Atenolol
beta-blocker
Our referenceBy the Layer Nutrition editorial team · How the atlas classifies the 664 molecules
What this medicine is for
Atenolol is a medicine in the “beta-blocker” category. Beta-blockers slow and ease the heart and lower blood pressure. They are never stopped abruptly.
For Atenolol in practice: Slows the heart and lowers blood pressure. It is generally taken over the long term, within regular monitoring, and is not stopped on your own initiative.
Under which brands it is found
Atenolol is used in about 14 presentations listed in France. It comes under various commercial names and as generics.
- Atenolol Arrow
- Atenolol Biogaran
- Atenolol Cristers
- Atenolol Eg
- Atenolol Evolugen Pharma
- Atenolol Sandoz
- Atenolol Sfdb
- Atenolol Teva
- and other presentations
Original brand-name products and generics deliver the same active substance; the choice between them is made with your doctor or pharmacist.
Our product for this treatment
You take Atenolol. For people who follow this type of treatment every day, we have designed a dedicated product.
Layer Nutrition Beta-Blockers
Melatonin helps you fall asleep faster. Magnesium and vitamin B6 help you reduce tiredness during the day.
- Contributes to the reduction of time taken to fall asleep (melatonin 1 mg, at bedtime)
- Contributes to the reduction of tiredness (magnesium, vitamin B6)
- Contributes to normal muscle function and to the normal functioning of the nervous system (magnesium)
Melatonin 1 mg · Magnesium 100 mg · B6 1.4 mg
One bottle, one dose per day. Reduced price from the second box, free delivery from two boxes.
How atenolol works
Atenolol belongs to the beta-blocker family, more precisely to the second-generation beta-1 adrenergic receptor antagonists described as cardioselective. It binds selectively to the beta-1 receptors of the heart and prevents catecholamines, adrenaline and noradrenaline, from exerting their stimulating effect there. As a result, the heart rate slows, the contractile force of the myocardium decreases and blood pressure falls. Atenolol acts without membrane-stabilizing activity and without intrinsic sympathomimetic activity: it is not a partial agonist, it simply blocks the receptor.
This selectivity for the beta-1 receptors is not absolute: at high doses, a blockade of the beta-2 receptors may appear. Beta-1 blockade does not, moreover, concern only the heart, it also acts on the kidney, where it reduces the secretion of renin, an enzyme that triggers a hormonal cascade increasing blood pressure. This drop in renin contributes to the drug's antihypertensive effect. Atenolol thus combines two levers, cardiac and renal, to lower pressure.
Why it is prescribed
Atenolol is approved by the health authorities in three main situations: arterial hypertension, angina pectoris (angina) and the acute phase of myocardial infarction. In hypertension, it lowers pressure by slowing the heart and reducing renin. In angina, it decreases the heart's workload and therefore its oxygen consumption, which spaces out the episodes of chest pain. After an infarction, it protects the weakened myocardium by reducing the adrenergic demand that weighs on it.
Beyond these indications, atenolol is used in situations where its cardiac braking action is sought. Doctors sometimes prescribe it for certain rhythm disorders, for a supraventricular tachycardia, for the prevention of migraine or to control the manifestations of a thyrotoxicosis. These uses fall outside the strict framework of the initial authorization, but they rest on the same pharmacological logic. The choice belongs to the doctor, according to each person's profile.
How to take it day to day
Atenolol is taken by mouth, once or twice a day, at a fixed time. Regularity matters: taking the tablet at the same moment each day maintains a stable concentration in the blood. Its elimination half-life, of roughly six to seven hours, explains this rhythm of one to two daily intakes. The treatment is not judged by an immediate sensation, because blood pressure and heart rate are controlled over time, without a signal felt from day to day.
One point is decisive: atenolol must never be stopped abruptly, because a sudden halt can cause a rebound, with an acceleration of the heart and a rise in pressure. Any change goes through the doctor, who reduces the dose gradually if needed. As for its fate in the body, atenolol undergoes little or no transformation by the liver and is eliminated almost entirely by the kidney, through filtration and active secretion, which requires adjusting the dose in case of renal insufficiency. A hydrophilic molecule, it crosses little the barrier that protects the brain, which limits its penetration into the central nervous system.
The effects to know about
Fatigue is the most frequent effect: in placebo-controlled studies, it affects 26% of people on atenolol versus 13% on placebo. Then come dizziness or lightheadedness (13% versus 6%), the sensation of cold extremities (12% versus 5%) and depressed mood (12% versus 9%). Shortness of breath concerns 6% of people versus 4% on placebo, and bradycardia, this marked slowing of the heart, 3% versus 0%. Digestive disorders remain rarer: diarrhea 3%, nausea 3%, versus respectively 2% and 1% on placebo.
One effect deserves particular attention in the person with diabetes: atenolol can mask the signs of a hypoglycemia, notably the palpitations and the tremors, those that usually give the alert. It can in the same way mask the signs of a hyperthyroidism. These are not complications in the strict sense, they are warning signals that the drug attenuates and that one must then know how to monitor otherwise. This is one of the reasons why follow-up accompanies the treatment.
On the plate
The blockade of the beta-1 receptors does not stop at the heart. The pineal gland, in the brain, uses these same receptors to command the manufacture of melatonin, the hormone that opens the night and sets sleep. By blocking them, atenolol reduces the nocturnal secretion of melatonin, an established pharmacological effect. In hypertensive people treated with a beta-blocker, a randomized controlled trial showed that an intake of melatonin improves sleep quality, which is consistent with this decline.
