Ischemic heart disease may be exacerbated after abrupt withdrawal.
Hypersensitivity to catecholamines has been observed during withdrawal.
Exacerbation of angina and, in some cases, myocardial infarction (MI) may occur after abrupt discontinuance.
When long-term beta-blocker therapy (particularly with ischemic heart disease) is discontinued, dosage should be gradually reduced over 1-2 weeks with careful monitoring.
If angina worsens markedly or acute coronary insufficiency develops, beta-blocker administration should be promptly reinitiated, at least temporarily (in addition to other measures appropriate for unstable angina).
Patients should be warned against interruption or discontinuance of beta-blocker therapy without physician advice.
Because coronary artery disease (CAD) is common and may be unrecognized, beta-blocker therapy must be discontinued slowly, even in patients treated only for hypertension.
This medication contains Atenomel. Do not take Tenormin if you are allergic to Atenomel or any ingredients contained in this drug.
Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.
Atenomel is generally well tolerated, and side effects are mild and transient. Its side effects include:
Atenomel can cause breathing difficulties in patients with asthma, chronic bronchitis, or emphysema. In patients with existing slow heart rates (bradycardias) and heart blocks (defects in the electrical conduction of the heart), Atenomel can cause dangerously slow heart rates and even shock. Atenomel reduces the force of heart muscle contraction and can aggravate symptoms of heart failure.
In patients with coronary artery disease, abruptly stopping Atenomel can suddenly worsen angina, and occasionally precipitate heart attacks. If it is necessary to discontinue Atenomel, its dosage can be reduced gradually over several weeks.
TENORMIN is indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure lowers the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including Atenomel.
Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than 1 drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program's Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).
Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent ardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly.
Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal.
Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (eg, on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy.
TENORMIN may be administered with other antihypertensive agents.
Tablets of 25 mg Atenomel, NDC 0310-0107 (round, flat, uncoated white tablets identified with “T” debossed on one side and 107 debossed on the other side) are supplied in bottles of 100 tablets.
Tablets of 50 mg Atenomel, NDC 0310-0105 (round, flat, uncoated white tablets identified with “TENORMIN” debossed on one side and 105 debossed on the other side, bisected) are supplied in bottles of 100 tablets.
Tablets of 100 mg Atenomel, NDC 0310-0101 (round, flat, uncoated white tablets identified with “TENORMIN” debossed on one side and 101 debossed on the other side) are supplied in bottles of 100 tablets.
Store at controlled room temperature, 20-25°C (68-77°F) . Dispense in well-closed, light-resistant containers.
Distributed by: AstraZeneca Pharmaceuticals LP, Wilmington, DE 19850. Revised: Oct 2012
How to use Atenomel
See also Warning section.
Take this medication by mouth with or without food as directed by your doctor, usually 1 to 2 times daily.
Apple juice and orange juice may prevent your body from fully absorbing Atenomel. It is best to avoid drinking apple/orange juice within 4 hours of taking Atenomel, unless your doctor or pharmacist tells you otherwise.
The dosage is based on your medical condition and response to treatment.
Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.
If this product is used for chest pain, it must be taken regularly to be effective. It should not be used to treat chest pain when it occurs. Use other medications (such as nitroglycerin placed under the tongue) to relieve chest pain as directed by your doctor.
It may take 1 to 2 weeks before you get the full benefit of this medication. Tell your doctor if your condition does not improve or if it worsens (for example, if your blood pressure readings remain high or increase, if your chest pain occurs more often).
Rated Atenomel for Heart Disease Report
When I was on half of a 25 mg tablet, there were no side effects, but I was still experiencing heart palpitations. When the dosage was increased to 25 mg, I experienced chronic and severe diarrhea. It took 4 months to figure out that this medication was the cause. I had no other adverse effects while on this medication.
What should I avoid while taking Atenomel (Tenormin)?
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
Metoprolol vs. Atenomel: What's the difference?
- Metoprolol and Atenomel are beta-blockers used to treat high blood pressure (hypertension), heart pain (angina), congestive heart failure, hyperthyroidism, abnormal heart rhythms, and some neurologic conditions.
- Metoprolol is also used to prevent migraineheadaches.
- Brand names for metoprolol include Lopressor and Toprol XL.
- A brand name for Atenomel is Tenormin.
- Side effects of metoprolol and Atenomel that are similar include abdominal cramps, diarrhea, constipation, fatigue, insomnia, nausea, depression, dreaming, memory loss, fever, impotence, lightheadedness, low blood pressure, cold extremities, and sore throat.
- Side effects of metoprolol that are different from Atenomel include indigestion, decreased exercise tolerance, increased triglycerides, bronchospasm, shortness of breath, or wheezing.
- Side effects of Atenomel that are different from metoprolol include slow heart rate, abnormal heart rhythm, numbness, and tingling.
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
- shortness of breath
- swelling of the hands, feet, ankles, or lower legs
- weight gain
Atenomel may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).