Overview

Atenolol (Tenormin) is known as a beta-blocker. That means the drug works in part by blunting the action of adrenaline, the body’s natural fight-or-flight chemical. People normally respond to stressful situations with a rapid pulse, a pounding heart and an increase in blood pressure. Atenolol (Tenormin) helps block such reactions. This medicine is normally prescribed for high blood pressure, chest pain, or heart attacks.

Although the FDA has not specifically approved its use for other purposes, doctors sometimes prescribe atenolol (Tenormin) to treat irregular heart rhythms, performance anxiety such as stage fright, and to prevent migraine headaches.

People’s Pharmacy Perspective
We suspect that one of the reasons beta-blockers are so popular with insurance companies and HMOs is that they are inexpensive. These drugs have been around a long time and generally have low cost generics available. Current research (1,2) however, suggest that due to their lack of efficacy, beta-blockers such as atenolol (Tenormin) should rarely be the first line of treatment for high blood pressure.

Experts also cast serious doubts about their effectiveness in the prevention of initial heart attacks and strokes for hypertensive patients and have concerns about the multiple side effects beta-blockers could cause (3,4). Beta-blockers are valuable for managing chest pain and especially preventing another heart attack after someone has already had one. Finally, they may also be valuable when adequate control is not achieved with other classes of drugs, but you and your physician will need to decide if the benefits outweigh the risks.

Be certain to consult a physician about your health, especially with regard to any signs or symptoms that may require diagnosis or medical attention. Information provided is not a substitute for the medical advice or care of a physician or other health care professional.

Special Precautions
Do not stop taking atenolol (Tenormin) suddenly without first talking to your doctor. Stopping abruptly may trigger serious and potentially fatal heart problems.

Atenolol (Tenormin) is not recommended for some people: People who have had an allergic reaction to beta-blockers, atenolol (Tenormin), or its components; people with certain heart problems, abnormal heart rhythms or heart failure, since the medicine could occasionally lead to serious cardiac complications.

Some people must be very carefully monitored if they take beta-blockers such as atenolol (Tenormin): Asthmatics and patients with other respiratory problems are especially vulnerable as these drugs can make breathing worse. Atenolol (Tenormin) is a little better than other beta-blockers in this regard, but monitor your breathing carefully.

Diabetics should inform their physicians if being prescribed atenolol (Tenormin) as the medication may mask the signs of low blood sugar levels. People with a history of depression should inform their doctors to ensure both their depression and beta-blocker therapy is well managed.

While atenolol (Tenormin) is less likely to affect the nervous system than others in its class, beta-blockers have been known to contribute to depression. People with a thyroid disorder should also be carefully monitored as atenolol (Tenormin) may mask signs of an overly active thyroid. People with kidney impairments or who are elderly may need their atenolol (Tenormin) dose adjusted.

Special Precautions
More people who must also be very carefully monitored if they take beta-blockers: Women who plan to become pregnant or breastfeed should not take this medication unless their doctors determine it is appropriate. Atenolol may cause harm to an unborn baby.

Be certain to inform your doctor of any other condition you have, as it may affect whether you should take atenolol (Tenormin), your dose, or require you to take special tests during treatment.

Taking the Medicine
Atenolol (Tenormin) should be taken with a full glass of water and can be taken at meal time or on an empty stomach. If you find this medicine causes digestive tract upset, it may be better tolerated when taken with food.

Atenolol (Tenormin) should not be taken together with orange juice as it may reduce the medication’s effect. (5) Avoid drinking alcohol, which could increase your symptoms of drowsiness and dizziness while you are taking atenolol (Tenormin). Don’t take calcium supplements or antacids at the same time as atenolol (Tenormin), as they may reduce its absorption.

You may need to temporarily stop taking atenolol (Tenormin) if you will be undergoing surgery since anesthesia may interact with atenolol (Tenormin) and affect how your heart functions. Be sure to let the surgeon and/or anesthesiologist know well in advance of surgery that you are taking atenolol (Tenormin). Never stop taking atenolol (Tenormin) suddenly. Your doctor must reduce your dose gradually to prevent serious heart problems.

Common Side Effects
Atenolol (Tenormin) can cause a number of side effects. They include a slower heart rate, sexual difficulties, sleep problems, tiredness, anxiety, and nervousness.

This medicine may also have a negative effect on cholesterol and other blood fats, so a lipid test before treatment and periodically thereafter would be prudent.

