these authors have identified all relevant research, it appears that atenolol is more effective than placebo in lowering blood pressure. It is not more effective than other medications, however. Furthermore, it does not appear to reduce the rates of cardiovascular morbidity or mortality. (Level of Evidence: 1a–)

Arpimed

Driving and operating machinery

Capotril can affect the ability to drive, usually when the drug is taken for the first time, or when the dose is changed by the doctor. If you experience dizziness while taking Capotril tablets, do not drive vehicles or operate machinery.

Capotril contains lactose, which is a disaccharide. If you are intolerant to some sugars, you should see your doctor before taking this drug.

How to take Capotril

Capotril should be taken exactly as prescribed by your doctor or as recommended by your pharmacist.

Recommended doses:

For the treatment of high blood pressure

The usual starting dose is 12.5 to 25 mg twice daily. The attending physician may gradually increase the dose to 100 to 150 mg per day. It may be necessary to take other medicines to lower blood pressure at the same time.

In elderly patients and those with kidney problems, start with a lower starting dose.

For heart failure

The usual starting dose is 6.25 to 12.5 mg two or three times a day. Your doctor may gradually increase your dose to 150 mg per day.

After a heart attack

The usual starting dose is 6.25 mg, which will then be increased by the treating physician to 150 mg per day.

For the treatment of patients with diabetes mellitus and kidney disease

The usual dose is 75 to 100 mg per day.

For children

The initial dose is 0.3 mg / kg of body weight, which can be gradually increased by the attending physician.

For children with kidney disease, in premature babies, newborns and infants

The starting dose should be 0.15 mg / kg body weight.

Different doctors sometimes prescribe different doses to the above groups of patients, therefore, in each individual case, you should consult a doctor. If necessary, for a dosage of 12.5 mg, the tablet can be halved.

Sometimes patients may experience dizziness after taking the first one or two doses of Capotril. In this case, you should lie down until these symptoms disappear.

Capotril should be taken at approximately the same time every morning.Capotril can be taken before, during, or after meals.

Even if you feel well, you should continue to take Capotril until your doctor decides otherwise.

When taking Capotril in a dose exceeding the recommended

If you or someone else has taken too many pills, you should go to the nearest emergency room of the treatment center or tell your doctor immediately. Take the package and any remaining tablets with you.

If You forgot to take Capotril

Do not worry if the next dose of the drug is missed. You just need to continue to take the usual dose according to the established schedule.

Do not take a double dose of the drug to make up for the missed dose.

If you have any further questions on the use of this medicine, you should ask your doctor or pharmacist.

Possible side effects

Like all medicines, Capotril can cause side effects, although not every patient gets them.

If any of the following adverse reactions develop, you should stop taking Capotril and consult a doctor immediately:

• edema of hands, face, lips or tongue,
• shortness of breath,
• sudden, unexpected rash or burning, redness or flaking of the skin,
• sore throat or fever,
• severe dizziness or fainting,
• severe abdominal pain,
• unnaturally fast or irregular heart rate,
• Yellowing of the skin and / or eyes (jaundice).

Frequent side effects (in 1-10 out of 100 people)

• Dizziness
• Itching
• Rash
• Hair loss
• Disorders of taste perception
• Respiratory distress
• Dry mouth
• Insomnia
• Diarrhea or constipation
• Dry, irritating cough
• Dyspeptic disorders, nausea, vomiting, abdominal pain

Uncommon side effects (in 1-10 out of 1000 people)

• Rapid, irregular, pronounced heartbeat
• Chest pain
• Low blood pressure
• Decreased blood flow to the arms and legs (eg, Raynaud’s syndrome)
• Tide
• Fatigue
• General poor health
• Pallor
• Swelling of the eyes and lips (angioedema)

Rare side effects (in 1-10 out of 10,000 people)

• Loss of appetite
• Dizziness
• Headache
• Numbness or tingling sensation
• Signs in the mouth
• Renal impairment or renal failure
• Changes in urinary frequency

