Atenolol: uses, side effects and cautions

The NHS says atenolol is used to treat high blood pressure, chest pain from angina and heart rhythm problems. It also helps recovery after a heart attack and may be used to prevent migraine. It is a beta blocker and is only available on prescription.

Most adults can take atenolol and it is sometimes prescribed for children. It is unsuitable if you have had an allergic reaction or serious side effect to atenolol or another beta blocker, other serious allergies (especially if you carry adrenaline auto-injectors), breathing problems such as asthma, an overactive thyroid, diabetes or kidney disease, or poorly controlled heart failure, very low blood pressure or circulation problems.

Atenolol usually comes as tablets that you swallow with a glass of water, without chewing, and can come as a liquid measured with the device supplied. Most people take it once a day, at the same time each day, and you can eat as normal. A doctor may start at a low dose and increase after around a week or more depending on how well it is working.

Missed a dose? Take it when you remember unless the next dose is nearly due, then skip it. Never double up. Extra doses can be dangerous, so call NHS 111. Do not stop atenolol without talking to your doctor, because your condition may get worse.

Tiredness and weakness, cold, numb or tingly hands and feet, nausea, vomiting, diarrhoea and a slow heart rate are common. They usually begin when you start or increase the dose and often get better over time. Ask a pharmacist or doctor about any that persist.

Rare serious effects: allergic reactions with throat swelling or breathing difficulty, heart problems causing breathlessness or fainting, liver problems with jaundice, and hallucinations. Call 999 for suspected anaphylaxis and NHS 111 for other serious effects. Avoid driving if you are tired, dizzy or have vision problems.

Slow pulse, tiredness and cold fingers can make people wonder whether the tablets are suiting them. A note of when symptoms appear, for example after a dose increase, gives the prescriber something concrete to work from.

If you carry an adrenaline auto-injector for a serious allergy, tell the prescriber, since the NHS lists that among the reasons atenolol may be unsuitable. Tell dental and surgical teams that you take a beta blocker before any procedure.

Named medicines include flecainide, digoxin, clonidine, candesartan, ibuprofen and other NSAIDs, insulin and other diabetes medicines, nasal decongestants and adrenaline. The NHS says that is not the full list. Limit alcohol, as it can increase the risk of side effects such as low blood pressure.

Tell your doctor if you are pregnant. Atenolol can be taken during pregnancy, but you and your baby may be offered extra checks, and the doctor will talk through risks and benefits. Taking it while breastfeeding may cause side effects in the baby; a doctor may recommend it if the benefits outweigh the risks or suggest another beta blocker.

Other beta blockers include bisoprolol, metoprolol, propranolol, carvedilol and nebivolol. Report suspected side effects via the Yellow Card scheme.