Atenolol Nycomed
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Terms and conditions of storage
Atenolol Nycomed is a cardioselective beta 1 -adrenoceptor blocker with antihypertensive, antiarrhythmic, antianginal action.
Release form and composition
Dosage form - film-coated tablets: biconvex, capsule-shaped, white, with a dividing line and engraving "AB55" or "AB57" (30 pcs. In a plastic bottle).
1 tablet contains:
- active substance: atenolol - 50 mg ("AB55") or 100 mg ("AB57");
- auxiliary components: sodium lauryl sulfate, corn starch, magnesium stearate, magnesium carbonate, gelatin;
- shell composition: titanium dioxide, propylene glycol, hypromellose E15, talc.
Indications for use
- arterial hypertension;
- cardiac arrhythmias: prevention of supraventricular tachyarrhythmias, sinus tachycardia;
- prevention of attacks of stable angina pectoris (except for Prinzmetal's angina).
Contraindications
- cardiogenic shock, hypovolemic shock and other shock conditions;
- sinoatrial (SA) blockade;
- atrioventricular (AV) block II-III degree;
- severe bradycardia (heart rate (HR) less than 40 beats per minute);
- decompensated chronic heart failure or acute heart failure;
- sick sinus syndrome;
- Prinzmetal's angina;
- severe arterial hypotension (systolic blood pressure (BP) with myocardial infarction below 100 mm Hg);
- cardiomegaly without signs of chronic heart failure;
- simultaneous administration of monoamine oxidase inhibitors (MAO);
- pheochromocytoma (in the absence of concomitant therapy with alpha-blockers);
- period of breastfeeding;
- age up to 18 years;
- individual intolerance to the components of the drug.
It is recommended to prescribe Atenolol Nycomed with caution in case of AV blockade of the 1st degree, compensated chronic heart failure, type 1 and 2 diabetes mellitus, hypoglycemia, metabolic acidosis, history of allergic reactions, bronchial asthma, chronic obstructive pulmonary disease, pulmonary emphysema, obliterating peripheral vascular diseases (Raynaud's syndrome, intermittent claudication), liver failure, myasthenia gravis, chronic renal failure, pheochromocytoma (only with the simultaneous use of alpha-blockers), thyrotoxicosis, psoriasis, depression (including history), during pregnancy, in elderly patients.
Method of administration and dosage
The tablets are taken orally before meals, swallowing whole and drinking plenty of liquid.
The frequency of admission is 1 time per day.
Recommended dosage regimen:
- arterial hypertension: the initial dose is 50 mg, a stable hypotensive effect occurs after 1-2 weeks of regular intake. In case of insufficient hypotensive effect, the daily dose can be increased to 100 mg. Higher doses should not be used, they do not enhance the hypotensive effect;
- angina pectoris: the initial dose is 50 mg, in the absence of an optimal therapeutic effect after one week of therapy, the dose is increased to 100-200 mg per day.
In case of impaired renal excretory function and in elderly patients, correction of the dosage regimen is required.
In renal insufficiency, the dose is prescribed taking into account creatine clearance (CC):
- CC 15–35 ml / min: no more than 50 mg per day or 100 mg 1 time in 2 days;
- CC less than 15 ml / min: no more than 50 mg 1 time in 2 days or 100 mg 1 time in 4 days.
Patients on hemodialysis are prescribed 25 or 50 mg, the tablet should be taken immediately after each dialysis procedure, in a hospital, since a significant decrease in blood pressure is possible. Elderly patients should be given an initial dose of 25 mg, then, to achieve a clinical effect, it can be increased under the control of blood pressure and heart rate. Since a daily dose above 100 mg increases the risk of side effects without enhancing the therapeutic effect, it is not recommended to use it.
Side effects
- on the part of the cardiovascular system: often - cold feet, hypotension, bradycardia; rarely - arrhythmias, development or exacerbation of chronic heart failure, chest pain, AV blockade, peripheral edema, orthostatic hypotension, fainting, cardiac conduction disturbances, Raynaud's syndrome;
- from the digestive system: often - abdominal pain, constipation, diarrhea, nausea, vomiting; rarely - cholestasis, dryness of the oral mucosa;
- from the nervous system: often - muscle weakness, asthenia; infrequently - sleep disturbances (insomnia, drowsiness); rarely - psychosis, headache, nightmares, depression, hallucinations, confusion, short-term memory loss, dizziness, anxiety, paresthesia of the limbs (with intermittent claudication and Raynaud's syndrome), taste disturbances, convulsions; very rarely - myasthenia gravis;
- on the part of the respiratory system: rarely - nasal congestion, bronchospasm, shortness of breath (while taking high doses, individual predisposition), wheezing;
- from the senses: decreased secretion of tear fluid, conjunctivitis, blurred vision, soreness and dryness of the eyes;
- on the part of the skin: rarely - itchy skin, rash, purpura, reversible alopecia, exacerbation of psoriasis; very rarely - lupus-like syndrome, psoriasis-like skin rash, hypersensitivity reactions (including urticaria, angioedema);
- on the part of the endocrine system: infrequently - symptoms of hyperthyroidism, hypoglycemia (with the use of insulin), hyperglycemia (in patients with type 2 diabetes mellitus);
- laboratory indications: infrequently - an increase in the activity of liver enzymes; rarely - leukopenia, agranulocytosis, hyperbilirubinemia, thrombocytopenia; very rarely - a positive test for antinuclear antibodies;
- others: rarely - decreased potency; very rarely - decreased libido.
special instructions
The use of Atenolol Nycomed should be accompanied by regular monitoring of blood pressure and heart rate (daily - at the beginning of treatment, then once every 3-4 months). In addition, once every 4-5 months in patients with diabetes mellitus, the level of glucose concentration in the blood is checked, and in elderly patients, renal function is examined.