Very rare side effects (affects less than 1 in 10,000 people)

• Dysfunction of the liver and increased levels of hepatic transaminases
• Confusion, depression, loss of consciousness
• Microstroke
• Blurred vision
• Heart problems, including heart attack, and chest infections
• Inflammation of the pancreas
• Runny nose
• Swelling of the tongue
• Impotence
• Stevens-Johnson syndrome (a severe condition with blisters on the skin, mouth, eyes and genitals)
• Liver damage and inflammation or jaundice
• Stomach ulcers
• Muscle pain
• Joint pain
• Wheezing or shortness of breath
• Rash or skin reactions
• Swelling of the mammary glands in men
• Fever
• Increased photosensitivity of the skin
• Changes in the level of various substances in the blood or lymphatic system (for example, potassium, sugars)

If any of these side effects becomes serious, or if you experience any side effects not listed in this leaflet, you should inform your doctor or pharmacist immediately.It will be very helpful if the patient pays attention to what he experienced, when it started and how long it lasted.

Additional information

What substances Capotril contains 25 mg tablets

active substance : captopril – 25 mg in each tablet;

other components: hydrogenated castor oil, ethyl cellulose, sodium starch glycolate, magnesium stearate, purified talc, monohydrate lactose, microcrystalline cellulose.

How and how much Capotril tablets should be stored

Capotril 25 mg tablets

The drug should be stored out of the reach of children, at a temperature not exceeding 25 ⁰ C, in its original packaging.

Shelf life – 3 years. Do not use after the expiration date stated on the package. The expiration date is the last day of the month indicated on the drug package.

Packaging description

Cardboard package containing 24 tablets (1 blister of 24 tablets), together with an enclosed leaflet.

What Capotril 25 mg tablets look like, what their packaging consists of

Round tablets with a flat end surface of white or almost white color with a specific odor, with a score on one side and a bevel on both sides.

Vacation conditions

Available by prescription.

90,000 Atenolol, 50 mg tablets, 30 pcs.

In patients with coronary artery disease, abrupt withdrawal of beta-blockers can cause an increase in the frequency or severity of anginal attacks, therefore, discontinuation of Atenolol in patients with coronary artery disease should be carried out gradually.

The selection of doses in patients with cardiac decompensation also requires special attention. Compared to nonselective beta-blockers, cardioselective beta-blockers have less effect on lung function, however, in obstructive airway diseases, Atenolol should be prescribed only in case of absolute indications.If necessary, the appointment in some cases, you can recommend the use of beta ₂ -adrenomimetics.

Atenolol masks the tachycardia that occurs during hypoglycemia and may increase the duration of the hypoglycemic response to insulin. Care must be taken with the simultaneous use of Atenolol and hypoglycemic drugs in patients with diabetes mellitus.

Particular attention is required in cases where surgery is required under anesthesia in patients taking Atenolol.The drug should be discontinued 48 hours before surgery. As an anesthetic, you should choose a drug with the lowest possible negative inotropic effect.

Carefully prescribe the drug to patients with psoriasis, pheochromocytoma, hyperthyroidism and severe myasthenia gravis, Raynaud’s disease and various obliterating diseases of peripheral arteries, patients with severe impairment of renal excretory function.

With the simultaneous use of Atenolol and clonidine, Atenolol should be stopped a few days earlier than clonidine in order to avoid withdrawal symptoms of the latter.

If intravenous administration of verapamil is necessary, this should be done at least 48 hours after taking Atenolol.

With the use of Atenolol, it is possible to reduce the production of tear fluid, which is important for patients using contact lenses.

Atenolol should be prescribed with caution to motor vehicle drivers and people working with mechanisms, due to a possible decrease in attention.

What is the best time to take your blood pressure medication? Scientists advise

• Michelle Roberts
• BBC News online

October 23, 2019

Photo Credit, Getty Images

To maximize the benefits of blood pressure medications, take them before bed, Spanish scientists advise.This simple advice could save lives, they write in a study published in the scientific journal European Heart Journal .

