Atenolol

Beta Blocker·Cardiovascular - Beta Blockers

Hypertension, angina, arrhythmias

PBSBETA BLOCKERTenormin, Noten50 mg tabletS4+1

Max Dose

100 mg/day

Half-life

6–7 h

Renal Adj.

DOSE RED.

Asthma

CONTRAIND.

Rapid Summary

Overview

Water-soluble, cardioselective beta-blocker. Unlike metoprolol, it relies heavily on renal clearance and does not cross the blood-brain barrier easily.

Maximum Dose

Max 100 mg/day

Clinical Focus

Must be dose-reduced in renal impairment to prevent profound drug accumulation and severe bradycardia.

Bottom Line

Atenolol is a simple once-daily beta-blocker for rate control and angina, but has fallen out of favour as first-line for hypertension due to inferior stroke outcomes.

Formulation & Access

Brand Names

Tenormin, Noten

Oral Routes

Tablets (50 mg, 100 mg).

Parenteral

Ampoule (5 mg/10 mL) for IV use (Rarely used, specialist only).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Hypertension, angina, arrhythmias.

Clinical Place

Historically widely used, but inferior to ACEi/ARBs for primary hypertension. Still useful for rate control.

Quick reference

Class & Role

Beta Blocker — Water-soluble, cardioselective beta-blocker.

Route / Formulation

Tablets (50 mg, 100 mg). (Tenormin, Noten)

Usual Dose & Max

PO 25-50 mg OD. Max 100 mg/day.

Key Indication Doses

Hypertension / Angina: PO 25-50 mg OD. Max 100 mg/day. AF Rate Control: PO 25-50 mg OD. Renal Impairment: If eGFR 15-35, Max 50 mg/day. If eGFR < 15, Max 25 mg/day or give every 48 hours.

Best Uses

Atenolol is a simple once-daily beta-blocker for rate control and angina, but has fallen out of favour as first-line for hypertension due to inferior stroke outcomes.

Avoid / Cautions

Severe asthma, 2nd/3rd degree heart block, cardiogenic shock. Pregnancy Category C. Associated with intrauterine growth restriction (IUGR).

Key Risks

Cardiovascular: Bradycardia, AV block, heart failure exacerbation. Renal: Toxicity/accumulation rapidly occurs with declining renal function. Neurological: Being hydrophilic, it causes fewer CNS side effects (nightmares, sleep issues) than lipophilic agents like metoprolol.

Key Interactions

Verapamil and Diltiazem (Risk of asystole). Digoxin, Amiodarone.

Monitoring

Baseline and routine U&E and eGFR to guide safe dosing. Hold if HR < 50 or SBP < 90.

Clinical Pearl

The most common cause of Atenolol-induced severe bradycardia in the elderly is an acute decline in renal function. Always check the eGFR before increasing the dose.

Access

Tenormin, Noten50 mg tablet

Brand: Tenormin, Noten
Formulation: Tablets (50 mg, 100 mg)

Atenolol

Beta Blocker·Cardiovascular - Beta Blockers

Hypertension, angina, arrhythmias

PBSBETA BLOCKERTenormin, Noten50 mg tabletS4+1

Max Dose

100 mg/day

Half-life

6–7 h

Renal Adj.

DOSE RED.

Asthma

CONTRAIND.

Rapid Summary

Overview

Water-soluble, cardioselective beta-blocker. Unlike metoprolol, it relies heavily on renal clearance and does not cross the blood-brain barrier easily.

Maximum Dose

Max 100 mg/day

Clinical Focus

Must be dose-reduced in renal impairment to prevent profound drug accumulation and severe bradycardia.

Bottom Line

Atenolol is a simple once-daily beta-blocker for rate control and angina, but has fallen out of favour as first-line for hypertension due to inferior stroke outcomes.

Formulation & Access

Brand Names

Tenormin, Noten

Oral Routes

Tablets (50 mg, 100 mg).

Parenteral

Ampoule (5 mg/10 mL) for IV use (Rarely used, specialist only).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Hypertension, angina, arrhythmias.

Clinical Place

Historically widely used, but inferior to ACEi/ARBs for primary hypertension. Still useful for rate control.

Quick reference

Class & Role

Beta Blocker — Water-soluble, cardioselective beta-blocker.

Route / Formulation

Tablets (50 mg, 100 mg). (Tenormin, Noten)

Usual Dose & Max

PO 25-50 mg OD. Max 100 mg/day.

Key Indication Doses

Hypertension / Angina: PO 25-50 mg OD. Max 100 mg/day. AF Rate Control: PO 25-50 mg OD. Renal Impairment: If eGFR 15-35, Max 50 mg/day. If eGFR < 15, Max 25 mg/day or give every 48 hours.

Best Uses

Atenolol is a simple once-daily beta-blocker for rate control and angina, but has fallen out of favour as first-line for hypertension due to inferior stroke outcomes.

Avoid / Cautions

Severe asthma, 2nd/3rd degree heart block, cardiogenic shock. Pregnancy Category C. Associated with intrauterine growth restriction (IUGR).

Key Risks

Key Interactions

Verapamil and Diltiazem (Risk of asystole). Digoxin, Amiodarone.

Monitoring

Baseline and routine U&E and eGFR to guide safe dosing. Hold if HR < 50 or SBP < 90.

Clinical Pearl

The most common cause of Atenolol-induced severe bradycardia in the elderly is an acute decline in renal function. Always check the eGFR before increasing the dose.

Access

Tenormin, Noten50 mg tablet

Brand: Tenormin, Noten
Formulation: Tablets (50 mg, 100 mg)