|The name of the preparation||Character; dose; package||Manufacturer||Price 100%||Price after refund||In which pharmacy?|
|Atenolol Sanofi 25||tablets; 25 mg; 60 tables||Sanofi-aventis||7.19||
Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.
A drug from the beta-blocker group that reduces the heart rate and its contraction force, and lowers blood pressure.
The active substance of the preparation is atenolol. It is a substance belonging to a group of medicines called beta-blockers (another name is beta-blockers). These drugs work by blocking certain types of receptors, called beta adrenergic receptors. Adrenergic receptors are found on the surface of nerve, muscle or glandular cells in numerous tissues and organs. Under physiological conditions, they are stimulated by adrenaline or noradrenaline released after activation of the sympathetic nervous system. The pharmacological blockade of beta receptors prevents them from being stimulated, thereby reducing the effects of adrenaline or noradrenaline on target tissues with beta receptors. Adrenaline increases the heart rate and spasm of peripheral blood vessels. The effects of atenolol, like other drugs in this group, lead to a reduction in the frequency of heart rhythm and the strength of its contraction and to lower blood pressure. Atenolol is selective for beta 1 receptors. Selective activity on the beta 1 receptors in the heart reduces the risk of side effects associated with the peripheral action of the drug (eg, the risk of airway narrowing associated with beta 2 receptor blockade in the bronchial smooth muscles). At doses greater than 100 mg, atenolol may also act on beta 2 receptors.
The preparation is indicated for the treatment of:
• angina pectoris
• cardiac arrhythmias with fast heart rate
• myocardial infarction (early intervention in the acute phase of myocardial infarction).
Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients. You can not use the preparation if you are present:
• second or third degree atrioventricular block
• decompensated heart failure
• cardiogenic shock
• syndrome of a sick sinus node
• untreated phaeochromocytoma
• metabolic acidosis
• bradycardia (heart rate less than 45 beats per minute)
• severe circulatory disorders in peripheral arteries
• if you are taking intravenous medicines from the group of Verapamil -type Calcium antagonists, diltiazem or other anti-arrhythmic agents.
The preparation must not be used during pregnancy unless in the opinion of the doctor it is absolutely necessary. The preparation is contraindicated during breast-feeding.
Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
Do not stop using the product suddenly, especially in people with ischemic heart disease. If cessation of treatment is required, the dose should be gradually reduced over a period of 1-2 weeks according to the doctor's individual recommendations and under strict supervision. Abrupt discontinuation of atenolol therapy may lead to worsening of disease symptoms and arrhythmias.
If you are planning any procedure requiring general anesthesia, be sure to inform your doctor about the use of beta blockers (there is a risk of serious interactions with other drugs). The doctor will make an individual decision to continue the beta-blocker treatment or he will advise you to stop using it at least 24 hours before the procedure.
Patients with compensated heart failure should start with very small doses and remain under strict medical supervision during treatment.
In patients with vasospastic angina (Prinzmetal), the preparation may increase the frequency and duration of angina pains. Be especially careful.
The use of beta-blockers may exacerbate circulatory disorders in the peripheral arteries (severity of Raynaud's syndrome, inflammatory artery diseases, chronic obstruction of the arteries of the lower limbs). The use of the preparation in this group of patients is possible only if the doctor deems it necessary. Be careful.
Because atenolol suppresses atrioventricular conduction, caution should be exercised in patients with first degree atrioventricular block.
Patients with diabetes should be cautious. Dose adjustment of antidiabetics may be necessary. Atenolol may mask the symptoms of hypoglycaemia (reduced blood Glucose ), such as palpitations, increased heart rate (tachycardia) or sweating. Blood glucose should be monitored frequently.
Before starting to use the product in people with psoriasis, the doctor will consider the benefit / risk ratio and will in each case individually decide whether to start treatment with atenolol. Beta blockers may exacerbate or cause psoriasis.
The preparation may also mask the symptoms of hyperthyroidism. Exercise caution and control heart rate and thyroid hormone levels.
The preparation may increase bradycardia. In the event of excessive reduction in heart rate (less than 50-55 beats per minute), consult a physician; your doctor may advise you to reduce your dose or gradually discontinue using it altogether.
The preparation may increase the sensitivity to allergens (also applies to patients undergoing desensitisation therapy) and intensify Anaphylactic reactions and reduce the effectiveness of adrenaline used in such cases. It should be avoided in people with an increased risk of anaphylactic reactions.
In patients with renal insufficiency, dosage adjustment is necessary; the doctor will adjust the dosage depending on the concentration of creatinine in the blood.
Caution should be exercised in the elderly and treatment should be started with the lowest possible dose.
Do not use the preparation in patients with asthma or chronic obstructive diseases of the lungs, unless the doctor deems it necessary. People with an increased risk of bronchoconstriction should exercise extreme caution. Patients with bronchial asthma or other obstructive airways disease may experience an increase in resistance in the airways. It may be necessary to take additional or increase the dose of bronchodilators that are used as prescribed by your doctor.
In patients with pheochromocytoma of the adrenal gland, treatment to block alpha-adrenergic receptors is necessary before and during treatment. Careful monitoring of blood pressure is necessary.
Does this preparation affect the ability to drive vehicles?
The preparation, especially in the initial period of treatment, may cause dizziness, fatigue or other symptoms that may impair the ability to drive vehicles and operate machinery / equipment.
The preparation is in the form of tablets. It is intended for oral use.Do not exceed the recommended doses because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts regarding the use of the preparation, consult a physician. The doctor will set the dosage individually, usually apply:
Hypertension: initially 50 mg per day, then your doctor may increase the dose to 100 mg taken once daily or in divided doses. Full antihypertensive effect is achieved after 1-2 weeks of use. The doctor may use combination therapy with other antihypertensive drugs.