On the plate, melatonin is found only in very small quantities, too low to compensate for the decline the treatment causes. Two other nutrients accompany melatonin in our formula and are found in many foods: magnesium, present in spinach, walnuts, legumes and the banana, and vitamin B6, supplied by salmon, the banana and chickpeas. A link between beta-blockers and coenzyme Q10 is sometimes mentioned, but it remains debated: the older data concern above all lipophilic molecules such as propranolol, and for atenolol, a hydrophilic molecule, they do not allow a depletion to be affirmed. When melatonin production slows under the effect of the drug, food alone does not fill this gap, and this is where a targeted intake takes its meaning, in addition to your treatment, never in its place.
Interactions and monitoring
Certain combinations call for caution. With calcium channel blockers, the slowing of the heart can add up and cause a bradycardia or a heart block. On stopping clonidine, atenolol can worsen the rise in pressure, this hypertensive rebound that must be anticipated. Agents that empty the reserves of catecholamines add their hypotensive effect to its own, while non-steroidal anti-inflammatory drugs (NSAIDs) can on the contrary reduce its effect on pressure. Atenolol is moreover contraindicated in case of sinus bradycardia, second- or third-degree atrioventricular block, cardiogenic shock or decompensated heart failure, and it calls for caution in case of asthma or bronchospasm.
Follow-up accompanies the treatment closely. The doctor regularly measures the heart rate and blood pressure, to check that the braking stays in the right range. The doctor evaluates renal function, since it is the kidney that eliminates the molecule and the dose depends directly on it. In the person with diabetes, blood sugar is monitored, all the more since atenolol can blur the signs of a hypoglycemia. This monitoring framework allows the dose to be adjusted and to spot early what needs to be.
Sources
- Atenolol - StatPearls, NCBI Bookshelf
- ATENOLOL tablet label
- Atenolol: MedlinePlus Drug Information
- Influence of beta-blockers on melatonin release
- Repeated melatonin supplementation improves sleep in hypertensive patients treated with beta-blockers
- Inhibition of coenzyme Q10-enzymes by clinically used adrenergic beta-receptor blockers
Related molecules
To explore in the « Heart and blood pressure » family and its neighbours.
See the whole « Heart and blood pressure » family · Back to the atlas
Frequently asked questions
What are the side effects of atenolol?
The leaflet most often mentions fatigue, a slower heart rate, cold hands and feet and dizziness, as well as sleep disturbances in some people. The effects felt vary from one person to another. Refer to the leaflet in your pack and speak to your doctor or pharmacist.
Should you take atenolol in the morning or at night?
What matters is taking it at the same time every day to keep a stable blood level. The timing and any adjustment depend on your situation. Follow the leaflet and the advice of your doctor or pharmacist.
What does atenolol interact with?
Atenolol can interact with other blood pressure treatments, certain antiarrhythmics, insulin and medicines such as diltiazem or verapamil. Tell your doctor or pharmacist about all your medicines and supplements, and check the leaflet before combining anything.
Can you drink alcohol while taking atenolol?
Alcohol can heighten certain effects such as dizziness or a drop in blood pressure. What to do can be read in the leaflet and discussed with your doctor or pharmacist.
Can you stop atenolol suddenly?
The leaflet advises against stopping beta blockers suddenly. Any discontinuation should be planned with your doctor, usually gradually. Never stop the treatment on your own.
Atenolol, pregnancy and breastfeeding: what should you do?
Atenolol crosses the placenta, and its use during pregnancy is subject to precautions in the leaflet. If you are pregnant, planning to be or breastfeeding, speak to your doctor or pharmacist before making any decision.
Does atenolol make you tired?
Fatigue is among the effects frequently reported in the leaflet, and disturbed sleep may contribute to it. If this tiredness bothers you day to day, raise it with your doctor or pharmacist.
Is atenolol suitable if you have diabetes?
The leaflet notes that atenolol can mask certain signs of low blood sugar in people with diabetes, which calls for particular vigilance. This question should be discussed with your doctor or pharmacist.
Atenolol and Tenormin: are they the same thing?
Atenolol is the active substance; Tenormin is one of its brand names, alongside many generics containing the same active ingredient. For any question about your specific product, refer to the leaflet or to your pharmacist.
Why is sleep often disrupted on atenolol, and what role does melatonin play?
Research (Stoschitzky et al., 1999) observed a reduction in the nighttime secretion of melatonin on a beta blocker, the hormone that accompanies falling asleep. This is one of the mechanisms that research links to the sleep disturbances reported with this class of medicines. Melatonin is therefore the first nutrient we consider for the BB01 reference.
In what form should you consider melatonin with a beta blocker?
It is melatonin itself that is concerned, since research links beta blockers to a lower nighttime secretion of this hormone (Stoschitzky et al., 1999). Our BB01 reference, designed for beta blockers, builds on this angle. How to fit it into your routine should be discussed with a healthcare professional.
Why add magnesium to this approach?
Magnesium contributes to nervous and muscular relaxation and to sleep, and it is the second nutritional focus chosen for the BB01 reference alongside melatonin. We favour a well tolerated form such as magnesium bisglycinate rather than a poorly absorbed salt.
Ces réponses portent sur le volet nutritionnel. Pour toute question sur votre médicament, la notice et votre médecin ou pharmacien font foi.