Atenolol

[suzy__0]

  My husband is borderling concerning his blood pressure.  He finally went to a doctor and he prescribed 50 mg of atenolol.  His first dose was on a saturday he took one on sunday and on monday mornimg.  We carpool to work and(this is monday morning) we were almost at my work place when he said that he didn't feel good he was shaking his head and he said his legs were getting heavy I told him to pull over but he said that he could drive, luckily we were pretty close to a hospital and we went there.  He was hooked up to a monitor, blood taken, cat scan, the whole works.  He described the feeling as falling or the feeling you get when going down in a elevator.  His pressure dropped very low and his pulse rate was at 64 to 79.  He was told to go home and rest.  The next morning on the way to work the same thing happened, but this time he listened to me and pulled over, I drove to another er  and he was checked , blood work only this time.  He didn't take any more of the medication and it has taken him over a week to feel close to normal.  He was told that the mecication would be out of his system after 24 hours.  What gives?  Now his pressure is higher than ever. His mom purchased a blood pressure monitor and he checks it morning and night, his next appt. is in 2weeks.  My question is why did this affect him this way, it really scared the both of us..I know he is afraid to try anything else but we need to do something.  Also the doctor said this was the best medication on the market.  Thank you for your time.  

[Cleveland Clinic, MD]

_
Dear Suzy,
Thank you for your question. Both atenolol (brand name - Tenormin) belongs to  a class of medications called beta-blockers.  This class includes the following other medications: generic (brand name), - propranolol (Inderal), Labetalol (Normodyne, Trandate), metoprolol (Lopressor), pindolol (Viskin), Nadolol (Corgard), and sotalol (Betapace).  These drugs work by binding to a receptor called the beta receptor.  Once this receptor is blocked the drug exerts its effect in various methods.  The heart rate is slowed, the blood pressure is lowered and heart rhythms are stabilized.  
Beta-blockers are used to treat high blood pressure, angina (chest pain), heart attacks, heart rhythm problems such as atrial fibrillation and more recently heart failure.  
Potential side effects include: >10 % mental depression, tiredness, weakness, dizziness
1-10% Bradycardia (slow heart rate), wheezing, irregular heart beat, reduced peripheral circulation, heartburn
<1% Rash, chest pain, constipation, decreased sexual activity, itching, nausea, vomiting, stomach discomfort, insomnia, heart failure, nightmares, confusion, headache, impotence, cold extremities.
Potential drug interactions include:
Increased effect of metoprolol - amiodarone, cimetidine, diltiazem, nifedipine, nicardipine, verapamil, flecainide, hydralazine, MAO inhibitors, quinidine, ciprofloxacin, propafenone, oral contraeptives, fluoxetine, sertraline.
Decreased effect of metoprolol - NSAIDS, salycylates, barbiturates, rifampin, clonidine.
The dosage and frequency depend upon the individuals metabolism and the drug being used.
There are no substitutes to beta-blockers. There are no drugs to counteract the side effects of beta blockers.
It is possible your husband's symptoms were due to the beta-blockers.  His doctor can best tell him what the next step is in terms of controlling his blood pressure.  Hang in there.  The long-term benefits of controlling blood pressure far outweigh the short-term inconvenience of finding the right medication.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center Webster at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.