Although Atenolol (Tenormin) is a little less likely to affect the nervous system than certain other drugs in this class, be alert for the beta-blocker blahs. Symptoms of psychological depression, fatigue, decreased concentration, memory loss and mood swings may come on slowly and insidiously.

Serious Side Effects
Obtain emergency medical care if you experience these signs of a potential allergic reaction: breathing difficulties, hives, or swelling in your face, lips, tongue, or throat. Call your doctor promptly if you experience any of these serious side effects:

  • wheezing, worsening asthma;
  • slow or uneven heartbeats;
  • feeling light-headed, fainting;
  • feeling short of breath, even with mild exertion;
  • swelling of your ankles or feet;
  • nausea, stomach pain, fever, loss of appetite, dark urine, pale stools, yellowing of the skin or eyes;
  • depression; or
  • cold feeling in your hands and feet.

There may be other side effects not listed here. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Drug Interactions
Atenolol (Tenormin) can interact with a number of other compounds, including the blood pressure medicine Catapres (clonidine). This drug should never be suddenly discontinued by a person on atenolol (Tenormin) or any other beta-blocker, as the sudden increase in blood pressure could be life-threatening.

Calcium channel blockers (verapamil, diltiazem), which are also heart/blood pressure medications, would have increased effects if given together with atenolol (Tenormin).

Taking atenolol (Tenormin) with calcium channel blockers is generally not advised as the combined effects might lead to serious heart problems. If they must be taken together, the dose for both or one medication may need to be reduced and cardiac function should be carefully monitored.

A potentially fatal increase in blood pressure could occur when epinephrine is injected into someone taking a beta-blocker such as atenolol (Tenormin). Epinephrine is often included with a local anesthetic injected for dental work or minor surgery, or may be given if someone has a serious allergic reaction that closes airways.

Many other
drugs interact with atenolol (Tenormin), including ampicillin and medicines used to treat anxiety, asthma, blood pressure and heart problems. Arthritis medicine and aspirin may reduce the effectiveness of some beta-blockers. Drugs used to treat migraines, tuberculosis and high cholesterol do not mix well with beta-blockers.

There may be other drugs that interact with atenolol (Tenormin) not listed here. Do not start any new medications or make changes to your treatment without first consulting your doctor.

References
1. Lindholm, L. H., et al. “Should Beta-Blockers Remain First Choice in the Treatment of Primary Hypertension? A Meta-Analysis.” Lancet 2005;366:1545-1553.

2. Kaplan, N.M., and Opie, L.H. “Controversies in Hypertension.” Lancet 2006;367:168-176.

3. Beevers, D.G. “the End of Beta-Blockers for Uncomplicated Hypertension?” Lancet 2005;366:1510-1512.

4. Carlberg, B., et al. “Atenolol in Hypertension: Is It a Wise Choice?” Lancet 2004;364:1684-1689.

5. Lilja JJ, et al. European Journal of Clinical Pharmacology. 2005;61:337.

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  1. Bonnie
    Scottsdale, AZ
    Reply

    I have been on 25-50 mgs of Atenolol for decades due to SVT’s w/arrhythmias. (Now age 62). Don’t drink orange juice while on this medication as it reduces its effects! I disregarded this warning and my heart started acting up again. No more o.j. for me… :(

  2. Mandy
    London
    Reply

    Hi I was prescribed. 50 mg of Atenolol approx 2 and half years ago by my cardiologist. I had what I thought was missing heartbeats, turned out I was having 10,000 extra beats a day even in sleep. I only took 25 mg and initially had very dry eyes and lost weight. I have now weaned myself off this med in last couple of months and now have constant dry mouth, high bp and cholesterol but worst is my hair has started falling out.

  3. off
    Reply

    Alice –
    You have allergies.
    Allergies can raise your BP – and Atenolol will make it worse because it suppresses adrenalin – the very thing your body uses to purge your body of allergens.
    I knew for a very long time I had allergies since birth but never knew I had mild anaphylacsis until the day I had it bad – airway stayed open – was a plus.
    Also have had what feels like summer flu but wasn’t because I was eating fresh fruits totally allergic too.
    Only way I can eat them is if I am taking tons of antihistamines.
    You need to find a doctor who will work with you to get you on an allergy free diet – make sure you are getting well balanced minerals and vitamins for you – while weaning you off drugs that are working counter to your body.
    Surfing the net – I did find an allergy site post from a person who was allergic to canola oil – it raised his BP – stopped it fine — also watch out for soy in foods – its related to peanuts.

