Doctors' Answers to "Frequently Asked Questions" - Atenolol

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Atenolol side effects [posted 1/13/99]
Question: Could atenolol be a cause of the sensory (probably small fiber) neuropathy my neurologist thinks I have?

Answer: Probably not.

Atenolol side effects [posted 1/11/99]
Question: My 88-year-old aunt has recently begun taking atenolol for hypertension. She is having diarrhea to the extent that she's afraid to go out in public. How should I advise her?

Answer: Switch to another medicine. There are many other classes to pick from and beta blockers are very hard for the elderly to tolerate. If she can't switch, using fiber expanders might help.

Can Atenolol Increase My Triglyceride Count [posted 10/30/98]
Question: I am 45 years old and have been taking Atenolol for almost 1 year. Atenolol was prescribed to control a mild hypertension condition. When I first went on the drug 10 mg was prescribed. Over the past 3-4 months I have noticed additional side effects that concern me. I spoke to the Doctor about these side effects and he said Atenolol should not be the cause. He said to reduce the dose to 5mg. Even at 5 mg I feel waves of fatigue and lightheadedness. For about 2.5 hours after I take Atenolol I experience irregular heartbeat and fatigue. Occaisionally I am awaken during the night with the irregular heartbeat. I am not taking any other medication with Atenolol. I want to come off it but I am concerned how to wean myself. Is 5mg/day a small enough dose to just stop or do I need to take less and less over a two week period. Also, how long does Atenolol stay in the body after you stop taking it? Thank you in advance for your response.

Answer: 5 mg is extremely low. There should be no problem stopping it, if you do not have coronary artery disease, which you are not describing. Just stop.

Can Atenolol Increase My Triglyceride Count [posted 10/30/98]
Question: I have been taking 75 mg of Atenolol for high blood pressure. It works well. My triglyceride count is high (getting higher each year). I eat a low fat diet and my doctor is concerned. Can this medication be causing an increase in my triglycerides?

Answer: Maybe, but triglycerides are really a pretty low factor in heart disease. There is a correlation between triglyceride levels and eventual development of diabetes mellitus. Lose weight would usually fix the elevated triglycerides;but, it's a pretty small risk unless they are over 2,000 or so.

Atenolol & St. John's Wart [posted 10/30/98]
Question: I have been taking 50mg of atenolol per day for mitrol valve prolapse. I experience some side effects which especially include fatigue, slight depression or occasional anger. I am considering trying St. John's Wort to level out my emotions. I asked the pharmacy if the combination was OK - they said not to take the two together if being treated for high blood pressure. When I said I was being treated for MVP, they said it was OK then. I was concerned about this, so I called to verify this with my doctor. The doctor's office said they don't recommend taking St. John's Wort at all because it hasn't been tested enough. So, is it really OK to take the combination when being treated for MVP?

Answer: Probably no problem. St. John's Wort is thought to be a mild MAO inhibitor. There is no contraindication to this class of drugs with beta blockers. Get a list of foods from your doctor that should be avoided with MAO inhibitors. Theorectically, these can produce a hypertensive crisis if taken with MAO inhibitors. In practice, rarely seen with St. John's Wort.

Skin Rash and Atenolol [posted 8/5/98]
Question: I have been taking Tenormin for a number of years for high blood pressure. In June I switched to Atenolol because it was cheaper. Beginning in August I developed a skin rash. At times it has been so bad I have been on Prednisone twice. While I'm on Prednisone the itching is controlled. Once I go off of it, the itching starts within a week. Could there be any connection between the Atenolol and the rash?

Answer: Wouldn't think so unless there are chemicals in the generic Atenolol not in Tenormin. Try going back on brand name Tenormin for 4-5 months and see if the rash abates.

Atenolol and Phosphate Levels [posted 7/17/98]
Question: Can the usage of Atenolol lead to a lower or dangerous level of phosphates within the system?

Answer: No.

Atenolol
Question: Is there any danger in taking 50 mg per day of atenolol if I have ocular hypertension and a reading of 21?

Answer: There shouldn't be.

Atenolol
Question: My mom is 65 years old with no significant medical history. She is known to have high blood pressure from time to time. This is usually in the doctors office, but when it is checked at home, it is fine. For the past 4 years, she has been doing step aerobics for 1 hour, 3 times a week. This is not a program designed for seniors and she keeps up well with women less than half her age. She does use a low block and limits her arm movements to prevent getting her heart rate too high. Her heart rate does reach 160-170 bpm and is down to normal range within an hour. Recently her medical doctor put her on atenolol 25 mg, saying 160 bpm is too high. Now her heart rate gets up to 130, but she doesn't feel as good. Is there significant benefit in putting Mom on a beta blocker.

