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- $Unique_ID{BRK03038}
- $Pretitle{}
- $Title{atenolol and chlorthalidone combination}
- $Subject{Tenoretic ICI Pharma Beta-adrenergic blocking agent diuretic atenolol
- chlorthalidone high blood pressure diuretic fluid accumulation elimination
- salt water kidneys beta blockers controlling impulses nerve pathways workload
- heart}
- $Volume{}
- $Log{}
-
- Copyright (C) 1993 Publications International, Ltd.
-
-
- atenolol and chlorthalidone combination
- ------------------------------------------------------------------------------
-
- BRAND NAME (Manufacturer)
-
- Tenoretic (ICI Pharma)
-
- TYPE OF DRUG
-
- Beta-adrenergic blocking agent and diuretic
-
- INGREDIENTS
-
- atenolol and chlorthalidone
-
- DOSAGE FORM
-
- Tablets (50 mg atenolol and 25 mg chlorthalidone; 100 mg atenolol and 25
- mg chlorthalidone)
-
- STORAGE
-
- Atenolol and chlorthalidone combination tablets should be stored at room
- temperature in a tightly closed, light-resistant container. The tablets
- should be protected from moisture during storage.
-
- USES
-
- Atenolol and chlorthalidone combination is prescribed to treat high blood
- pressure. Chlorthalidone is a diuretic, which reduces fluid accumulation in
- the body by increasing the elimination of salt and water through the kidneys.
- Atenolol belongs to a group of medicines known as beta-adrenergic blocking
- agents or, more commonly, beta blockers. They work by controlling impulses
- along certain nerve pathways, thereby decreasing the workload on the heart and
- lowering blood pressure.
-
- TREATMENT
-
- This medication can be taken with a glass of water, with meals,
- immediately following meals, or on an empty stomach, depending on your
- doctor's instructions.
- Try to take the medication at the same time(s) each day. Avoid taking a
- dose after 6:00 p.m.; otherwise, you may have to get up during the night to
- urinate.
- If you miss a dose of this medication, take the missed dose as soon as
- possible, unless it is almost time for your next dose. In that case, do not
- take the missed dose at all; just wait until the next scheduled dose. Do not
- double the dose.
- Atenolol and chlorthalidone combination does not cure high blood
- pressure, but it will help to control the condition as long as you continue to
- take it.
-
- SIDE EFFECTS
-
- Minor.
-
- Anxiety, constipation, cramps, decreased sexual ability, diarrhea,
- difficulty in sleeping, dizziness, drowsiness, dryness of the eyes and skin,
- gas, headache, heartburn, loss of appetite, nervousness, restlessness, stomach
- discomfort, sweating, or tiredness. These side effects should disappear as
- your body adjusts to the medication.
- Chlorthalidone can cause increased sensitivity to sunlight. It is
- important, therefore, to avoid prolonged exposure to sunlight and sunlamps.
- Wear protective clothing and sunglasses, and use an effective sunscreen.
- If you become extra-sensitive to the cold, be sure to dress warmly during
- cold weather.
- Plain, nonmedicated eye drops (artificial tears) may help to relieve eye
- dryness.
- To relieve constipation, increase the amount of fiber in your diet (fresh
- fruits and vegetables, salads, bran, and whole-grain breads) unless your
- doctor directs you to do otherwise.
- Sucking on ice chips or chewing sugarless gum helps to relieve mouth and
- throat dryness.
- To avoid dizziness or light-headedness when you stand that may be a
- result of taking atenolol and chorthalidone combination, contract and relax
- the muscles of your legs for a few moments before rising. Do this by
- alternately pushing one foot against the floor while raising the other foot
- slightly, so that you are "pumping" your legs in a pedaling motion. This will
- increase the blood flow through your body.
-
- Major.
-
- Tell your doctor about any side effects that are persistent or
- particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
- blurred vision, cold hands and feet, confusion, depression, difficulty in
- breathing, dry mouth, excessive thirst, excessive weakness, fever, hair loss,
- hallucinations, itching, joint pain, mood changes, muscle pain or spasms,
- nausea, nightmares, numbness or tingling in the fingers or toes, palpitations,
- rapid weight gain (three to five pounds within a week), reduced alertness,
- ringing in the ears, skin rash, sore throat, swelling, unusual bleeding or
- bruising, vomiting, or yellowing of the eyes or skin.
-
- INTERACTIONS
-
- Atenolol and chlorthalidone combination can interact with other types of
- medications:
- 1. Indomethacin, aspirin, and other salicylates may decrease the
- blood-pressure-lowering effects of beta blockers.
- 2. Concurrent use of atenolol and calcium channel blockers (diltiazem,
- nifedipine, verapamil) or disopyramide can lead to heart failure or very low
- blood pressure.
- 3. Cimetidine can increase blood levels of atenolol, resulting in greater
- side effects. Side effects may also be increased when atenolol is taken with
- clonidine, digoxin, epinephrine, phenylephrine, phenylpropanolamine,
- phenothiazine tranquilizers, prazosin, reserpine, oral contraceptives (birth
- control pills), or monoamine oxidase (MAO) inhibitors. At least 14 days
- should separate the use of atenolol and the use of an MAO inhibitor.
- 4. Atenolol can antagonize (act against) the effects of theophylline,
- aminophylline, albuterol, isoproterenol, metaproterenol, and terbutaline.
- 5. Alcohol, barbiturates, and rifampin can decrease blood levels of beta
- blockers, resulting in decreased effectiveness.