A study says the tablets are better at protecting against strokes and heart attacks when taken before bed rather than in the morning.

Experts have concluded that the “biological clock” and the natural rhythm of our body affect a person’s response to drugs.

How to synchronize your medication intake with your biological clock?

Researchers are finding increasing evidence that many medicines, including those for the heart, work better when taken at specific times of the day.

The study, published in the European Heart Journal, is the largest of its kind to date. It was attended by 19 thousand people taking drugs for blood pressure.

The participants were randomly divided into two groups: one took the tablets in the morning, the other before going to bed. Researchers monitored their condition over the next five years or more.

In the end, they concluded that those who took their medication in the evening had half the risk of dying from heart attack, stroke, or heart failure.

Photo by Getty Images

Blood pressure should drop at night when we sleep and our bodies are resting.

If this does not happen and the pressure remains high, then the risk of heart attack or stroke increases, experts say.

A study found that taking medication in the evening can help control blood pressure at night in people with hypertension (high blood pressure).

Study participants who took their medication before bed had significantly lower average blood pressure levels both during the day and at night.At night, their blood pressure was lower than that of those who took their medications in the morning.

Lead Investigator Professor Ramon Hermida of the Spanish University of Vigo said doctors can take this into account and start recommending their patients to take their blood pressure medication at night: “It’s completely free and could save many lives.”

“The current guidelines for the treatment of hypertension do not provide any guidance on when to take the medication.The most common medical recommendation is to take the pill in the morning with breakfast, but it is based on the erroneous theory that it lowers morning blood pressure levels, “he says.

A study by Hermida showed that people who take drugs before bedtime, rather than in the morning, have more controlled blood pressure and a significantly lower risk of death, heart disease and problems with blood vessels, the professor noted.

However, he added that more research is still needed among different populations to to check whether his conclusions with his Spanish colleagues apply to all patients taking different blood pressure medications.

“While this study confirms previous findings in this area, there is a need to continue to conduct research among other ethnic groups, as well as among people who work in shifts, to truly prove that bedtime medication is beneficial for people with heart disease. vascular disease, “says Vanessa Smith of the British Heart Foundation.

“If you are taking medication for blood pressure, you should consult your doctor or pharmacist before changing the time you take the pills.There may be specific reasons why your doctor told you to take your medication in the morning or evening, “she warns.

A person’s lifestyle also affects blood pressure. The following can negatively affect it:

• Excessive alcohol consumption
• Smoking
• Overweight
• Inactivity
• Excessive salt intake

Combination therapy of arterial hypertension – a challenge to the future

WITH.A. ANDRIEVSKAYA, Dr. med. D., Professor, President of the Odessa Regional Association of Cardiology / Odessa Regional Cardiac Dispensary /

The forecasts made on the basis of data from past years make us tend to conclude that in 2025 30% of the world’s population will suffer from arterial hypertension – AH (Fig. 1). The data of domestic statistics are familiar to many doctors: annually we register 105 thousand strokes resulting from hypertension, and 50 thousand cases of myocardial infarction. Every 5 minutes one of our compatriots is diagnosed with a stroke, every 10 minutes in Ukraine a patient with myocardial infarction is added.European experience shows that in industrialized countries – France, Germany, Great Britain – blood pressure (BP) can be controlled in 70% of patients. In Ukraine, unfortunately, the statistics are the opposite: in 70% of patients, it is not possible to achieve blood pressure control. The data is threatening, since in 2011-2012. more than 12.3 million people with hypertension are registered in our country In rural areas, 8.1% of patients with hypertension receive effective treatment, in cities this figure reaches 14.3%.

Science is constantly looking for new effective forms of hypertension treatment.One of the important areas is to increase adherence to treatment. In this context, it is appropriate to quote the statement of C. Everett Koop, former US Secretary of Health: “Drugs do not work in patients who do not take them.” That is, the first task of a doctor is to select a project therapy, to ensure that patients comply with compliance, follow the recommendations of a cardiologist. Figure 2 shows the position of cardiologists and therapists in terms of patient adherence against the vigilance of other professionals.