  4. Alice
    Reply

    I have been on Atenolol for 4-5 years and no problems till recently. I have had some bouts of what I was told was psoriasis and now The Dr. upped me from 50 mg once a day to twice a day. I have had two very sore throats and100 and 100.5 fever in a month. The second time was the worst ever! I couldn’t swallow for two days and was in bed three days and felt bad longer and still do. Neck glands swollen, whole mouth red, lips pealing, toothpaste burned like very hot sauce, lips stuck to my partial plate denture, very dry mouth, small soft nodule in palm of hand for a month so far.
    From my research, I now believe these problems were caused by Atenolol. I actually thought it was two bouts of strep throat but the symptoms were definitely different. Atenolol was the forth med that I was on after being allergic to others. Benicar nearly killed me with anaphylactic shock. Now I realize that I should not have let the Dr. go higher on the dose but he said the insurance would make me get another Dr. if he didn’t lower my pressure more even though I was happy with the amount it had come down.
    Went from up to 200 over 109 to 145 over 85 and had maintained that for 4 to 5 years. Called my insurance and they said this was not the case. Now working on weight and exercise.
    Would like to know if others have experienced any of this.
    Thanks.

  5. Karen
    Reply

    I have been on Tylenol for 16 years for tachycardia and it never occurred to me that many of the symptoms I have, as described by many others, might be caused by it. I take meds for depression which I have had for many many years. Some of the symptoms might be ascribed to this but I have many of the symptoms described above the loss of appetite (i do not have an appetite at all, never feel hungry, just have cravings) loss of memory, diahrrea, often 20 mins after I eat, lethargy, digestion problems and I seem to live in a fog. Atenolol could accerbate the depression problems as I have had to change and increase the drugs I take for them. The problems seem to be increasing. Do Tylenol symptoms increase with time? I am so tired of living like this.

  6. off
    Reply

    Have you had more than one echo cardiogram? Are you on an aspirin regimen?
    Had one echo that said mitral valve – 3 that proved it was not that.
    There is mitral valve syndrome where certain food etc sensitivities can cause a mis-diagnosis.
    The chest pains may be acid reflux.
    Have you been tested for allergies?

  7. vickymay50
    Reply

    Hi Chris, I’m Mark, it’s all the Atenolol, I went thru withdrawals for about a month or more, heavy heart palpitations, heart rate went to 125, just sitting still, got asthma put on weight, got acid reflux, you name it, I got it from atenolol, mood swings, anger, relationship problems, I think the doctors are full it, its poison for me, it took a couple of months to clear it from my body. I would go to the hospital thinking I was dying, but I read the other comments on here and realized it would have been a waste of time and money, just decrease your dosage, but its going to take time, my bp and heart rate ran high for several week, best wishes Mark

  8. Christopher B.
    Reply

    HOW TO COME OFF THIS ??
    I am on Atenolol 25mg a day. Well was. I took the med for alternate days I was fine with that, now I am on to the next phase and I fell a little it ill. I now take my med on Monday and Thursday.
    1st week of this phase and felt ok but during the weekend on saturday. I felt ill and change in my heart rythm speeding up and slowing down. Anxiety is all over the place and all I want is water (been peeing a lot lately and throat hurts).
    I had three panic attacks last night and couldn’t get to sleep in two days. I managed to sleep the other night but I slept when there was daylight and woke up at 1pm and last night I had around 3-4 hours sleep. I can’t sleep. I know anxiety is playing apart because I keep feeling like ill have a heart attack or heart failure, something stupid like that, I have found it difficult to breath lately although I can manage to speak full sentences so it may just be anxiety.
    It all started off with stomach pains, a load of wind/gas in my stomach/intestines? and constipated. Is this normal? (Although that day I was fruit mad, I had a large orange for breakfast, apple for dinner lol and a Banana to put me on for my tea/dinner? and then had my sunday roast which was good) My appetite has increased. I have been eating more frequent.
    I have been having chest pains and odd pressure there but there’s not a lot I can do about it. Please give me some reassurance.
    I tried to come off this last time but went off it suddenly and became ill within 4 days o.o I am not too sure why and heart was beating up to 135 beats per minute while laying down..
    Now I think that’s because I stopped it just like that and the doctor said it was okay but obviously not, doctors fault. Any advice? anyone had any experience similar to this? please I am anxious and depressed. At least when I was on Atenolol everyday 25mg I was able to sleep like fall asleep without worrying.
    Will this pass?
    I am only 18 years of age. I have Mitral Valve Prolapse. I get worked up about it sometimes and the cardiologist keeps saying I have nothing to worry about but when I experience shit like this it makes me wonder what the heck they’re doing to me by giving me this shit medicine. Its hard to come off, I agree, strongly agree with others
    I have had a health scare in December lol I had a legal high-_- it mixed with my previous medication that I was on called Flecanide or something like that and that made me feel ill and I couldn’t move much at all..
    It’s been over 6 months since then or just over it, what to do?
    I am not as bad as last night because I took my med today this morning but even then I still felt a little bit ill (I have been sneezing a lot lately and wheezing too)
    I hope I have made this clear as to what I am experiencing.

