Atenolol
TENORMIN
Pronunciation: a-TEN-oe-loel
“A tin Tenor man”
LOL hat with β prongs → beta blocker cue
What it isBeta-1-selective antagonist; hypertension and angina.
Why this oneHydrophilicity and renal elimination mean fewer CNS and hepatic-interaction effects than with propranolol or metoprolol.
What limits itPrevents stroke less effectively than several alternatives in older adults and accumulates in kidney disease. Never stop abruptly.
Atenolol prescription history
Animated chart of estimated U.S. prescriptions per year, Antihypertensives (1953–2026). Atenolol enters in 1981 (estimated).
FDA-approved for
- hypertension/angina (1981)
Off-label
- performance anxiety
Principal riskBradycardia; abrupt withdrawal can precipitate ischemia
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityBradycardia and hypotension; renal impairment can prolong severe overdose toxicity.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hypertension | Adults | 50 mg QD (25 mg QD if elderly/renally impaired) | 100 mg QD | 100 mg/day |
| Angina pectoris | Adults | 50 mg QD | 100 mg QD | 200 mg/day |
| Acute myocardial infarction | Adults | IV 5 mg over 5 min ×2 (10 min apart), then 50 mg PO ×2 (12 h apart) | 100 mg QD or 50 mg BID | 100 mg/day |
Titration Hypertension: assess after 1–2 weeks before increasing; angina: after 1 week
Renal Adjust in severe impairment: CrCl 15–35 mL/min max 50 mg/day; CrCl <15 max 25 mg/day; hemodialysis: 25–50 mg after each dialysis
Hepatic Undefined
Instructions
- Discontinue gradually in angina patients — do not stop abruptly
- Acute-MI IV regimen initiated only in a monitored setting after hemodynamic stabilization
Available strengths
- tab 25, 50, 100 mg
Contraindications
- Sinus bradycardia
- Heart block greater than first degree
- Cardiogenic shock
- Overt (uncompensated) cardiac failure
Cautions
- Do not discontinue abruptly (risk of angina exacerbation/MI)
- Bradycardia and hypotension
- Bronchospasm/wheezing in bronchospastic disease
Adverse reactions
- Bradycardia
- Cold extremities
- Postural hypotension
- Dizziness
- Fatigue/tiredness
- Depression
- Nausea
- Diarrhea
- Dyspnea
- Wheezing
Pregnancy Undefined
Lactation Undefined
Cost
Generic entry1988
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Memory aids: interaction avatars
Open Atenolol in the interactive console ↗
Self-check
- When can atenolol accumulate?
In kidney disease. - What helps atenolol cause fewer CNS effects than propranolol or metoprolol?
Hydrophilicity.