Tenorox

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Tenorox: instructions for use and reviews

1. Release form and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Use in childhood
11. In case of impaired renal function
12. For violations of liver function
13. Use in the elderly
14. Drug interactions
15. Analogs
16. Terms and conditions of storage
17. Terms of dispensing from pharmacies
18. Reviews
19. Price in pharmacies

Latin name: Tenorox

ATX code: C07BB03

Active ingredient: atenolol (Atenolol) + chlortalidone (Chlortalidone)

Manufacturer: Oxford Laboratories Pvt. Ltd. (Oxford Laboratories Pvt. Ltd.) (India)

Description and photo update: 2020-05-02

Tenorox is an antihypertensive combination drug.

Release form and composition

The drug is produced in the form of coated tablets and coated tablets, forte: biconvex, round, with a dividing line on one side; the shell is almost white or white, at the break there is a homogeneous core of almost white color (10 pieces in a strip of aluminum foil, 10 strips in a cardboard box; 14 pieces in a blister, 2 blisters in a cardboard box. Each pack also contains instructions on the use of Tenorox).

1 tablet contains:

active substances: atenolol - 50 mg + chlorthalidone - 12.5 mg (coated tablet) or atenolol - 100 mg + chlorthalidone - 25 mg (coated tablet, forte);
additional components: corn starch, lactose, sodium lauryl sulfate, purified talc, povidone, colloidal silicon dioxide, magnesium stearate, hydroxypropyl methylcellulose, carbon tetrachloride, titanium dioxide, light liquid paraffin, polyethylene glycol-400, white beeswax, carropyl alcohol wax, isopropyl alcohol methylene chloride.

Pharmacological properties

Pharmacodynamics

Tenorox is a combined drug with a long-term antihypertensive effect. The effect of the drug is due to the action of its two active substances - β ₁ -adrenergic blocker and diuretic:

atenolol: cardioselective β ₁ adrenoblokator advantageously act on the β ₁ adrenergic receptors of the heart; with an increase in the dose, the selectivity of the agent decreases; does not show membrane stabilizing and internal sympathomimetic effects; as well as other β-blockers, it exhibits a negative inotropic effect, reduces the frequency of heart contractions, as a result of which it is not recommended for use in heart failure;
Chlorthalidone: a non-thiazide sulfanilamide diuretic that enhances the excretion of sodium and chlorine; provides an increase in the release of magnesium, potassium and bicarbonate.

The combination of atenolol with diuretics is acceptable and in most cases more effective than taking each of the components separately.

Pharmacokinetics

After oral administration, atenolol is absorbed from the gastrointestinal tract (GIT) by 50%. In blood plasma, its maximum concentration (C _max) is observed 2–4 hours after administration. In the liver, only a small part of atenolol is metabolized, and over 90% of the absorbed agent is excreted unchanged. The half-life (T _1/2) is approximately equal to 6-9 hours, but it can increase in the presence of a pronounced degree of renal failure, since the excretion of this substance is carried out mainly through the kidneys. Atenolol binds to plasma proteins by about 6-16%.

Chlorthalidone after oral administration is absorbed from the gastrointestinal tract by 60%, in the blood plasma C _max is fixed after about 12 hours. T _1/2 is an average of 50 hours, the agent is excreted mainly through the kidneys. Chlorthalidone binds to plasma proteins by about 75%.

Chlorthalidone and atenolol, when taken simultaneously, have an insignificant effect on the pharmacokinetics of each other.

Tenorox after a single oral daily dose is effective for at least 24 hours.

Indications for use

Tenorox is recommended for the treatment of arterial hypertension.

Contraindications

Absolute:

cardiogenic shock;
severe bradycardia;
severe arterial hypotension;
metabolic acidosis;
significant violations of peripheral circulation;
heart failure (acute and chronic);
sick sinus syndrome;
atrioventricular block (AV block) of II and III degrees;
Prinzmetal's angina;
pheochromocytoma;
obstructive bronchitis, bronchial asthma;
hypokalemia, diabetes mellitus;
myasthenia gravis;
gout;
acute renal failure (ARF);
acute hepatitis;
pregnancy;
period of breastfeeding;
age up to 18 years;
hypersensitivity to any of the constituents of the drug.