  9. Samuel C.
    Reply

    I am prescribed 50 milligrams about an all day and 20 milligrams of Norco have a day for my high blood pressure I’ve been having dizzy spells lightheadedness leg cramps a very severe shortness of breath and feeling weak and lethargic and I’ve seen that duh getting wind of this is not very easily done as some people have heart attacks from the morning off of it I also have been passing bright red blood and large blood clots in my bowell movement the last month with every movmentI think I’ll take a trip to the ER right now.

    • Kimberly
      Reply

      Hey Chris how do you know your heart rate was so high? Did you count the beats or something? I too have a mitral valve prolapse. I have a lot of heart palpitations like non stop even when I’m sleeping. I only take 12.5 mg of altenelol but I just started it and my palls are getting worse then they’ve ever been. I have to take my pills again tonight and I don’t want to, not sure what to do.

  10. Todd
    Reply

    I started taking Atenolol 25 mg a month ago. I was on listenopril, but it was not working well. My bp went from 160s/90s to 120s/70s. This medication has worked out well for me. I had some really crazy dreams the first two weeks, but that has passed. I also get a full nights sleep now, whereas I had trouble sleeping before. One other benefit is I have lost 10 pounds without dieting – you won’t hear me complain about that. My doctor said he has two other patients who lost weight on Atenolol, but it is not typical and not an excuse to raid the refrigerator.

  11. off
    Reply

    KW – Had migraines most of my life. While searching on ways to wean myself off of atenolol saw a post mentioning making sure I had enough magnesium in my diet. Discovered had enough potassium – but not enough magnesium. Started magnesium supplement during the time I was reducing Atenolol – 2 months after I took the last atenolol pill – my migraines ended. Have taken magnesium supplement every day since. (more than 2 years since last migraine).
    I also removed all high processed oils and sugars from my diet. So its now only cane sugar, honey, real maple syrup, butter, and olive oil.
    Keep track of your sons diet – increase in use of corn oil and corn syrup in foods also caused an increase in my migraines – rate dropped off when I removed all corn from my diet. Also saw an allergy site post where the poster stated that canola oil increased his BP so rather than meds he dropped it.

  12. KW
    Reply

    Hi there,
    My son is 7, and has been taking this since he was 5 for LQTS (long QT syndrome). In the past couple of months we have noticed a huge change in his mental well being. Suffering from nightmares, hallucinations, lack of concentration and the list goes on.
    He has also been suffering from migraines (diagnosed). However atenolol hasn’t really helped with this.
    Will these symptoms worsen with continued use as he will be on this for the rest of his life?
    Thanks

  13. Helen G.
    Reply

    Hi Betty I am in the same situation fed up with bp pills. What was your diet and how much apple cider vinegar did you take?
    Regards
    Helen

  14. Col
    Reply

    I’m 69 and about 5 years ago had a blocked artery. After stenting I was put on 25mg Atenalol having had high blood pressure for many years that no one had managed to cure. About two years ago a different cardiologist upped the dose to 50mg. It seemed okay but about two months ago I started to get severe breathing problems, although mainly when I was at rest walking was okay, also blurred vision and dizziness/faintness.
    I saw the Doc who got a chest xray and ecg and could see nothing wrong. I now have an appointment with a cardiologist. My B/P after taking the Atenolol goes as low as 95/60 and my heart rate drops to 50/55. I think the dose is too high and I have decided to try 25mg see what happens, but I’m confused why should this suddenly happen after two years?
    People’s Pharmacy response: No one knows why it would pop up after two years, but do be persistent. There is certainly a good chance your shortness of breath, if not caused by atenolol, is being made worse by the drug.

