Atenolol (Tenormin) Considerations for Use*
US/FDA Approved Indication: Heart Rate Control for Atrial Fibrillation
|Black Box Warning*||Abrupt cessation may exacerbate angina pectoris and MI.|
Mechanism of Action
Blocks binding of catecholamines to beta-1 receptors; Beta-1 selective
Non-acute setting or maintenance: 25 to 100 mg PO daily
Elderly: Start at 25 mg PO daily; titrate to desired heart rate
Hepatic Impairment: No dosage adjustment needed
|Major Side Effects||
Hypotension, heart block, bradycardia, asthma, heart failure
|Dosage forms and Strengths||
PO: 25 mg, 50 mg, 100 mg tablets
Abrupt cessation my precipitate angina, MI, arrhythmias, or rebound HTN; discontinue by tapering over 1-2 weeks.
Concomitant amiodarone, digoxin, disopyramide, or non-dihydropyridine calcium channel blockers may increase the risk of bradycardia.
Monitor closely f or HF exacerbation and hypotension when titrating dose.
Do not abruptly discontinue without physician’s advice.
* Refer to prescribing information for more complete information.
†Dosages given in the table may differ from those recommended by the manufacturers.
- American College of Cardiology (ACC), American Heart Association (AHA), and the European Society of Cardiology (ESC). ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation. Washington, DC: American College of Cardiology.
- Heart Rhythm Society. AF360 Pocket Guide: Practical Rate and Rhythm Management of Atrial Fibrillation. 2010, Washington, DC: Heart Rhythm Society.
- Tarascon Pocket Pharmacopoeia® 2012.