Re: Reaction to Atenolol

Posted By Ethel Horst on March 03, 1999 at 08:14:40:

In Reply to: Re: Reaction to Atenolol posted by CCF CARDIO MD - CRC on March 03, 1999 at 07:45:38:






i have been on 50mg of atenolol for 3 months, and for the past few weeks have been experiencing some strange symptoms, including fatigue, dizziness, pressure in my face and neck and especially jaw, teeth chattering, confusion.  My primary physician has not yet found the cause (ruled out heart problems), but is reluctant to think the atenolol could be causing the problem, since it offers few side affects and I have been on it so long.  Can anyone offer examples of other patients who have been affected by atenolol in any way similar?  Thanks.





Dear Bill,
Thank you for your question. Atenolol (Tenormin) belongs to  a class of medications called beta-blockers.  This class includes the following other medications: generic (brand name), - propranolol (Inderal), atenolol (Tenormin), 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.
The reactions you are describing are not typical for beta blockers.
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.  Be sure to discuss with your physician before stopping any medications on your own.
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 website 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.