📋 Indications & Clinical Dosage
*Hypertension:*
Adult: 50/12.5 mg tab daily, alternatively increased if necessary to 100/25 mg daily, doses higher than 50 mg atenolol rarely necessary.
*Angina:*
Adults: 100/25 mg tab once daily or 50/12.5 mg tab twice daily. Children: Not recommended.
⛔ Contraindications
Second or third degree heart block, cardiogenic shock.
⚠️ Precautions & Warnings
AV block, heart failure (avoid if un-controlled), peripheral arterial circulatory disorders (avoid if severe), Prinzmetals angina, myasthenia gravis, Ischaemic heart disease, withdraw gradually, history of bronchospasm, diabetes, hyperthyroidism, renal or hepatic impairment, psoriasis, elderly, consider withdrawal before elective surgery, anaphylaxis risk due to increased sensitivity to allergens, Always withdraw gradually over period of 1-2 weeks IV administration requires cardiac and blood pressure monitoring.
Dose adjustment in renal impairment: with oral use max 50mg daily if eGFR15-35 ml/minute/1.73m2; max 25mg daily or 50 mg on alternate days if eGFR less than 15 ml/minute/1.73m2.With intravenous use max 10 mg on alternate days if eGFR15-35 ml/minute/1.73m2; max.10 mg every 4 days if eGFR less than 15 ml/minute/1.73m2.
🔄 Drug Interactions
Verapamil, lithium, digitalis, or Class 1 antidys-rhythmic agents.
⚠️ Adverse Reactions / Side Effects
Allergic interstitial nephritis, jaundice, Cold extremities, muscular fatigue, bradycardia, rashes and dry eyes (discontinue), nausea, dizziness, hyperuricaemia. Rare: Idiosyncratic reactions such as thrombocytopenia and leucopenia.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Avoid. Use only when no safer alternative exists for a serious problem.
Lactation / Breastfeeding:
Caution advised
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.