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Atenolol and Chlorthalidone


Pronunciation

 (a TEN oh lole & klor THAL i done)


U.S. Brand Names

 Tenoretic®


Synonyms

 Chlorthalidone and Atenolol


Generic Available

 Yes


Canadian Brand Names

 Tenoretic®


Use

 Treatment of hypertension with a cardioselective beta-blocker and a diuretic


Pregnancy Risk Factor

 D


Lactation

 Excretion in breast milk unknown


Adverse Reactions

 See individual agents.


Drug Interactions

 See individual agents.


Pharmacodynamics/Kinetics

 See individual agents.


Dosage

 Adults: Oral: Initial (based on atenolol component): 50 mg once daily, then individualize dose until optimal dose is achieved


Dietary Considerations

 Should be taken on empty stomach.


Patient Education

 See individual agents. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to become pregnant. Consult prescriber if breast-feeding.


Nursing Implications

 May contain povidone as inactive ingredient


Cardiovascular Considerations

 See individual components.


Dental Health: Effects on Dental Treatment

 Atenolol is a cardioselective beta-blocker. Local anesthetic with vasoconstrictor can be safely used in patients medicated with atenolol. Nonselective beta-blockers (ie, propranolol, nadolol) enhance the pressor response to epinephrine, resulting in hypertension and bradycardia; this has not been reported for atenolol. Many nonsteroidal anti-inflammatory drugs, such as ibuprofen and indomethacin, can reduce the hypotensive effect of beta-blockers after 3 or more weeks of therapy with the NSAID. Short-term NSAID use (ie, 3 days) requires no special precautions in patients taking beta-blockers.


Dental Health: Vasoconstrictor/Local Anesthetic Precautions

 No information available to require special precautions


Mental Health: Effects on Mental Status

 May cause fatigue, insomnia, and confusion which can clinically look like depression


Mental Health: Effects on Psychiatric Treatment

 Concurrent use with other psychotropics may produce an additive hypotensive response (especially low potency antipsychotics and TCAs)


Dosage Forms

 Tablet:

50: Atenolol 50 mg and chlorthalidone 25 mg

100: Atenolol 100 mg and chlorthalidone 25 mg


References

Foster CA and Aston SJ, "Propranolol-Epinephrine Interaction: A Potential Disaster," Plast Reconstr Surg , 1983, 72(1):74-8.

Wong DG, Spence JD, Lamki L, et al, "Effect of Nonsteroidal Anti-inflammatory Drugs on Control of Hypertension of Beta-Blockers and Diuretics," Lancet , 1986, 1(8488):997-1001.

Wynn RL, "Dental Nonsteroidal Anti-inflammatory Drugs and Prostaglandin-Based Drug Interactions-Part Two," Gen Dent , 1992, 40(2):104, 106, 108.

Wynn RL, "Epinephrine Interactions With Beta-Blockers," Gen Dent , 1994, 42(1):16, 18.


International Brand Names

 Tenoretic® (CA)


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