Adult:

Compensated heart failure. Variant angina, acute MI, DM; peripheral vascular disorders; hepatic and renal dysfunction; elderly patients, children. Lactation. If atenolol and clonidine are co-admin, then gradual withdrawal of clonidine should take place a few days after withdrawal of atenolol. Lactation: Drug enters breast milk; neonates born to mothers who are receiving atenolol at parturition or breastfeeding may be at risk for hypoglycemia and bradycardia; use with caution

Child: 

Atenolol is a competitive cardioselective beta1-blocker and does not have effect on ?beta2-receptors except in high doses. It reduces resting and exercise-induced heart rate as well as myocardial contractility.

Administration:

Concomitant admin w/ reserpine may increase hypotension and bradycardia. Additive w/ Ca channel blockers, hydralazine, methyldopa. Increased risk of bradycardia and heart block w/ verapamil and diltiazem. May decrease hypotensive effects w/ NSAIDs (e.g. indometacin). Enhanced bradycardic effect w/ disopyramide, amiodarone or digitalis glycosides. May exacerbate rebound HTN upon discontinuance of clonidine treatment.

Interaction:

Hypersensitivity. Sinus bradycardia, sinus node dysfunction, heart block >1st degree, compensated cardiac failure, cardiogenic shock, bronchospastic diseases, peripheral vascular diseases. Pregnancy.

Contraindications:

• Sinus bradycardia, heart block greater than first degree, cardiogenic shock, and overt cardiac failure.
• Those patients with a history of hypersensitivity to the atenolol or any of the drug product’s components

Side Effect:

Renal impairment: CrCl (ml/min) <15 25 mg or 50 mg on alternate days. 15-35 50 mg/day. Dialysis patients 25-50 mg after each dialysis.

Pregnancy:

D is the pregnancy category. When administering Atenolol to a breastfeeding mother, extreme caution is advised. Breast-fed newborns have been found to have clinically severe bradycardia. Infants born prematurely or with compromised renal function may be more susceptible to side effects.

Precautions & Warnings:

General: Patients already on a beta blocker must be evaluated carefully before Atenolol is administered. Initial and subsequent Atenolol dosages can be adjusted downward depending on clinical observations including pulse and blood pressure. Atenolol may aggravate peripheral arterial circulatory disorders.

Impaired Renal Function: The drug should be used with caution in patients with impaired renal function.

Geriatric Use:

• Hypertension and Angina Pectoris: Due to Coronary Atherosclerosis: Dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
• Acute Myocardial Infarction: Dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Evaluation of patients with hypertension or myocardial infarction should always include assessment of renal function.

Storage Conditions

Do not use it after the expiration date. All drugs should be kept out of the reach of youngsters. Only on a licensed physician's prescription can it be dispensed.