a pharmacist at work behind the counter of a pharmacy, mistake, atenolol shortage, ethical question

Over the last decade or so, the United States has been increasingly plagued with drug shortages. Sometimes the scarce medications are pricey brand-name products, but frequently enough hospitals and pharmacies run low on common generic medications. One reader has encountered an atenolol shortage.

How Will an Atenolol Shortage Affect You?

Q. I recently tried to refill my prescription for atenolol and was informed there was a nationwide shortage. My drugstore was out of it.

Years ago, after trying many other prescriptions, atenolol was the only thing that worked to control my elevated blood pressure. As a side benefit, it also toned down my essential tremor.

I am loath to switch to metoprolol and hope I can find more atenolol soon. Too much adrenaline causes my elevated blood pressure. Will metoprolol act on adrenaline?

Is there any indication when this atenolol shortage will end?

An End to the Atenolol Shortage:

A. Drug shortages have become commonplace, even for old generic drugs like atenolol. The FDA anticipates that atenolol should become available again in February, 2018.

In the meantime, metoprolol might substitute, though your doctor will need to make that determination. Atenolol and metoprolol are both beta-blockers, which means that both block excess adrenaline. Both medications are used to treat high blood pressure and chest pain (angina) due to clogged coronary arteries. They are not identical, however, and your physician would need to determine an appropriate dosage of the metoprolol if that is what you must take until the atenolol shortage has eased.

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  1. Gail

    How can Atenolol be different from different manufacturers? Isn’t it a definite, consistent formula?

    • Jacqueline A. F.

      Yes, they can be different because formularies can/may differ from one manufacturer to another. We are all human but unique in many ways. That’s why one size does not fit all where medications are concerned. Most pharmacies now only want to offer their “Preferred” brands/manufactures and not our requested brands. When/if we participate and pay attention to our bodies better than we do our vehicles’ maintenance, maybe we will experience much better outcomes.

  2. Mel

    I’ve been on Atenolol by Sandoz for over 20 years. Worked great, once I got the dosage right. No serious side affects, though my guess is that it’s played into a bit of weight gain (also have hypothyroid issues which doesn’t help even though on meds for that).

    Fast forward to February 2018, and Sandoz no longer makes Atenolol. Tried Zandus brand. Awful. Made me very edgy. Also gave me huge, almost unbearable headaches.

    Switched to Teva Atenolol almost 2 weeks ago. When I first took my usual dose, zoned me out big time. No way could I drive. Became confused. Cut dose in half. Was fine for about 4 days, but then my BP started to spike higher and higher. So I went back to the original dose. Still zonks me out a bit, makes me a little loopy some days. Some days not so much. Also seems to depress me. Not my usual positive, high energy self. Why the inconsistency? Will it get better with time as my body adjusts?

    Thinking of try Atenolol by Mylan. Seems most of the people who have written here are having luck with it.

    The other alternative might be Tenormin. But that’s around $400 a month!!!

    Would love as much feedback as possible on the different brands of Atenolol and how you reacted as I’m getting very discouraged and need help.

    I am normally a very active, social and positive person but with this Teva brand of Atenolol, not so much. I want to travel, hike, kayak, and do all the stuff I always do, but can’t now because I don’t know from day to day how the current Atenolol made by Teva is going to affect me. Sometimes I’m fine on it, sometimes not. Doesn’t seem consistent, reliable or predictable.


  3. Jim
    Northern Kentucky

    I, too, ran afoul of the atenolol shortage, and my doctor put me on metropolol. I took the first dose and soon experienced a feeling of difficulty concentrating, as if I’d taken a tranquilizer. Also noticed my heart was beating harder than before. These symptoms passed after about four or five hours, and I felt no different than on atenolol except for a stronger heartbeat. I contacted another pharmacy (CVS), and they were out of atenolol too. I tried one more, a local pharmacy, and they had them so I got a new 90 day supply! My doctor had told me other patients of his often preferred metropolol over atenolol. Not me! I have since abandoned my previous pharmacy and have recently refilled my atenolol at my local pharmacy with no trouble. If you don’t want or dislike metoprolol, try shopping around. Good luck!

    • Angie
      North Carolina

      I’m glad its not just me…..I was doing fine on Atenolol Mylan) for years until I got the refill from another company (I heard because the manufacturing company in Puerto Rico was damaged in the recent disaster). I immediately had problems with the new manufacturer and was switched to Metoprolol…which was not a good substitute for me….I felt drugged…it put me to sleep. I tried another medication which was costing me a $50 copay per month/and they could not verify it was gluten free (which I am allergic to), so, I am hoping the AtenoloI from Mylan is available soon.

  4. Matty

    I had been taking atenolol for a few years, with good results. I have anxiety attacks and have been under a lot of stress for several years. When I was first given metropolol I complained of waking at night with my heart pounding very hard. The doctor double checked the side affects and said it could not be the beta blocker.