Obviously, patients are significantly more adherent to the treatment of osteoporosis, HIV, alimentary canal diseases, diabetes mellitus than to the therapy of hypertension. Less adherence is noted only by neurologists who treat pathologies of the central nervous system.

Combination therapy is one way to improve adherence to antihypertensive therapy. In fact, by prescribing one pill to a patient, we prescribe 2-3 drugs. The advantage of well-chosen combinations is also the fact that low doses of active substances are used, therefore, it is possible to avoid the development of side effects.The result of such therapy is an additive effect, not a summation, but a mutual increase in the action of an antihypertensive drug by multiplying the positive qualities of the drugs that make up the combination. The advantages of combined antihypertensive therapy are also a change in pharmacodynamic properties, which allows an increase in the duration of action, an increase in the frequency of response to therapy, a decrease in treatment costs, an increase in the activity of each drug in comparison with a monotherapy regimen, complementary mechanisms of action, and a rapid achievement of target blood pressure.

Let us turn to the history of the creation of combination therapy for the treatment of a population with hypertension. In the 1980s, a differentiated choice of drugs was carried out in favor of monotherapy. In the 1990s, the position of combination antihypertensive therapy as a strategy for the initial treatment of hypertension was strengthened.In 1997, the VI Joint National Committee of the USA approved the use of a combination of two drugs for patients with hypertension of 2-3 degrees at the beginning of treatment at doses that are ineffective in monotherapy. In 2003, the VII Joint National Committee introduced a rule called “20/10”.It suggested starting treatment with a combination at BP> 20/10 mm Hg. from the original, i.e. most patients should be given this therapy.

The first fixed combinations of antihypertensive drugs appeared in the early 1960s. First, combinations of high-dose rauwolfia derivatives were used. A little later, regimens based on diuretics of medium / high doses were used with the addition of β-adrenergic receptor blockers (β-adrenergic blockers), angiotensin-converting enzyme (ACE) inhibitors.Further, combinations without diuretics became widespread (β-blockers and dihydropyridine calcium antagonists – AA; dihydropyridine AA and ACE inhibitors / angiotensin II receptor blockers – ARB II; nondihydropyridine AA and ACE inhibitors). At the current stage, fixed low-dose combinations are used, usually containing diuretics in very low doses (hydrochlorothiazide 6.25-12.5 mg; indapamide 0.625 mg). Figures 3-5 graphically show how views on possible drug combinations have changed.

According to the latest data presented at the European Congress of Cardiology, for example, a useful but not preferred combination of β-blockers and hypothiazide or chlorothiazide has emerged. A free position of the doctor in the choice of combinations for hypertensive therapy is assumed. The prohibition applies only to the combination of ACE inhibitors and sartans. European recommendations are also supported by domestic combinations. In particular, the antihypertensive portfolio of the oldest pharmaceutical enterprise in Ukraine – the pharmaceutical company “Darnitsa” – includes the drug Amlopril, which combines 7 molecules specified in the pilot project.Since the population receives it at a reduced price, this drug is offered for active use. The pharmaceutical company “Darnitsa” has created a successfully working double combination Sardip, including losartan and amlodipine, as well as the only three-component combination in Ukraine – the drug Tonorma (atenolol, chlorthalidone, nifedipine) (Table 1).

Sartans were not chosen by chance, since the drugs of this class are constantly being improved, studies are continuing on their study and the indications for their use are expanding.At the beginning of their history, they were used for coughing while taking an ACE inhibitor and left ventricular hypertrophy. In 2007, such indications as diabetic nephropathy, microalbuminuria, proteinuria, heart failure, postinfarction cardiosclerosis, atrial fibrillation, metabolic syndrome were added. Losartan is effective as an antihypertensive drug at the level of monotherapy with first-line drugs, which have approximately the same therapeutic potency at the level of 50-55%. However, it has been shown that the addition of amlodipine to losartan significantly increases its antihypertensive effect.