Relative (Tenorox tablets should be used with extreme caution):

1st degree AV block;
broncho-obstructive syndrome; with a deterioration in bronchial conductivity caused by taking the drug, treatment with β-adrenomimetics (for example, salbutamol) is indicated.

Tenorox, instructions for use: method and dosage

Tenorox tablets are taken orally 1 tablet per day, swallowed whole, without chewing.

The recommended starting dose of atenolol is 50 mg once a day. In case of insufficient severity of the effect, take 1 tablet forte containing atenolol at a dose of 100 mg.

After a long course of treatment, the cancellation of Tenorox should, if possible, be carried out gradually, since it contains a β-blocker.

Side effects

Tenorox is generally well tolerated. Adverse events caused by taking it are rare and are usually transient and mild.

blood and lymphatic system: purpura, eosinophilia, agranulocytosis; rarely - leukopenia, thrombocytopenia;
nervous system: increased fatigue, sleep disturbances, apathy, headache, dizziness, emotional lability, confusion, disorientation, acute psychosis, hallucinations, paresthesias;
cardiovascular system: cold extremities, worsening symptoms of heart failure, bradycardia; orthostatic hypotension, accompanied by fainting; cardiac arrhythmias, including AV block; symptoms of intermittent claudication, Raynaud's syndrome;
respiratory system: bronchospasm in patients with bronchial asthma or with a history of its development;
digestive system: dry mouth, nausea (caused by chlorthalidone), anorexia, constipation / diarrhea, pancreatitis; rarely - an increase in serum levels of hepatic transaminases, hepatotoxicity with symptoms of intrahepatic cholestasis;
sense organs: visual impairment;
skin: skin rash, exacerbation of psoriasis, psoriasis-like skin reactions, alopecia;
laboratory parameters: hyponatremia (due to chlorthalidone), hyperuricemia; hypokalemia (impaired glucose tolerance), Tenorox should be used with extreme caution in patients with a known tendency to diabetes mellitus;
others: an increase in the number of antinuclear antibodies (the clinical significance of this fact has not been established), a decrease in potency.

Overdose

Symptoms of an overdose of Tenorox can be increased drowsiness, a significant decrease in blood pressure (BP), severe bradycardia, acute heart failure (AHF), bronchospasm, convulsions.

If an overdose is suspected, the patient is shown careful observation and stay in the intensive care unit. Gastric lavage is performed, to prevent absorption of the drug remaining in the gastrointestinal tract, activated charcoal and laxatives are taken. With bronchospasm, bronchodilators are prescribed, with a decrease in blood pressure and shock - plasma or plasma substitutes. It is possible to use hemodialysis or hemoperfusion. In case of significant diuresis, fluids and electrolytes are administered.

special instructions

Special instructions associated with taking atenolol

Tenorox can mask the signs of hypoglycemia and thyrotoxicosis.

In the case of the development of bradycardia against the background of treatment (a decrease in the heart rate up to 50 beats per minute), it is necessary to reduce the dose or stop taking the drug.

You should not abruptly stop using Tenorox in patients with coronary artery disease (CHD).

In smokers, the therapeutic effect of the drug may be weaker.

If surgery is required under general anesthesia, Tenorox should be discontinued 48 hours before surgery.

During the treatment period, sensitivity to allergens may increase, which exacerbates the risk of severe anaphylactic reactions. Individuals on desensitized therapy should use the drug with extreme caution, since for such patients, the usual doses of epinephrine prescribed for the treatment of allergic reactions may not be sufficient.

Against the background of the use of Tenorox, there may be a decrease in the production of tear fluid, which should be taken into account by patients when wearing contact lenses.

Special instructions associated with taking chlorthalidone

Due to the risk of hypokalemia, potassium concentration should be monitored regularly, especially in elderly patients, in patients with heart failure receiving cardiac glycosides, in individuals with an unbalanced diet (low potassium content) or with complaints of functional gastrointestinal disorders.

When Tenorox is combined with cardiac glycosides, hypokalemia can provoke arrhythmias.

During therapy, hyperuricemia may occur; an increase in serum uric acid levels in the blood may sometimes require the use of uric acid excretion agents.

In the vast majority of patients, taking Tenorox at a dose of 1 tablet forte per day demonstrates satisfactory results. With an increase in the dose of a means of further lowering blood pressure, either it is not fixed, or it is insignificant, however, if necessary, additional use of another antihypertensive drug is allowed.