  15. Bill
    Reply

    I have high blood pressure and high cholesterol probably some caused by genetics, anyway I have been on Lisinopril for over four years and now Atenolol for just about a year and a half. I have notice some brain clouds but nothing serious, but I am getting concern and will cut back if it continues to worsen.
    I did want to say that at the age of sixty-three I really do not feel that bad, but I am concern about high blood pressure do to my Fathers health and his death caused by dementia. I am also taking Crestor that is a blessing, and will continue as long as necessary, my blood pressure is under control and so is my cholesterol. So it is a mixed blessing I guess, but I am positive and optimistic and hope everyone here will be also.
    Some of the comments I have read here, is not only blood pressure, or that of the heart, but mental challenges. Some of the drugs I have found talked about here, are for depression and mental challenges, even some of the conditions and concerns are more of a mental health issues and not that of blood pressure.
    I hope everyone the best, but if you’re having mental issues, please seek out help, and of course watch your meds. In conclusion I strongly believe that there are more positive results and positive outcomes from the use of Atenolol and Lisinopril medication, but you need to work with a professional with experience. Thank you and God Bless.

  16. Mark
    Reply

    Hi Craig, I’m down to 12.5 a day, it’s my first day, I would really like to know how it turned out for you, I hope you get this message and reply, and that goes for anyone else that has gotten off this drug, I would appreciate any info… the peoples pharmacy has been the best forum that I’ve encountered so far… yours sincerely. Mark

  17. Mark
    Reply

    Well when it comes to trusting doctors, I’m done, now I’m going to start weening myself of this atenolol, I’ve tried before but the withdrawals were horrible but I feel just as sick taking it every day, 9 months and a doctor later my health is shot, I can’t breath, I’m 20 pounds heavier, I can’t think, I can’t sleep, and I’m to tired to fight, but I am turning more violent, so now I’m secluding myself from people at least until I get this drug out of my system, my friends are tired of my complaining and now I’m tired of my friends.

  18. G Read
    Reply

    I have been on atenol for 6 years and have put on weight cannot sleep have dreadful sweats. Back of my legs ache I am 71 years old, I bought a blood pressure machine and do a test every month which turns out normal. Doctor had me wired up for 48 hours and it showed no problem. Why then am I on 50 mg tablet it seems to high.

  19. cws
    Reply

    I have been on 25 mg Atenolol for a couple of months now, I have stage 1 HBP and my doctor wanted to put me on a water pill, but I have Sulfa allergies…it is gross, but two hours almost exactly after I take my pill, with or without food, I am in bathroom with loose bowels, and have gotten to the point I want to carry extra underwear, it hits so suddenly and with a few seconds warning (not exaggerating)… I thought it was a side effect that would subside, have an appointment next week, going to be addressed, but I also have anxiety issues, which I am on 50 mg Sertraline (Zoloft) and when I get wound up, I have the same effect… I am having more anxiety flare ups since being on the Atenolol… not sure if it is the drug, or me???? worrying about the drug…

  20. Brandy
    Reply

    Hi I was atenolol 50mgs for 4 to 5 months then I went down to 25mgs for the last 2 weeks and as of today I been off of it for 2 days I was put on it because my blood pressure was a little high but I was getting a lot of side effects I have 4 kids and I didn’t want to do nothing or go nowhere and my husband said one day that I was not being myself and I had a lot of mood swings and mad all the time I felt like I was walking around in a cloud I seen it for myself I said that is it I want off of this so I have my own blood pressure monitor so I been taking it and its been fine

  21. bg
    Reply

    Does it cause brown spots?

  22. Steve
    Reply

    I was on clonidine, lisinipril and atenolol. For a couple of years and I still take the clonidine. The other two drugs were horrors. Rashes, brain fog, terrible depression, anxiety (panic attacks). My doc now has me on Xanax, serequel and ambien and I am a much happier, healthy person. I don’t think I have had any side effects from the psychotropic drugs like I did with the high blood pressure ones. It is so maddening that doctors and pharmacists treat you like some crazed drug addict because you take them.

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