- 6. The action of beta blockers may be increased if they are used with
- chlorpromazine, furosemide, or hydralazine, which may have a negative effect.
- 7. Atenolol and chlorthalidone can interact with insulin and oral
- antidiabetic agents--raising or lowering blood sugar levels and masking the
- symptoms of low blood sugar.
- 8. Chlorthalidone can decrease the effectiveness of oral anticoagulants
- (blood thinners, such as warfarin), antigout medications, and methenamine.
- 9. Fenfluramine may increase the blood-pressure-lowering effects of this
- drug, which can be dangerous.
- 10. Cholestyramine and colestipol can decrease the absorption of
- chlorthalidone from the gastrointestinal tract. Chlorthalidone should,
- therefore, be taken one hour before or four hours after a dose of
- cholestyramine or colestipol (if you have also been prescribed one of these
- medications).
- 11. Chlorthalidone may increase the side effects of amphotericin B,
- calcium supplements, cortisone-like steroids (such as cortisone,
- dexamethasone, hydrocortisone, prednisone, and prednisolone), digoxin,
- digitalis, lithium, quinidine, sulfonamide antibiotics, and vitamin D.
- BE SURE TO TELL YOUR DOCTOR about all of the medications you are
- currently taking, especially any of the ones listed above.
-
- WARNINGS
-
- * Tell your doctor about unusual or allergic reactions you have had to
- medications, especially to atenolol or any other beta blocker (acebutolol,
- betaxolol, carteolol, esmolol, labetalol, metoprolol, nadolol, penbutolol,
- pindolol, propranolol, and timolol), to chlorthalidone or other diuretics
- (such as bendroflumethiazide, benzthiazide, chlorothiazide, cyclothiazide,
- hydrochlorothiazide, hydroflumethiazide, methyclothiazide, metolozone,
- polythiazide, quinethazone, trichlormethiazide, and furosemide), or to any
- sulfa drug, including oral antidiabetic medications and sulfonamide
- antibiotics.
- * Tell your doctor if you now have or if you have ever had asthma,
- diabetes mellitus, heart disease, gout, kidney disease or problems with
- urination, liver disease, lung disease, pancreatitis, poor circulation in the
- fingers or toes, systemic lupus erythematosus, or thyroid disease.
- * Chlorthalidone can cause potassium loss. Signs of potassium loss
- include dry mouth, thirst, weakness, muscle pain or cramps, nausea, and
- vomiting. If you experience any of these symptoms, call your doctor. To help
- prevent this problem, your doctor may have blood tests performed periodically
- to monitor your potassium levels. To help avoid potassium loss, take this
- medication with a glass of fresh or frozen orange juice or cranberry juice, or
- eat a banana every day. The use of a salt substitute also helps to prevent
- potassium loss. Do not change your diet, until you discuss it with your
- doctor. Too much potassium may also be dangerous.
- * While taking this medication, limit your intake of alcohol in order to
- prevent dizziness and light-headedness.
- * Do not take any over-the-counter (nonprescription) medications for
- weight control or for allergy, asthma, cough, cold, or sinus problems unless
- you first check with your doctor.
- * To prevent severe water loss (dehydration) while taking this
- medication, check with your doctor if you have any illness that causes severe
- or continuous nausea, vomiting, or diarrhea.
- * This medication can raise blood sugar levels in diabetic patients.
- Blood sugar should be monitored carefully with blood or urine tests when this
- medication is being taken.
- * You may want to check your pulse while taking this medication. If your
- pulse is much slower than your usual rate (or if it is less than 50 beats per
- minute), check with your doctor; a pulse rate that slow may cause circulation
- problems.
- * Atenolol can affect your body's response to exercise. Make sure that
- you ask your doctor what an appropriate amount of exercise would be for you,
- taking into account your medical condition.
- * Before having surgery or any other medical or dental treatment, tell
- your doctor or dentist that you are taking this medicine. Often, this
- medication will be discontinued 48 hours prior to any major surgery.
- * This medication can cause dizziness, drowsiness, light-headedness, or
- decreased alertness. Therefore, exercise caution whenever driving a car or
- operating potentially dangerous equipment.
- * A doctor does not usually prescribe a "fixed-dose" drug like this as
- the first choice in the treatment of high blood pressure. Usually the patient
- first receives each ingredient singly. If there is an adequate response to
- the fixed dose contained in this product, it can then be substituted. The
- advantage of a combination product is increased convenience and (often)
- decreased cost.
- * It is important that you do not stop taking this medicine unless you
- first check with your doctor. Some conditions worsen when this medicine is
- stopped suddenly, and the danger of a heart attack is increased in some
- patients. Your doctor may, therefore, want you to gradually reduce the amount
- of medicine you take before stopping completely. Make sure that you have
- enough medicine on hand to last through vacations, holidays, and weekends.
- * Be sure to tell your doctor if you are pregnant. Animal studies have
- shown that some beta blockers can cause problems in pregnancy when used at
- very high doses. Studies have not been conducted in humans, but there has
- been some association between use of beta blockers during pregnancy and low
- birth weight, as well as breathing problems and slow heart rate in newborn
- infants. However, other reports have shown no effects on newborn infants.
- Also, tell your doctor if you are breast-feeding an infant. Although problems
- in humans have not been reported, small amounts of this medication may pass
- into breast milk, so caution is warranted.
-
- ----------------
-
- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
-