Let’s get acquainted with the results of a study carried out in the Odessa Regional Cardiological Dispensary, dedicated to the study of the antihypertensive effect of the drug Sardip (amlodipine 5 mg, losartan 50 mg) of the pharmaceutical company “Darnitsa”.

The aim of the study was to evaluate the clinical efficacy of 12-week antihypertensive therapy of this combination, its effect on clinical status, systemic hemodynamics, cardiac function, and to assess the safety of the drug.Rationale – the recommendations of the Ukrainian Society of Cardiology in 2008, which indicate the feasibility of using combined low-dose antihypertensive therapy as a starting point in most patients with AH of the 1st and 2nd degree. Among the carefully conducted clinical studies to assess the clinical condition of patients, 24-hour blood pressure monitoring, ultrasound examination of the heart and other types of studies were performed. The antihypertensive effect of the drug is shown in Figure 6.

In addition, the number of headache attacks per week decreased by 62.5%, dizziness – by 95.4%. The dynamics of hypertensive crises was characterized by the absence of complicated hypertensive crises, the development of uncomplicated crises in the first month 1.5 times a week, in the second month – once a week, the absence of those in the third month of treatment.

Special attention should be paid to the three-component drug of hypertensive therapy Tonorma of the pharmaceutical company “Darnitsa”.The first triple combination antihypertensive drug appeared in the 1970s. It was a combination of reserpine, hydralazine, and hydrochlorothiazide (adelfan-esidrex). In May 2009, the FDA (USA) approved the first modern three-way combination (amlodipine, valsartan, hydrochlorothiazide in one tablet). In July 2010, a combination of amlodipine, olmesartan, and hydrochlorothiazide was approved. The FDA requirement for approval of fixed three-way combinations is a demonstration that the combination of the three drugs is more pronounced in lowering blood pressure than the combination of any two ingredients.The basis for approval is a decrease in blood pressure> 3 mm Hg, compared to the effects of all possible two-component combinations at maximum doses. Clinical studies conducted for other purposes have shown retrospectively that it is inevitable in terms of the effectiveness of triple therapy (Fig. 7).

The three-component combined drug Tonorma (atenolol, nifedipine, chlorthalidone) is the brainchild of the NSC “Institute of Cardiology named after academician N.D. Strazhesko “. All its components are known for good antihypertensive action, while they neutralize the side effects of each other (Table 2).

Let’s dwell in more detail on the action of each of the components. Chlorthalidone is one of the most potent antihypertensive drugs. It reduces plasma volume, reduces the general peripheral vascular resistance, has a pleiotropic effect that is not found in other diuretics, reduces platelet aggregation, angiogenesis, and vascular permeability.Atenolol played an unenviable role for a very long time, as it was compared with new, experimental drugs and often lost in comparison. Nevertheless, today up to 40 million units of atenolol are sold annually in the world, and the results of the TIPS-2 study, announced at the International Congress of the European Society of Cardiology (ESC) in 2011 in Paris, convincingly demonstrate the effectiveness and relevance of atenolol-containing combinations. TIPS-2 data on a polytablet containing atenolol, hydrochlorothiazide, ramipril, simvastatin, aspirin showed that this combination can reduce cardiovascular risk by 65-70% and is well tolerated by patients in both half and full dosage of components.Like the polypill in the TIPS-2 study, TONORMA contains three antihypertensive drugs, two of which are atenolol and a diuretic.

Thanks to the presence of three components in one tablet, TONORMA allows you to increase the effectiveness of treatment and more often reach the target blood pressure level. The results of clinical studies demonstrate the effectiveness of TONORM in the treatment of arterial hypertension at the level of 86% (Fig. 8).