Angina: 50-100 mg once daily or in divided doses. In people with ischemic heart disease, the drug should not be stopped suddenly because it may cause angina pains or a heart attack.
Arrhythmias with rapid heartbeat: the product is initially administered intravenously by qualified medical personnel; then, after obtaining control, treatment is continued with the oral preparation at a dose of 50-100 mg 1 once a day.
Myocardial infarction, early intervention in the acute phase of myocardial infarction: initially the preparation is administered intravenously by qualified medical personnel; then, the treatment is continued with an oral preparation at a dose of 50 mg after 15 minutes after intravenous administration, then after 12 hours 50 mg, and then, after a further 12 hours, 100 mg per day.
In patients with impaired renal function, your doctor will adjust your dosage depending on your creatinine level in your blood. If the creatinine clearance is less than 35 ml / min but the greater that 15 ml / min the dose is 50 mg per day. If you have severe renal insufficiency (creatinine clearance less than 15 ml / min), the dose is 25 mg per day, or 50 mg every other day. In patients undergoing dialysis, the dose is 50 mg after each dialysis, and treatment should be performed in a hospital setting, due to the risk of a significant reduction in blood pressure.
Elderly patients may need a dose reduction, especially if they have kidney failure.
There are insufficient data on the safety and efficacy of the preparation in children and its use is not recommended in this age group.
During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or plan to become pregnant, please inform the doctor prescribing the prescription for this medicine.
Atenolol can have a detrimental effect on pregnancy, fetus and newborn development. The preparation must not be used during pregnancy unless in the opinion of the doctor it is absolutely necessary. Only a doctor can assess the risk-benefit ratio in your case.
Do not use the product during breast-feeding.
Tell your doctor about all medicines you have recently taken, including those that are over the counter.
Intravenous intake of calcium antagonists, such as verapamil or diltiazem, is contraindicated during beta-blockers and for 48 hours after discontinuation.
Caution should be exercised if the preparation is used in parallel with:
• calcium antagonists (verapamil, diltiazem) taken by mouth - risk of decreased heart rate, severe hypotension and heart failure
• calcium dihydropyridine antagonists (eg Nifedipine , Amlodipine , felodipine , lacidipine, nicardipine, nimodipine, nitrendipine) - risk of hypotension and further worsening of symptoms in patients with latent heart failure
• digitalis glycosides - the risk of worsening of atrio-ventricular conduction and reduction of heart rate (bradycardia)
• clonidine - if clonidine is used in parallel with the beta-blocker and treatment should be discontinued, beta-blocker treatment should be discontinued several days prior to discontinuation of clonidine (abrupt discontinuation of clonidine during the beta-blocker period may result in a significant rise in blood pressure and danger to life); if the use of clonidine is to be replaced by the use of a beta-blocker, a break of several days should be observed after discontinuation of clonidine and before the start of beta-blocker
• Class I antiarrhythmics (such as quinidine, disopiramid, Lidocaine , phenytoin, flecainide, propafenone) - the risk of worsening of the atrio-ventricular conduction and a significant reduction in the strength of myocardial contraction
• sympathomimetic drugs (eg adrenaline) - a risk of beta-blockers being reduced and the risk of a significant increase in blood pressure
• insulin and oral antidiabetic agents - beta blockers, including atenolol, can mask the symptoms of hypoglycaemia; you should monitor your blood glucose; dose adjustment of antidiabetic drugs may be necessary (as prescribed by your doctor)
• non-steroidal anti-inflammatory drugs (ibuprofen, indomethacin) - the antihypertensive effect of beta-blockers, including atenolol, may be reduced
• preparations used for anesthesia - bradycardia may increase (decrease in heart rate) and significant hypotension (it is necessary to inform the anesthesiologist about the use of a beta-blocker)
• antihypertensive drugs and other drugs that may lower blood pressure (eg Nitroglycerin , antidepressants, barbiturates, neuroleptics, phenothiazine derivatives, baclofen, amifostine) - the risk of potentiation of antihypertensive effect and hypotension; you should have regular blood pressure monitoring
• other beta-blockers (including those used topically, such as, for example, Timolol contained in eye drops used in the treatment of glaucoma) - the risk of increasing the systemic effect of the preparation; if such combination treatment is used, the patient should remain under strict medical supervision.
The effectiveness of adrenaline in treating the symptoms of anaphylactic reactions may be reduced in patients taking beta-blockers.
Like all medicines, also Atenolol Sanofi, it can cause side effects, although they will not occur in all patients using this product. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
Frequently possible: reduced heart rate (bradycardia), nausea, vomiting, abdominal pain, diarrhea, feeling tired, feeling cold in the extremities. Uncommon: sleep disorders, increased liver enzymes. Rare: thrombocytopenia (decreased platelet count), purpura, hallucinations, confusion, nightmares, mood changes, psychosis, dizziness and headaches, sensory disturbances such as tingling and numbness (paresthesia), visual disturbances, dryness and eye irritation, severity of heart failure, heart blockage, hypotension (including orthostatic, sometimes fainting), severity of Raynaud's syndrome, exacerbation of existing claudication, bronchospasm in patients with bronchial asthma, dry mouth, toxic effects on the liver, including bile retention , exacerbation of psoriasis symptoms, psoriasis-like lesions, alopecia, rash, sexual dysfunction. Very rare: increased anti-nuclear antibodies. Possible occurrence of hypersensitivity reactions such as angioneurotic edema and urticaria.