The patient should be trained in the method of self-counting heart rate and warned about the need to see a doctor if the heart rate is less than 50 beats per minute.
In patients with thyrotoxicosis, the drug can mask tachycardia and other clinical signs of the disease. It is contraindicated to abruptly cancel therapy, since symptoms may increase. With diabetes mellitus, taking the drug can hide tachycardia caused by hypoglycemia. Atenolol almost does not increase the hypoglycemia that developed during the use of insulin, and does not delay the recovery process to normal blood glucose levels.
Cancellation of the drug in patients with coronary heart disease should be carried out by a gradual (over two or more weeks) dose reduction, since abrupt withdrawal is associated with the risk of an increase in the frequency or severity of angina attacks.
The use of cardioselective beta-blockers in patients with obstructive airway pathologies should be prescribed only when absolutely indicated, or beta 2 -adrenomimetics should be recommended.
With bronchospastic diseases, the drug can be used in case of ineffectiveness and / or intolerance to other antihypertensive drugs. Treatment is recommended to be carried out strictly observing the dosage regimen in order to prevent the development of bronchospasm.
In case of planned surgery, the drug should be discontinued 48 hours before the onset of anesthesia; a drug with a minimal negative inotropic effect is used as an anesthetic.
In the case of combination therapy with clonidine, Atenolol Nycomed should be discontinued 1-3 days earlier in order not to cause a withdrawal syndrome.
Reserpine and other drugs that reduce the supply of catecholamines can enhance the effect of beta-blockers, therefore, when combining these drugs, patients need to ensure careful control of blood pressure in order to avoid a pronounced decrease or bradycardia.
With depression, the development of which is associated with the use of beta-blockers, therapy is recommended to be discontinued.
Verapamil can be administered intravenously no earlier than 48 hours after the last dose of the drug.
Abrupt withdrawal of the drug can cause the development of severe arrhythmias and myocardial infarction, therefore, therapy should be discontinued by gradually decreasing the dose over two or more weeks, by 25% every 3-4 days.
Patients with contact lenses should consider the effect of the drug on reducing tear production.
Against the background of the use of Atenolol Nycomed in elderly patients, arterial hypotension (systolic blood pressure below 100 mm Hg), increasing bradycardia (less than 40 beats per minute), AV blockade, ventricular arrhythmias, severe liver and / or kidney function disorders, or bronchospasm may develop, in this case, it is necessary to reduce the dose or cancel the treatment.
Before conducting studies to determine the content of catecholamines, vanillyl mandelic acid, normetanephrine in urine and blood, antinuclear antibody titers, stop taking the drug in 1-2 days.
Smoking reduces the effectiveness of beta-blockers.
The action of the drug can cause impaired concentration and reduce the speed of psychomotor reactions, therefore, patients are advised to be careful when driving vehicles and mechanisms.
Drug interactions
With the simultaneous use of Atenolol Nycomed:
- verapamil or diltiazem - cause mutual reinforcement of action;
- insulin, oral hypoglycemic agents - enhance their effect;
- different groups of antihypertensive drugs, nitrates - cause an increase in the antihypertensive effect;
- nifedipine - a significant decrease in blood pressure is possible;
- estrogens, NSAIDs, glucocorticosteroids - weaken the antihypertensive effect of the drug;
- amiodarone, cardiac glycosides - increase the risk of AV conduction disorders and the development of bradycardia;
- derivatives of xanthine, ergotamine - reduce the effectiveness of atenolol;
- lidocaine - reduces the rate of excretion, the risk of its toxic effect increases;
- phenothiazine derivatives - increase the serum concentration level of each drug;
- reserpine, methyldopa, clonidine, verapamil - can cause severe bradycardia;
- aminophylline, theophylline - can cause a mutual decrease in therapeutic effects;
- cimetidine - slows down metabolism, increasing the concentration in blood plasma;
- tricyclic and tetracyclic antidepressants, antipsychotics, hypnotics and sedatives, ethanol - enhance the depressing effect on the central nervous system;
- coumarins, non-depolarizing muscle relaxants - lengthen the period of their action;
- inhalation agents for anesthesia (hydrocarbon derivatives) - increase the risk of arterial hypertension, suppression of myocardial function;
- allergen extracts for skin tests, used for immunotherapy allergens - increase the risk of developing severe systemic allergic or anaphylactic reactions.
While taking Atenolol Nycomed, intravenous (IV) administration of diltiazem and verapamil can cause cardiac arrest, iodine-containing X-ray contrast agents - increase the risk of anaphylactic reactions.
Intravenous administration of phenytoin, the use of drugs for general anesthesia (derivatives of hydrocarbons) increase the likelihood of lowering blood pressure and the severity of the cardiodepressant effect.
With concomitant therapy with MAO inhibitors, the hypotensive effect of the drug is significantly enhanced, therefore this combination is contraindicated. You can start using each of the drugs only after a break in treatment of at least 14 days.
Terms and conditions of storage
Store in a place protected from light and moisture at temperatures up to 25 ° C. Keep out of the reach of children.
The shelf life is 5 years.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