There is evidence that triple therapy is necessary in 25% of hypertensive patients. It is not surprising that we expect further strengthening of the position of combination antihypertensive therapy.Three-component therapy is a good alternative, a reserve for treating patients who cannot otherwise achieve controlled BP values. It is advisable to use an inexpensive, effective domestic drug in order to change the blood pressure control indicator, which in Ukraine, as already mentioned, is at most slightly more than 14% for the urban population.

The list of used literature is in edition

Increased heart rate

Increased heart rate or tachycardia

this is a pathological process that indicates a restless physiological state.Let’s look at when is an increased heart rate , find its causes and methods of treatment.

If strong heartbeat has a physiological nature, that is, it arose due to fright, physical exertion or excitement, then this does not harm the body. But if it occurs for no apparent reason, then such a condition is dangerous for the body. Since rapid heart rate impairs blood flow to the heart muscle and increases its oxygen consumption.And this can cause myocardial infarction or an attack of angina pectoris.

Causes of increased heart rate

The reasons for the increased heart rate vary. Sometimes this is a temporary phenomenon and the heart rhythm is restored on its own without treatment. But in some cases, an increased heart rate is a symptom of serious pathological processes in the body. The most common causes of an increased heart rate can be fear, anxiety, and anxiety. Note that some medications cause an increased heart rate.Excessive caffeine consumption, fever and allergies are also causes of increased heart rate.

But in some cases an increased heart rate indicates disorders of the autonomic nervous system or endocrine disorders. As a rule, with such violations, a person has problems with the adrenal glands and may even have tumor lesions. In pregnant women, palpitations are normal and physiological.In this case, the increased heart rate is associated with an increase in the volume of blood circulation due to the additional circulatory system of the child.

Increased blood pressure and heart rate

High blood pressure and palpitations are the first symptoms of tachycardia and the most common complaints when visiting a cardiologist. Let’s look at how to normalize your condition if your heart rate suddenly increases and your blood pressure rises.

• Get into a comfortable position and try to relax.Inhale slowly and deeply. After a couple of minutes, the heartbeat will return to normal.
• If the first method did not help you, then try to inhale, cover your nose and mouth with your hand, but try to exhale. This will raise your blood pressure and allow your heart to resume its normal rhythm. This method of restoring a normal heartbeat is called the Vasiliev method.
• A sip of cold water is another option to calm your heartbeat. Passing through the esophagus, water exerts pressure on the heart, which normalizes its work.Sometimes cold washing helps to normalize the pulse and blood pressure much faster.
• If stress is the cause of the increased blood pressure and heart rate and pressure, try to relax and meditate for a while. This will normalize blood pressure and heart rate. Aromatherapy is another method of relaxation and normalization.
• Tincture or decoction of motherwort helps to normalize conditions. With pronounced tachycardia, it is recommended to take Corvalol, Validol or Anaprilin.
• Healthy eating is another effective method of normalizing blood pressure and heart rate. Add more fish and seafood to your diet. Foods enriched with omega-3 fatty acids are great for heart function. And regular exercise will temper and prepare the heart for stress.
• High blood pressure and heart palpitations can occur due to a lack of magnesium in the body. Take vitamin complexes to strengthen the body. If you are taking medications, pay attention to their side effects, as it is possible that high heart rate and high blood pressure are the cause of the drug’s action.

Increased fetal heart rate

An increased fetal heart rate can be diagnosed by performing an ultrasound scan in the fifth week of pregnancy, that is, in the third week of embryo development. The fetal heart rate allows you to find out how the baby is developing, whether everything is normal with him or there are any problems and complications.

Doctors say that a normal fetal heart rate should be twice as high as that of a pregnant woman.So, at 6-8 weeks of pregnancy, the baby’s pulse is 130-140 beats per minute, and in the ninth week about 190 beats per minute, at 33 weeks the heartbeat is kept at 160 beats per minute.

An increased heart rate, that is, tachycardia in the fetus, may indicate intrauterine hypoxia. As a rule, this condition occurs due to the fact that a woman suffers from iron deficiency anemia or spends a lot of time in a stuffy room. But most often, an increased heart rate in the fetus occurs during the moments of movement and physical activity of the mother.

