Atenolol tablets 50mg №10×3

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Atenolol tabl. excipients: basic magnesium carbonate, corn starch, potato starch, magnesium stearate, talc.
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: Tablets of white or almost white color, flat-cylindrical, with a chamfer. Tablets with a dosage of 100 mg are at risk. Slight marbling is allowed. Pharmacotherapeutic group Selective beta-blockers. ATX code: C07AB03. Pharmacological action Pharmacodynamics Atenolol is a selective beta-blocker, with a predominant effect on beta-1-adrenergic receptors. The selectivity of atenolol decreases with increasing dose. It does not have membrane-stabilizing and internal sympathomimetic activity. The mechanism of action of atenolol and other beta-blockers is not fully understood. It has antianginal, antihypertensive and antiarrhythmic effects. It has negative chrono-, dromo-, batmo- and inotropic effects: it reduces the automatism of the sinus node, slows down atrioventricular (AV) conduction, reduces myocardial contractility and its oxygen demand. Pharmacokinetics Absorption After oral administration, 50-60% of atenolol is absorbed in the digestive tract. The maximum plasma concentration (2 μg / ml) is reached after 2-4 hours. Distribution Less than 5% of atenolol binds to blood proteins. Atenolol is a hydrophilic substance, poorly penetrates the blood-brain and placental barriers, penetrates into breast milk. Metabolism Less than 10% of atenolol is metabolized in the liver. Withdrawal Most of atenolol (85%) is excreted in the urine unchanged. The half-life is 6-7 hours. Special groups of patients The half-life in patients with renal insufficiency may be prolonged. Atenolol is removed by hemodialysis. Indications for use Angina pectoris, arterial hypertension; secondary prevention in hemodynamically stable patients with acute myocardial infarction. Contraindications Absolute: hypersensitivity to the components of the drug; cardiogenic shock; atrioventricular (AV) block II–III degree; severe bradycardia (heart rate (HR) less than 45 beats / min); sick sinus syndrome; acute or chronic heart failure in the stage of decompensation; arterial hypotension (systolic blood pressure (BP) less than 100 mm Hg); untreated pheochromocytoma; severe disorders of peripheral circulation; age up to 18 years (efficacy and safety of the drug have not been established), pregnancy, lactation. Relative: bronchial asthma and severe obstructive respiratory failure, intermittent claudication and Raynaud’s syndrome, insulin-dependent diabetes mellitus. Precautions Patients with angina pectoris should not abruptly stop treatment with atenolol (this can cause severe arrhythmias or acute myocardial infarction); the dose is reduced gradually; if necessary, prescribe another antianginal drug to avoid worsening angina symptoms. Atenolol reduces the risk of arrhythmia, myocardial ischemia and hypertensive crises, however, during general anesthesia, the prevention of sympathoadrenergic compensatory reactions contributes to the development of hypotension. In cases where treatment with atenolol cannot be stopped before general anesthesia, administration of atropine is recommended to prevent the predominance of vagal influence; the use of general anesthetics that suppress cardiac activity should be avoided. The drug should be discontinued 48 hours before anesthesia (to restore the response to the influence of catecholamines). Atenolol in patients with Prinzmetal’s angina may increase the number and duration of angina attacks. The appointment of atenolol in such patients requires extreme caution and is possible only in combination with other antianginal drugs. Given the negative dromotropic effect, it is prescribed with caution to patients with AV blockade of the 1st degree. In diabetes mellitus, atenolol may mask tachycardia caused by hypoglycemia. In thyrotoxicosis, atenolol may mask certain clinical signs of thyrotoxicosis (eg, tachycardia). Abrupt withdrawal of atenolol in patients with thyrotoxicosis is contraindicated. In the event of symptomatic bradycardia (less than 55 beats / min), the dose of atenolol should be reduced. In patients with a history of severe anaphylactic reactions (especially to iodine-containing contrast agents), in patients receiving desensitizing treatment, atenolol increases the risk of allergic reactions, being an antagonist of adrenaline. In the event of the appearance in elderly patients of increasing bradycardia (less than 60 beats / min), arterial hypotension (systolic blood pressure below 100 mm Hg. Art.), AV blockade, bronchospasm, ventricular arrhythmias, severe liver and kidney dysfunction, it is necessary to reduce the dose of atenolol or stop treatment. In patients with impaired renal function, the dose of atenolol should be adjusted according to creatinine clearance (CC). Compared with non-selective beta-blockers, cardioselective beta-blockers have less effect on lung function, however, in obstructive airway diseases, atenolol is prescribed only in case of absolute indications. Patients with bronchospastic diseases can be prescribed