Answer: Probably not, but it would depend on her overall cardiac condition. This can be assessed by a stress echo. But, I'd let her go if she was my patient, assuming no history of coronary disease and normal ejection fraction.

Atenolol
Question: I am taking a generic brand (by Geneva Generics) of Atenolol. My most recent prescription looks different from the original. Tablets are white, round, and marked GGl7. Others were fatter and smaller white pills. Checked w/ pharmacy, they say okay. Nervous about taking.

Answer: I wouldn't be concerned. Beta-blockers are easy to synthesize and fairly cheap as a consequence. Generics are common, and I haven't seen any difference in my practice.

Atenolol and St. John’s Wort
Question: I am currently taking 100 mg of atenolol per day for hypertension. I have been slightly depressed and had a low energy level. I have been prescribed a blend that includes St. johns wort. I have read that it is a MAO inhibitor. Can I take that with Atenolol ?

Answer: St. Johns Wort has only recently been studied in any depth. It appears to have less side effects while addressing depression. There would be no obvious interaction to date with atenolol. However, beta blockers are generally to be avoided in depression due to their ability to produce depression in susceptible patients.

Atenolol
Question: I was diagnosed with Mitral Valve Prolapse about 10 years ago. When I visited my new family doctor and told him that I was taking Atenolol/Tenormin for the condition, he seemed genuinely surprised. Should I be taking an alternative prescription for MVP? Is atenolol the best way to go?

Answer: Treatment for Mitral Valve Prolapse is aimed at symptoms generally. Occasionally, a patient has such severe tacharthymias(fast heart beats) that treatment is necessary. However, generally, it is done to address the symptoms of MVP rather than change the course of the problem. If you have documented rapid beats(in excess of 130 for greater than 10 seconds or so), or if you have passed out etc. with rapid heart beats, the medication is necessary and must be continued. However, if it is merely for the sensation of extra beats or occasional fast beats, it is merely for symptom control. Atenolol is a semi-selective beta-blocker and is the class of drugs generally used with MVP. Occasionally, calcium channel blockers are used if the person cannot tolerate beta-blockers.

Atenolol
Question: I take 100 mg of Atenolol per day for Wolfe Parkinson White Syndrome. I am having difficulty losing weight even though I exercise regularly with weight training and aerobics. Could the Atenolol be contributing to this difficulty, and how can I overcome it? I have gained approximately 25 lbs. since I started using it about 5 years ago.

Answer: While it is possible, I haven’t really seen patients complain of weight gain with beta blockers. Fatigue is common-- possibly you’re less active with beta blockers.

Atenolol and Zestril
Question: Could you please give me some information on the drugs Atenolol and Zestril? I need to know what they are used for and the side effects of each. Also, can they be used together?

Answer: Atenolol is a selective beta-blocker. Beta Blockers are common drugs used to treat many different problems. They are very effective in treating hypertension, angina, rapid heart beats, and have been used to treat stage fright and occasionally anxiety. They also have similar side effects. Beta Blockers come as selective and non-selective. The non-selective beta-blockers can cause some bronchospasm and asthma. The selective blockers can also, but much less frequently. Common side effects to both selective and non-selective beta blockers are fatigue, slow heart rate, nausea, nightmares and difficulty sleeping, impairment of insulin release, depression, and occasional skin rash. These drugs should never be stopped abruptly and require a tapering if discontinued. Zestril is a "Ace inhibitor". This is a class of drugs which block the conversion of renin to angiotensin by blocking the enzyme in the lung responsible for this conversion. Hence, angiotensin converting enzyme inhibitors (ACE). This class of drugs has remarkably few side effects except for cough. Occasional people develop a rash or other problems, but most don't know they are taking it. Beta-blockers and ACE inhibitors are used together commonly since they act in different manners in treating hypertension.

Atenolol
Question: My father has been on atenolol for many years. My mother says he is currently taking 50 mg daily. Dad shows many signs of depression and anger, and we are searching for a link as to why he is experiencing this. Could atenolol (tenormin) be the cause?