Increased heart rate at low pressure

An increased heart rate with low blood pressure is very common. As a rule, such symptoms can be observed in the case of profuse blood loss, traumatic, anaphylactic and other genesis of shock. Low blood pressure and high pulse can be a symptom of vegetative-vascular dystonia. In this case, the patient has a pronounced pallor of the skin and mucous membranes, frequent dizziness and nausea occur.

Against the background of low blood pressure, tachycardia can develop, which is accompanied by an increased heartbeat, pain in the stomach and heart. Many patients complain of the appearance of an unreasonable feeling of fear and anxiety. Increased heart rate and low blood pressure are the cause of headaches and constant dizziness.

Increased heart rate during pregnancy

An increased heart rate during pregnancy is considered normal.Pregnancy is a special period in the life of every woman, since at this time the body begins to work in a different mode. A rapid heart rate during pregnancy is a heart rate in excess of one hundred beats per minute. This condition is accompanied by certain symptoms: chest pains, dizziness, headaches, shortness of breath. Many pregnant women experience fainting and numbness in various parts of the body.

As a rule, in most pregnant women, tachycardia is mild and does not cause medical concern.This is because the heart provides normal blood flow to the uterus. If tachycardia causes concern, then the pregnant woman is advised to relax and rest, drink more purified water to maintain water balance in the body and avoid stress. This will help bring your heart rate back to normal. But if an increased heart rate during pregnancy causes constant painful symptoms and anxiety, then the woman is referred to a cardiologist to diagnose the symptoms of tachycardia.

Increased heart rate in a child

An increased heartbeat in a child may occur due to emotional stress (fear, stress, fear, joy) or be a symptom of diseases of the cardiovascular system.In addition, in children, the heartbeat increases due to weather changes and elevated temperatures. Do not forget that the younger the baby, the higher his pulse, that is, the number of heartbeats.

If an increased heartbeat in a child has arisen due to emotional or physical stress, then the condition will normalize by itself. But there are times when tachycardia does not manifest itself due to the above factors. In this case, a rapid pulse can be a symptom of heart failure, myocarditis, rhythm disturbances.To cure an increased heartbeat in a child, it is necessary to make a cardiogram, as this will determine the cause of this condition.

If the baby has acute attacks of tachycardia, which last for several hours and are accompanied by painful sensations (pain in the heart, dizziness, nausea), then this condition is called paroxysmal tachycardia. Heart palpitations can also occur in infants. In this case, the baby is thrown into a cold sweat, a convulsive state and fainting appear.In this condition, it is very important to calm the child down. If the child is already 4-7 years old, give the child a glass of cold water to drink and try to induce vomiting. If after that the attack has not passed, urgently call an ambulance and do not postpone the trip to the cardiologist.

What to do with an increased heart rate

What to do with an increased heartbeat is a question that interests people suffering from this symptom. To determine whether a rapid pulse is a symptom of a disease, it is necessary to consult a cardiologist, make an electrocardiogram, ultrasound examination of the heart, thyroid gland, make an electrocardiogram and take a blood test for hormones.If the tests are negative, then the increased heart rate is most likely due to secondary tachycardia.

In this case, a rapid pulse is treated with drugs, antidepressants and sedative herbs (valerian, mint, rosehip, lemon balm). The duration of treatment should be from three to six months. Exhausting physical activity and constant stress is another common cause of an increased heart rate. In this case, it is necessary to change the level of stress and change the situation, since constant stress on the heart will lead to myocardial disease or atrial fibrillation.

Treatment of increased heart rate

Treatment for an increased heart rate depends on the underlying cause. The most unpleasant thing is that an increased heart rate is almost always accompanied by painful symptoms – dizziness, shortness of breath, nausea, vomiting, fainting.

There are several methods to cure an increased heartbeat, one of them involves drug therapy with pills, injections and droppers, and the second is a method of traditional medicine, that is, herbal treatment.Traditional medicine methods can also be used when the heart palpitations are caused by stress, insomnia or nervous feelings.