Influence on the ability to drive vehicles and complex mechanisms

It is unlikely that Tenorox therapy can adversely affect the ability to drive a car or operate complex equipment. However, the risk of increased fatigue and dizziness should be considered while taking the drug. Adverse reactions are intensified with the simultaneous administration of ethanol.

Application during pregnancy and lactation

The use of the drug is contraindicated for pregnant and lactating women.

Pediatric use

Patients under 18 years of age are not prescribed Tenorox.

With impaired renal function

Tenorox is contraindicated in patients with acute renal failure.

Patients with functional impairment of the kidneys should take the drug with caution.

For violations of liver function

In the presence of acute hepatitis, drug therapy is not prescribed.

Use in the elderly

Elderly patients often need a lower dose of Tenorox - ½ tablet with 50 mg atenolol.

Drug interactions

cardiac glycosides: the time of AV conduction increases when combined with β-blockers;
dihydropyridines, including nifedipine: the threat of a pronounced decrease in blood pressure in persons with latent heart failure is aggravated, signs of circulatory disorders may appear;
sympathomimetic agents (norepinephrine, epinephrine): a pronounced increase in blood pressure is possible due to the neutralization of the effect of β-blockers;
class I antiarrhythmics (including disopyramide): the cardiodepressive effect is summed up when combined with β-blockers;
salicylates (in high doses): the toxic effect of these funds on the central nervous system (CNS) may be aggravated;
non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, indomethacin; estrogens, salicylates: the hypotensive effect of Tenorox is weakened;
lithium preparations: the renal clearance of lithium decreases as a result of the action of diuretics;
clonidine: there is an increased risk of exacerbation of rebound hypertension, which may develop after discontinuation of this drug; with the combined use of these funds, Tenorox should be discontinued several days before the end of the course of treatment with clonidine; if it is necessary to switch from clonidine to Tenorox, the latter should be used only a few days after the withdrawal of clonidine;
angiotensin-converting enzyme (ACE) inhibitors (enalapril, captopril): a sharp increase in the hypotensive effect is possible at the beginning of joint therapy, therefore, caution should be exercised with this combination;
monoamine oxidase (MAO) inhibitors: there is an increase in blood pressure; the combination is not recommended;
curariform muscle relaxants: the effect of these drugs is enhanced;
means for general anesthesia: in combination with Tenorox, the threat of arterial hypotension is aggravated; it is necessary to use a general anesthetic that shows, if possible, the minimum negative inotropic effect; it is required to avoid the use of drugs for general anesthesia, leading to a decrease in myocardial contractility;
carbenoxolone, furosemide, glucocorticoids, amphotericin B: there is an increase in potassium excretion;
barbiturates, diuretics, phenothiazines, tricyclic antidepressants, vasodilators and other antihypertensive drugs, ethanol: an increase in the antihypertensive effect is possible;
calcium channel blockers (CCBs) (diltiazem, verapamil): it is possible to increase the negative inotropic effect against a background of reduced myocardial contractility and / or violations of sinoarterial or AV conduction, which can cause a pronounced decrease in blood pressure, severe bradycardia and heart failure; CCBs should not be administered intravenously for 48 hours after the end of Tenorox;
guanfacine, reserpine, clonidine: severe bradycardia may develop;
oral antidiabetic drugs, insulin: the effect of these drugs may increase; signs of hypoglycemia may include general weakness, increased sweating, tremor, tachycardia, decreased tone of the eyeball; blood glucose should be monitored regularly.

Analogs

The analogs of Tenorox are AtheHexal compositum, Tenoric, Tenoretic, Atenolol compositum Sandoz, Tenonorm, etc.

Terms and conditions of storage

Store in a place out of the reach of children, protected from light and moisture, at a temperature below 25 ° C.

The shelf life is 3 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Tenorox

Currently, there are no reviews on Tenorox on specialized sites, on the basis of which it would be possible to objectively assess the effectiveness and disadvantages of this tool.

The price of Tenorox in pharmacies

The average price for Tenorox, film-coated tablets can be (for a package containing 28 pcs.): 50 mg / 12.5 mg - 120 rubles; 100 mg / 25 mg - 150 rubles.

Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!