Atenolol + Chlorthalidone is indicated for the management of hypertension. It helps lower blood pressure, thereby reducing the risk of both fatal and non-fatal cardiovascular events, including stroke and myocardial infarction.

Atenolol + Chlorthalidone

Atenolol and chlorthalidone can be used either alone or together for the management of hypertension. Clinical studies have demonstrated that when combined in a single tablet, there is no significant effect on the bioavailability of either drug. This fixed-dose combination therefore offers a convenient and effective option for simultaneous administration.

Atenolol is a beta1-selective (cardioselective) beta-adrenergic receptor blocker that provides:

• reduction in heart rate both at rest and during exercise, along with decreased cardiac output
• lowering of systolic and diastolic blood pressure at rest and during physical activity
• reduction in reflex orthostatic tachycardia

Chlorthalidone is a long-acting monosulfonamyl diuretic with relatively low toxicity. It promotes diuresis by significantly increasing the excretion of sodium and chloride in the distal convoluted tubule of the nephron.

The initial dose is Atenolol 50 mg and Chlorthalidone 25 mg once a day. If an optimal response is not achieved, another antihypertensive agent may be added gradually beginning with 50 percent of the usual recommended starting dose to avoid an excessive fall in blood pressure. Atenolol is excreted via kidneys and therefore dosage should be adjusted in cases of severe impairment of renal function.

Use in elderly: Clinical studies of Atenolol & Chlorthalidone combination did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.

Atenolol + Chlorthalidone may enhance the effects of other antihypertensive drugs when used together.

• Concomitant use with catecholamine-depleting agents (e.g., reserpine) may increase the risk of hypotension and marked bradycardia.
• Calcium channel blockers and amiodarone may produce additive cardiovascular effects when administered with this combination.
• Prostaglandin synthesis inhibitors (e.g., indomethacin) may reduce the antihypertensive effect of beta-blockers.
• Concurrent use with digitalis glycosides may further slow atrioventricular conduction and reduce heart rate, increasing the risk of bradycardia.

This combination is contraindicated in patients with hypersensitivity to atenolol, chlorthalidone, or sulfonamide-derived drugs. It is also contraindicated in patients with sinus bradycardia, heart block greater than first degree, cardiogenic shock, overt cardiac failure, or anuria.

Adverse effects of this combination are similar to those of its individual components. Atenolol-related effects include bradycardia, cold extremities, postural hypotension, leg pain, dizziness, vertigo, light-headedness, fatigue, lethargy, drowsiness, depression, abnormal dreams, diarrhea, nausea, wheezing, and dyspnea. Chlorthalidone-related effects include orthostatic hypotension, loss of appetite, gastric irritation, vomiting, abdominal cramps, constipation, vertigo, purpura, photosensitivity, rash, urticaria, hyperglycemia, glycosuria, hyperuricemia, muscle spasms, weakness, and restlessness.

Pregnancy Category D. This medication should be used with caution during breastfeeding.

This combination may worsen peripheral arterial circulation disorders. Serum electrolytes should be monitored periodically to detect potential imbalances.

There is limited information regarding overdose in humans. Management should be symptomatic and supportive, including removal of unabsorbed drug by emesis or activated charcoal. Atenolol may be removed by hemodialysis. Monitoring and correction of dehydration, electrolyte imbalance, and hypotension are essential.

Combined antihypertensive preparation.

Store in a cool and dry place, protected from light.