Treatment of increased heart rate is carried out with the help of herbal infusions of valerian, cumin, motherwort or fennel seeds. You can purchase an herbal and take it before meals for several months. But the best way to get rid of an increased heart rate is to avoid stressful situations and live a healthy lifestyle.

Medicine for increased heart rate

The medicine for an increased heart rate can be different. So, some patients, in the fight for normal heart function, take medications (pills, injections), others lead an active lifestyle and avoid stressful situations that provoke tachycardia, but still others use traditional medicine methods. But in any case, it is recommended to seek medical help before starting treatment. The doctor will prescribe a set of tests to diagnose the condition of your body and heart function.

In the treatment of increased heart rate, two groups of drugs are used: sedatives and antiarrhythmic drugs. Let’s take a closer look at each group of drugs.

• Sedatives – such preparations are made on a herbal, that is, natural basis, their task is to calm the nervous system and improve the normal functioning of the heart. The most popular sedatives are valerian (tablets, decoction, tincture, drops), motherwort, novo-passit, diazepam.
• Antiarrhythmic drugs that act on the cardiovascular system.The main task of such drugs is to normalize heart palpitations. The most popular drugs in this group are adenosine, verapamil and flecainide. Please note that such drugs should be taken only as directed by a cardiologist.

Pills for increased heart rate

Heart rate pills are one of the treatments for tachycardia. Let’s take a look at the main types of pills used to treat increased heart rate.

• Beta-blockers are pills that reduce the effects of hormones that cause stress. Most popular: concor, atenolol.
• Cardiac glycosides – these tablets are prescribed by a cardiologist and, as a rule, to patients who have an increased heart rate due to heart failure. Most often, dogoxin is prescribed.
• Sedatives – tablets that act as a sedative. Recommended for people who suffer from emotional instability and frequent stress.As a rule, such tablets are based on herbal ingredients. The most commonly used tablets are valerian or novo-passit.
• Antioxidants – tablets that belong to this group are used as an adjunct to the main therapy. As a rule, patients are prescribed preductal or mexicor.

Please note that taking any pills with an increased heart rate must be approved by your healthcare professional. Some pills are not available without a prescription.In addition, it is the attending physician, the cardiologist, who prescribes the course of treatment and warns of possible side effects from taking the pills.

Treatment of increased heart rate with folk remedies

Treatment of increased heart rate with folk remedies is an affordable and quite effective method for everyone to normalize a rapid pulse. Often, herbal infusions and decoctions of herbs are used to treat tachycardia, which gently and effectively affect the body. The most popular herbs for the treatment of tachycardia are motherwort, St. John’s wort, mint, rue, chamomile, lemon balm.Let’s look at several recipes for treating increased heart rate with folk remedies.

Take fresh millennial herb and rue. From the plants, you need to squeeze out the juice in the same proportions. Add 10-12 drops of the herb to a glass of water and take it twice a day for no longer than 14 days.

• Hawthorn juice is another folk remedy in the fight against increased heart rate. 10-20 drops in a quarter glass of water should be taken three times a day, before meals.A medicinal decoction can be prepared from hawthorn, the action of which does not differ from the action of juice. 30 grams of hawthorn is poured with boiling water and insisted for 3-4 hours. Take before meals, by? glasses.
• Herbal tea effectively helps to cure heart palpitations in both children and adults. Mix a spoonful of dry millennial, a spoonful of lemon balm and a spoonful of valerian root. Pour boiling water over the herbs and maintain a steam bath for 40 minutes. As soon as the broth has cooled it can be taken.

In addition to herbal treatments, traditional therapies use healthy, natural foods (fruits and vegetables) to help normalize your heart rate.For the treatment of tachycardia, it is recommended to use: pears, apricots, plums, corn, citrus fruits, nuts, raspberries, cucumbers, beets and cabbage, tomatoes and red peppers. Products are best consumed fresh, making juices and salads from them.