    I had been put on a statin once or 2x a week, as I had very bad reactions to that. In the course of the past few months, I have dropped the statin, and continue with the metropolol. My anxiety attacks have increased… I have been tired, wake up with heart pounding and now, I realize that I have also been having low blood sugar, in spite of eating a Lot of chocolate. I am not diabetic.

    I have been unable to take lisinopril due to bad reactions.
    I am sure that my symptoms are caused by the metropolol. I will check with my doctor Monday.

    Hopefully atenolol will be available soon, or something else will work.

    • Deborah

      I was doing so well until I was not able to get Mylan Atenolol. When I was taking Atenolol my BP was great, and my anxiety/panic was under control. Now that I have had to take Metoprolol I have horrible anxiety, pounding heart, erratic BP, and sometimes very high pulse. I hate the Metoprolol! I will switch back to Atenolol as soon as I can.

  5. Ruth

    Hi i was taking mylan brand Atenonol 50 mg since 1985 …since July 2017 their is shortage so CVS pharmacy have me teva i was a mess so scary to me ,took teva until August…than second time refill i got Zydus ..now this month sandoz…omg terrified I don’t feel right ..my palpitations are more pulse uneven, I feel tired depressed…i told pharmacy they just say it’s your anxiety which I suffer and panic disorder…so my cvs i called ask update on mylan manufacturer girl said we don’t have any atenonol at all ..no one not even dr said anything about this …cant miss a dose..so I’m on sandoz atenonol 4 days now my pulse slow fast irregular …i was put on this atenonol years ago for blood pressure and palpitations..i just feel aren’t they messing with heart this changing …my question is until resolved can someone please tell me if they took teva or zydus or sandoz which is better my days nights are depressing im at a loss i call pharmacy get question with question im fearful i don’t know what to do …thank you .

  6. Laura

    I had been on Atenolol since I was 49 (I’m not 65 1/2), and I was doing just fine. Dumbly, I had sometimes skipped my doses. A few weeks ago, I went in for a cardio check-up just because I wanted to be sure everything was good. I was told I had a 4.2 cm diameter aorta enlargement and on the verge of an ascending aneurysm. I had no other symptoms except an occasional rapid heartbeat. I had been switched to Metoprolol in August when the shortage came to light. But my PCP had me on only 50 mg per day, and now my cardiologist has me on 100 mg per day. I am an emotional mess. I am on the verge of crying most of the day. If someone looks at me wrong or if my husband says something, I lose it emotionally. I also cannot stay asleep, struggling to get 7 hours per night. I am hoping I can find Atenolol someplace else. Has anyone tried to get it in Canada?

    • George

      LAURAWA DECEMBER 24, 2017 AT 3:09 PM
      Hope you have this resolved by now.
      Called in Dec 2017 and Atenolol was available Canada.
      Canada might be a backup source.
      Good Luck George

    • Linda J.
      Arlington, Texas

      I took Atenelol made by Mylan for years and had no problems. Then Mylan stopped and the pharmacy gave me Atenelol manufactured by Teva. Horrible reaction with severe cramping, nausea, indegestion that lasted all day. It depressed me. Hoping Mylan starts producing it soon. Tried Metroprolol yrs. Ago, did not like the way my heart pounded so hard. Good luck..

  7. Linda

    I was also changed to Metoprolol after my Atenolol prescription ran out due to a “shortage of Atenolol”. I could NOT tolerate the Metoprolol after a few weeks because of dizziness, lightheadedness, and higher blood pressure readings than normal. I started calling some of the pharmacies in my town to see when the Atenolol would be available again. I was lucky to find a pharmacy that had gotten the Atenolol back. That was only three weeks after I was told they didn’t know when or if Atenolol would be available again. Since so many of the people have not been able to get Atenolol it concerns me that maybe I am not really getting the real thing. My last script was filled in October 2017.

  8. Mike

    What is this shortage about. My script is now out. 100mg pills for 30 years for spikes in adiline. What other drug is good for this?

  9. KitaK

    I’ve taken Atenolol since 1995 when a hysterectomy left me with an extremely high heart rate (178bpm). Yes I had side effects on the Atenolol but it worked. Since August I’ve been unable to fill my script, and my doctor has substituted Metoporol. It is not sufficient. I’m constantly sleepy. I’ve gained weight. I’m awake every night at 2 am without fail. Worst of all, my heart rate is close to, if not over 100bpm (normally in the mid 70’s). I’m wondering if the brand name Tenormin is in a shortage as well and if that would be a better substitute.

    • vivian

      I have checked on Tenormin, and it is not available either. You should know the manufacturer of Tenormin, AstraZeneca, is heavily affiliated with all of the drug companies (six in all) that manufacture its generic form, atenolol.

      It is highly questionable to me as to why there is this sudden shortage of this drug. I have no intention of airing my opinion on American’s healthcare system, but is my belief that there is a less than moral reason behind all of this.

      It is okay for you to research other options for your condition. I asked my doctor to change me from Metoprolol (his alternative to Atenolol, which worked for me for years) to Propranolol. It has been working far better than Metoprolol, for me at least.