Answer: Beta Blockers are common drugs used to treat many different problems. They are very effective in treating hypertension, angina, rapid heart beats, and have been used to treat stage fright and occasionally anxiety. They also have similar side effects. Beta Blockers come as selective and non-selective. The non-selective beta blockers can cause some bronchospasm and asthma. The selective blockers can also but much less frequently. Common side effects to both selective and non-selective beta blockers are: fatigue, slow heart rate, nausea, nightmares and difficulty sleeping, impairment of insulin release, depression, and occasional skin rash. These drugs should never be stopped abruptly and require a tapering if discontinued.

Question: I have recently started taking atenolol again for tachycardia and resultant drops in blood pressure. Seven months ago I had an ablation for WPW. I am experiencing extreme fatigue, and exceptionally vivid dreams which seem to be interfering with my sleep cycle. Is there something similar to atenolol which wouldn't have these side effects?

Answer: Beta Blockers are common drugs used to treat many different problems They are very effective in treating hypertension, angina, rapid heart beats, and have been used to treat stage fright and occasionally anxiety. They also have similar side effects. Beta Blockers come as selective and non-selective. The non-selective beta blockers can cause some bronchospasm and asthma. The selective blockers can also but much less frequently. Common side effects to both selective and non-selective beta blockers are: fatigue, slow heart rate, nausea, nightmares and difficulty sleeping, impairment of insulin release, depression, and occasional skin rash. These drugs should never be stopped abruptly and require a tapering if discontinued. Calcium channel blockers can often slow the heart without these side effects. Drugs like verapamil are used commonly to treat rapid heart rhythms.

Question: I have conflicting information on whether desoxyn (methamphetamine) and/or atenolol (tenormin) may contribute to glucose elevation in the blood. I take 60mg of desoxyn and 25mg of atenolol daily. I have narcolepsy, but I have recently experienced elevated blood sugar. Decreasing the level of Desoxyn seems to lower the blood sugar level to normal levels. Could my observation be valid, or is there no connection between the medication and the diabetic condition?

Answer: Atenolol is included in a class of drugs called beta-blockers. Beta-blockers do have the potential ability to increase glucose by inhibiting the release of insulin. Other potential problems with diabetics include masking of low sugar symptoms and blunting of the return of glucose after an excessively low sugar. Some beta-blockers like atenolol are selective beta-blockers and have less of these effects, particularly in doses under 100mg. In practice, 25mg of atenolol would not be expected to have too many effects on a diabetic. Methamphetamine has no such direct effect on insulin. Indirectly, they may affect the patient’s weight and their insulin requirements.

Hair Loss
Question: My girlfriend's daughter recently started taking Atenolol due to an enlarged aeorta. Within the past two weeks she has suddenly started experiencing RAPID hair loss. Her doctor says that it cannot possibly be caused by the Atenolol, but my girlfriend and I can come up with no other explanation. Is it possible that the Atenolol could be causing this hair loss? Thank-you.

Answer: Atenolol belongs to a class of drugs called beta-blockers. These drugs block the beta receptors in the body. As a consequence, they are used in treating high blood pressure, hypertension, anxiety disorders, rapid heart beat syndromes and a host of other problems. The most common side effects of the beta-blockers are slow heart rates, fatigue, and occasional dyspnea. Hair loss is also seen in about 1-5% of patients.

"Heart Dropping"
Question: I am a 26 year old female who has a 10 yr history of PSVT. Recently I was prescribed Atenolol 50 mg. I have only been taking it for a week, but I keep having the sensation of my heart "dropping" as if I were in an elevator at least 10 x day. Is this a side effect of the drug? Would a lower dosage help stop this?

Answer: I suspect you are having PACs due to the bradycardia induced by the atenolol. This occurs when the puylse becomes slow and an extra beat is initiated by the heart. The subsequent beat after the PAC has additional time to fill and generates an extra large discharge of blood. The "drop" sensation comes from the beat after the extra beat. However, the extra beat is induced by slowness caused by atenolol. Have you tried to decrease your dosage to 25 or 12.5 mg to see if it decreases the PSVT and eliminates this problem?

Neuro-Cardiogenic Syncope
Question: My husband, 40 years old, was recently diagnosed with neuro-cardiogenic syncope and prescribed 10mg of Atenolol per day. I understand this is a very low dosage, however I'm concerned about his change in behavior/personality. He's now very quick to anger, seems irritable even though he says he feels fine. He doesn't show any signs of depression and his blood pressure is 120/80. I haven't noticed any signs of impotency (no problems there) or hair loss. I have noticed that he's tired, his face is red and puffy. He weighs approx. 210. We're tired of walking on eggshells.

Answer: Yes, change the medication to something else-not a beta blocker, this is unacceptable.



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