Properties
What is it?
Composition One tablet of Atenoric contains active substances Atenolol 100 mg and Chlorthalidone 25 mg. Mechanism of action A combined hypotensive agent with prolonged action based on the effectiveness of its components. Atenolol - a cardioselective beta-1-adrenoblocker. It has antianginal, hypotensive, and antiarrhythmic effects. It reduces the automaticity of the sinus node, atrioventricular conduction, myocardial oxygen demand, myocardial excitability, and slows down heart rate. Arterial blood pressure reduction is due to the above mechanisms and suppression of renin secretion. It does not have sympathomimetic or membrane-stabilizing activity. Chlorthalidone - a moderately potent diuretic with a prolonged effect. It disrupts the reabsorption of sodium and chloride ions and equivalent amounts of water in the distal tubules of the nephron, increases the excretion of potassium and magnesium ions and bicarbonates from the body, inhibits the excretion of uric acid and calcium ions, and reduces the sodium ion content in the vessel wall, which reduces its sensitivity to vasoconstrictive factors. Cmax of atenolol in plasma is reached 2-4 hours after administration. 90% of the substance is excreted by the kidneys within 48 hours. T1/2 is 6-10 hours. Cmax of chlorthalidone in plasma is reached 17-30 hours after administration. T1/2 depends on the dose administered and ranges from 40 hours for doses of 50 mg to 200 mg. Elimination occurs mainly through the kidneys and partly through bile. Indications - Arterial hypertension; - Angina pectoris on exertion (for long-term treatment). Dosage and administration For arterial hypertension, the initial dose is 1/2 tablet once daily; if ineffective, 1 tablet once daily. Further dose increase in most cases does not lead to further reduction in blood pressure. It is permissible to switch patients from other hypotensive agents directly to Atenoric, except for clonidine. In elderly patients with impaired renal excretory function, the dose of Atenoric should be selected considering creatinine clearance (CC). CC 15-35 ml/min - 1/2 tablet/day or 1 tablet every other day. CC less than 15 ml/min - 1/2 tablet every other day. The drug is administered once daily before meals with a small amount of liquid, preferably in the morning. Side effects Cardiovascular system: bradycardia, AV conduction disturbances, cold extremities, in rare cases, symptoms of acute heart failure. Digestive system: nausea, constipation, diarrhea, dry mouth. Respiratory system: rarely - bronchospasm. Endocrine system: in rare cases - hypoglycemic states in patients with diabetes mellitus. Genitourinary system: in rare cases - decreased potency. Allergic reactions: erythema, itching. Sometimes: sweating, general weakness, decreased lacrimal gland secretion. Contraindications Acute heart failure, chronic heart failure, atrioventricular block II, III degree, bradycardia, labile course of insulin-dependent diabetes mellitus (Type I), sinoatrial block, bronchial asthma, hypokalemia, severe liver and kidney dysfunction, children, hypersensitivity to the components of the drug. Special instructions During pregnancy, the necessity of using the drug for the mother must outweigh the potential risk of its negative impact on the fetus. During lactation, the issue of discontinuing breastfeeding should be decided. The drug should be prescribed with great caution in patients with impaired renal and/or liver function, Raynaud's syndrome, and other obliterating diseases of the peripheral arteries. Patients using contact lenses should take the drug with caution, as it reduces the ability of the lacrimal glands to secrete. To avoid a sharp increase in blood pressure in patients with pheochromocytoma, Atenoric is prescribed only after treatment with alpha-adrenoblockers. Atenoric is not used to relieve anginal attacks. To avoid "withdrawal syndrome," discontinuation of long-term treatment with Atenoric should be gradual. To avoid a sharp decrease in blood pressure, alcohol consumption is not allowed during treatment with Atenoric. Overdose: symptoms - bradycardia, arterial hypotension, acute heart failure, bronchospasm. The action of insulin or oral hypoglycemic agents is enhanced when used in combination with Atenoric. Simultaneous use of Atenoric with ethanol, antihypertensive agents, tricyclic antidepressants, barbiturates, diuretics, phenothiazines, and peripheral vasodilators may cause a sharp or significant decrease in blood pressure. Atenoric (generally beta-blockers) is not prescribed with verapamil, and each of them can be taken only a few days after discontinuation of the other drug. Storage conditions and shelf life The shelf life of the drug is 3 years. Store at a temperature of 10-25°C, protected from light, in a dry place, out of reach of children! Dispensing from pharmacy By prescription Registration # and date Ts N R - 002648 13.06.2007