selective beta-blockers in case of intolerance and / or ineffectiveness of other antihypertensive drugs, but the dosage should be strictly monitored. An overdose of atenolol is dangerous for the development of bronchospasm. Patients with pheochromocytoma should be given alpha-blockers before starting treatment with atenolol to prevent the risk of raising blood pressure. The drug Atenolol is prescribed with caution to patients with psoriasis – the risk of exacerbation of the disease during treatment with atenolol. The drug Atenolol is prescribed with caution to patients with obliterating peripheral vascular diseases (“intermittent” claudication, Raynaud’s syndrome). Athletes should be aware that atenolol, like other beta-blockers, is listed as doping. Patients with allergic reactions of the anaphylactic type to any substance taking beta-blockers may respond with a more severe allergic reaction to repeated exposure to the allergen (accidental, diagnostic or therapeutic). Such patients may not respond to the usual doses of epinephrine used to relieve an allergic reaction. Pregnancy and lactation Atenolol crosses the placental barrier, is found in the blood of the umbilical cord, and accumulates in breast milk. In this regard, the drug is not prescribed to pregnant women, as this can cause fetal growth retardation. At the time of treatment should stop breastfeeding. Influence on the ability to drive a car and work with other mechanisms Violation of the ability of patients to drive a car or work with machinery is unlikely when using the drug Atenolol. However, one should take into account the fact that dizziness and fatigue may occur. Dosage regimen Assign inside before meals, without chewing, drinking a small amount of liquid, preferably at the same time. Adults Arterial hypertension Treatment with the drug Atenolol begins with a dosage of 50 mg 1 time per day. To achieve a stable antihypertensive effect, 1-2 weeks of administration are required. With insufficient severity of the antihypertensive effect, the dose is increased to 100 mg in one dose. A further increase in the dose is not recommended, as it is not accompanied by an increase in the therapeutic effect. Further reduction in blood pressure can be achieved by combining atenolol with other antihypertensive agents, such as diuretics. Angina pectoris The initial dose of atenolol is 50 mg per day. If within a week the optimal therapeutic effect is not achieved, increase the dose to 100 mg per day. Further increase in dose is not recommended. Myocardial infarction 12 hours after intravenous administration, provided there are no adverse reactions after injection, the drug Atenolol is prescribed at a dosage of 50 mg orally, then after 12 hours – 100 mg 1 time per day. If bradycardia and/or hypotension occur, atenolol should be discontinued. Children There is no experience with the use of atenolol in pediatric practice. For this reason, the use of the drug in children is not recommended. Patients with renal insufficiency In the presence of renal insufficiency, dose adjustment is recommended depending on the CC. In patients with renal insufficiency with CC values above 35 ml / min / 1.73 m2 (normal values u200bu200bare 100-150 ml / min / 1.73 m2), there is no significant accumulation of atenolol. With CC values of 15-35 ml / min / 1.73 m2, the half-life of atenolol increases to 16-27 hours, the recommended dosing regimen is 50 mg per day or 100 mg every other day. With CC values less than 15 ml / min / 1.73 m2, the half-life of atenolol is more than 27 hours, the recommended dosing regimen is 50 mg every other day or 100 mg 1 time in 4 days. For patients on hemodialysis, the drug Atenolol is prescribed 25 mg / day or 50 mg / day immediately after each dialysis, which must be carried out under stationary conditions, since a decrease in blood pressure may occur. Elderly patients In elderly patients, the dosage regimen depends on the functional state of the kidneys. The recommended initial single dose is 25 mg. Increasing the dose is possible under the control of the level of CC, blood pressure, heart rate. Side effectEstimation of undesirable effects is based on the following data on the frequency of occurrence: very often (? 1/10), often (? 1/100 to <1/10), infrequently (? 1/1000 to <1/100), rarely (? 1/10000 to <1/1000), very rare (<1/10000), not known (cannot be estimated from the available data). On the part of the blood and lymphatic system Rarely: platelet purpura, anemia (aplastic), thrombosis. Psychiatric disorders Often: drowsiness or insomnia. Rare: mood changes, nightmares, confusion, depression, hallucinations, anxiety, confusion. From the side of the nervous system Rarely: dizziness, headache, paresthesia. Not known: decreased ability to concentrate, decreased reaction time, increased fatigue, convulsions. On the part of the organ of vision Rarely: visual disturbances, decreased secretion of lacrimal fluid, dryness and soreness of the eyes, conjunctivitis. From the side of the cardiovascular system Often: bradycardia, manifestation of angiospasm (coldness of the lower extremities). Rare: palpitations, development (aggravation) of symptoms of chronic heart failure (swelling of the ankles, feet, shortness of breath), conduction disturbances, arrhythmia, atrioventricular block, orthostatic hypotension, aggravation of intermittent claudication, Raynaud's syndrome. From the respiratory system Rarely: dyspnea, bronchospasm, apnea, nasal congestion. From the digestive system Often: gastrointestinal disorders (nausea, vomiting, abdominal pain, constipation or diarrhea, taste disturbance). Rarely: dryness of the oral mucosa. On the part of the hepatobiliary system Often: increased activity of "liver" enzymes, hyperbilirubinemia. Rare: hepatotoxicity, including cholestasis. On the part of the skin Rarely: alopecia, dermatitis, exacerbation of the course of psoriasis, skin itching and rashes. Not known: increased sweating, photosensitivity, hypersensitivity reactions, including angioedema and urticaria. From the side of metabolism Very rarely: the development of a hypoglycemic state is possible, especially in patients with diabetes mellitus on the background of hypoglycemic therapy. On the part of the reproductive system Rarely: decreased potency, decreased libido, Peyronie's disease. Other Often: increased fatigue, weakness. Not known: muscle weakness. Laboratory indicators Very rarely: increased activity of "liver" enzymes, hyperbilirubinemia. Interaction with other medicinal products With the simultaneous use of atenolol and: antidiabetic agents for oral use, such as insulin, it is possible to enhance or prolong their action. In this case, the symptoms of hypoglycemia (especially tachycardia and tremor) may be masked or disappear. In this regard, it is necessary to regularly monitor blood sugar; tricyclic antidepressants, barbiturates, phenothiazides, nitroglycerin, diuretics, vasodilators and other antihypertensive agents (for example, prazosin) may increase the hypotensive effect; calcium channel blockers (for example, nifedipine), in addition to enhancing the hypotensive effect heart failure may develop; calcium channel blockers with a negative inotropic effect (for example, verapamil, diltiazem) may increase their action, especially in patients with impaired ventricular function and / or AV conduction, which increases the risk of arterial hypotension, bradycardia. If it is necessary to administer verapamil, this should be done no less than 48 hours after atenolol is discontinued; cardiac glycosides, reserpine, ?-methyldopa, guanfacine and clonidine may experience a significant slowdown in heart rate; indomethacin may decrease the antihypertensive effect of atenolol; narcotic drugs increase the antihypertensive effect. In this case, an additive, negative inotropic effect of both drugs is manifested; peripheral muscle relaxants (for example, suxamethonium, tubocurarine) may increase the neuromuscular blockade, therefore, before the operation, accompanied by anesthesia, the anesthesiologist should be informed that the patient is taking atenolol; aminophylline and theophylline, mutual suppression of therapeutic effects; lidocaine may reduce its excretion and increase the risk of toxic effects of lidocaine; sympathomimetic agents (for example, adrenaline) can help weaken the action of ?-blockers; nitrates, peripheral vasodilators, monoamine oxidase inhibitors (MAO) increases their hypotensive effect; propafenone enhances the effect of atenolol , which is part of the drug; preparations containing potassium, the effect of the latter is weakened; drugs that depress the central nervous system (CNS) increase the sedative effect; narcotic analgesics increase narcotic effect, dangerous inhibition; anticholinesterase agents, angiotensin-converting enzyme inhibitors (captopril, enalapril, lisinopril) leads to an increase in the level of potassium in the blood. In patients taking atenolol and clonidine at the same time, the latter can be canceled only a few days after stopping treatment with atenolol. Atenolol enhances the hypotensive effect of prazosin, their combination leads to a greater decrease in blood pressure than when taking only one drug. Calcium channel blockers such as verapamil and diltiazem, or other antiarrhythmic agents (eg, disopyramide) should not be used during treatment with atenolol. Overdose Symptoms: bradycardia, AV block II and III degree, heart failure, hypotension, bronchospasm, hypoglycemia. Treatment: symptomatic, pronounced bradycardia is stopped with atropine (1-2 mg intravenously), and, if necessary, beta-adrenergic receptor stimulants (isoprenaline - 25 mcg intravenously, slowly; or orciprenaline - 0.5 mg intravenously, slowly). The use of cardiac glycosides and glucagon is shown; installation of an artificial pacemaker. Upakovka10 tablets in a blister pack. 3 blister packs with a leaflet are placed in a pack of cardboard. Storage conditions In a place protected from light and moisture, at a temperature not exceeding 25 ° C. Keep out of the reach of children. Shelf life 2 years. Do not use after the expiration date. Terms of dispensing from pharmacies By prescription. Buy Atenolol tablets 50mg No. 10x3 Price for Atenolol tablets 50mg No. 10x3