    • Hopeful
      New Jersey

      I tried the replacement Metoprolol for a week with same dosage of my Atenolol, then 2x/day for 3 days but my Blood Pressure remains high (147/83) the lowest, started having constant headaches, drowsiness, and interrupted sleep.
      I went to see my PMD again today and we will try to add Norvasc with my Metoprolol regimen.
      I pray that this combination would work for me until Atenolol is back in the market.

  10. Cynthia
    Richmond, Va

    I was switched to Metoprolol but it took a couple weeks to get the dosage right. Atenolol drops the heart rate more than the other beta blockers, so I had a rate in the high 80’son Metoprolol.

    • Becky

      I had the same problem. My doctor put me on Metoprolol and I had a terrible reaction. Chest pounded, heart started skipping beats, blood pressure went higher along with my pulse, had problems breathing and my hands and feet swelled. I was just told my drug store can’t get Atenolol again. Not sure what doctor can do now. Very worried.

      • Matty

        I had a very similar reaction.

  11. Angie
    St. Louis

    I took metoprolol and it made me extremely irritable. My Dr. didn’t believe me, but switched me after really complaining. I had relief within a day. I was so irritable that if I dropped a pencil, I was yelling and wanted to punch something. Watch out for this side effect.

  12. Paula Wells
    Clarksburg, MA

    The pharmacy recently substitute metoprolol for my brother’s usual Atenolol, and his heart rate accelerated to 118 from its usual 70-75 and he felt as though he was going to faint. He has had a quintruple bypass and has high blood pressure. The cardiologist office located a local pharmacy that still had a 90 day supply of metoprolol. We are hopeful the shortage will cease.

  13. Pat

    I had been taking Metoprolol for a number of years because I have an electrical problem in my heart (SVT). I recently read in AARP news that some medications cause sleep issues and suggested that Metoprolol was suspect. They also suggested alternative beta-blockers that might not interfere as much with sleep: Atenolol was first on the list. My pharmacist told me it was not available these days so my doctor had me try Bisoprolol – did not agree with my stomach. I am now on Carvedilol and seem to feel OK although I’m not sure it is helping with my sleep issues. Have recently been taking tart cherry juice concentrate at bedtime (2 TBsp in 4oz water) and think I have less difficulty getting to and staying asleep most nights. ??? I’ll keep trying to find solutions to getting a better night’s sleep.

  14. Lisa
    Raleigh, NC

    DH was put on Metoprolol because of the shortage and he literally lost his mind. It made him seem if he had dementia. So… they are not interchangeable for everyone.

    • Lynda

      Anyone over the age of 65, please be careful with Metoprolol, I was put on this after
      years of Atenolol (shortage?). After three to four weeks I began forgetting things,
      and was confused easily. Made me very afraid of these drugs. Hope you will
      remember this. I would not want anyone else to feel this way.

  15. Martha

    I understand one should not stop taking atenolol without talking with doctor, as it can cause heart attack, chest pains, irregular heartbeat. Can you speak to this as it relates to shortage of atenolol?

  16. Linda

    For a future topic, I would like to see other ways to reduce adrenaline spikes – with one’s doctor’s ok. For years I took the beta blocker, atenolol, for mildly elevated BP. I noticed that it didn’t do much for my labile (adrenaline) readings, some perfectly fine, sometimes when under stress or white coat response, quite high. Over time, I believe the drug caused tiredness, depression and lightheadedness. So, I very slowly reduced it until I no longer take a beta blocker at all. Meanwhile, I added L-Arginine, the amino acid that keeps blood vessels relaxed and smooth and is said to remove plaque over time. In addition I added a modest amount of GABA for reducing the stress naturally as it is a precursor to seratonin. This improves the function of the parasympathic nervous system. In addition, I improved my diet to include BP health and heart health, such as fermented beet kraut and adding beets to my juicing. My doctor approves, but tells me that most of his patients would rather just take a medication for their problems. However, I do believe that over time, beta blockers may produce a detrimental effect, where using plants and natural supportive supplements improve your health – not even mentioning the profound benefits of breath work, tapping, and meditation!! There is never a shortage of supply there. My opinion only. It has worked for me. Your readers may have medical concerns that require a doctor’s attention.

    • Rose

      Linda, I would love to know more about your regimen. How much L-Arginine and GABA How much beet root are you using?

      • Jacqi

        Linda, thanks for sharing your regimen. Good to know we have options to not be held hostage by this situation. The “Shortage” may be by design but it could be a blessing in disguise. We must take personal responsibility in addition to physician monitoring to research and share information and also remember that nutritious whole foods and supplements can be our medicine with determination and dedication.

    • Linda J.
      Arlington, Texas

      I took Atenelol made by Mylan for years and had no problems. Then Mylan stopped and the pharmacy gave me Atenelol manufactured by Teva. Horrible reaction with severe cramping, nausea, indegestion that lasted all day. It depressed me. Hoping Mylan starts producing it soon. Tried Metroprolol yrs. Ago, did not like the way my heart pounded so hard. Good luck..

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