Tenoren^®

Tenoren ® is the preparation of Atenolol. It is a synthetic, β₁ -selective (cardioselective) adrenoreceptor blocking agent without membrane stabilizing or intrinsic sympathomimetic activity.

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Tenoren ® is indicated for the following conditions –
- Hypertension - Angina Pectoris - Cardiac Arrhythmia - Acute Myocardial Infarct

Hypertension: The initial dose is 50 mg once daily. If an optimal response is not achieved, the dose should be increased to 100 mg once a day.

Angina pectoris: The initial dose is 50 mg once daily. If an optimal response is not achieved within one week, the dose should be increased to 100 mg once a day. Some patients may require a dose of 200 mg once a day for optimal effect.

Cardiac arrhythmia: The initial dose is 25-50 mg once daily. If an optimal response is not achieved, the dose should be increased to 100 mg once a day.

Acute myocardial infarction: Atenolol can be given orally 50 mg twice a day or 100 mg once a day after initial therapy with intravenous Atenolol (Patients who present within 12 hours of onset of chest pain, intravenous Atenolol 5 mg should be injected over 5 minutes followed by another 5 mg intravenous injection 10 minutes later. In patients who tolerate the full intravenous dose, e.g. 10 mg, Tenoren ® 50 mg tablet should be initiated 10 minutes after the last intravenous dose followed by another 50 mg oral dose 12 hours later).

Elderly and renal impairment:
25 mg once a day.
Patients on hemodialysis: 25 mg or 50 mg after each dialysis; this should be done under hospital supervision as marked falls in blood pressure may occur. Children and adolescents:
Safety and effectiveness in pediatric patients have not been established.

Atenolol can cause fetal harm when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus. Caution should be exercised when Atenolol is administered to a woman, who is breast feeding.

Patients already on a β₁ blocker must be evaluated carefully before Atenolol is administered. Initial and subsequent Atenolol dosages can be adjusted downward depending on clinical observations including pulse and blood pressure. Atenolol may aggravate peripheral arterial circulatory disorders.

Warnings
In patients who have congestive heart failure controlled by digitalis and/or diuretics, Atenolol should be administered cautiously. Continued depression of the myocardium with β -blocking agents over a period of time can, in some cases, lead to cardiac failure.

In general, Atenolol is well tolerated although in a small undesired events have been reported, such as hallucinations, headache, impotence, purpura, thrombocytopenia, visual disturbance, sick sinus syndrome, dry mouth, reversible mental depression, dry eyes.

Atenolol is contraindicated in sinus bradycardia, heart block greater than first degree, cardiogenic shock, and overt cardiac failure. It is also contraindicated in patients with a history of hypersensitivity to Atenolol or any of the drug product's components.

Combined use of beta-blockers and calcium channel blockers with negative inotropic effects e.g. verapamil and diltiazem can cause severe hypotension, bradycardia and cardiac failure. Digitalis glycosides, in association with beta-blockers, may increase atrio-ventricular conduction time. In addition beta-blockers have interaction with clonidine that may result in severe rebound hypertension. Concurrent administration of indomethacin reduces the antihypertensive action.

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Store in cool & dry place. Protect from light.