Atenolol 50 mg tablets 30
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Atenolol - 50 mg.
It has antianginal, antihypertensive and antiarrhythmic effects. It does not have membrane-stabilizing and internal sympathomimetic activity.
Reduces the formation of cyclic adenosine monophosphate (cAMP) stimulated by catecholamines from adenosine triphosphate (ATP), reduces intracellular current ca2 +.
In the first 24 hours after oral administration, against the background of a decrease in cardiac output, there is a reactive increase in the total peripheral resistance of the vessels, which within 1-3 days gradually returns to the original, and then gradually decreases.
Hypotensive effect is associated with a decrease in the minute volume of blood, a decrease in activity renin-angiotensin system, sensitivity of baroreceptors and effects on the central nervous system.
The hypotensive effect is manifested by both a decrease in systolic and diastolic blood pressure (BP), a decrease in shock and minute blood volumes.
In medium therapeutic doses, it does not affect the tone of the peripheral arteries. The hypotensive effect lasts 24 hours, with regular use it stabilizes by the end of the second week of treatment.
The antianginal effect is determined by a decrease in myocardial oxygen demand as a result of a decrease in heart rate (lengthening of diastole and improvement of myocardial perfusion) and contractility, as well as a decrease in myocardial sensitivity to the effects of sympathetic stimulation.
Reduces the heart rate (heart rate) at rest and during physical exertion. By increasing the final diastolic pressure in the left ventricle and increasing muscle stretching Ventricular fibers can increase the need for oxygen, especially in patients with chronic heart failure.
The antiarrhythmic effect is manifested by the suppression of sinus tachycardia and is associated with the elimination of arrhythmogenic sympathetic influences on the conducting system of the heart, a decrease in the rate of propagation of excitation through the sinoatrial node and an elongation of the refractory period.
Inhibits the conduction of impulses in the antegrade and to a lesser extent in the retrograde direction through the AV (atrioventricular) node and along additional pathways.
The negative chronotropic effect manifests itself 1 hour after administration, reaches a maximum after 2-4 hours, lasts up to 24 hours.
Reduces the automatism of the sinus node, reduces heart rate, slows down AV conduction, reduces myocardial contractility, reduces the need for myocardium in oxygen. Reduces myocardial excitability.
When used in medium therapeutic doses has a less pronounced effect on the smooth muscles of the bronchi and peripheral arteries than non-selective beta-blockers.
Increases the survival rate of patients who have had myocardial infarction (reduces the incidence of ventricular arrhythmias and angina attacks).
Practically does not weaken the bronchodilating effect of isoproterenol.
Unlike non-selective beta-blockers, when administered in medium therapeutic doses, it has a less pronounced effect on organs containing beta2-adrenergic receptors (pancreas, skeletal muscles, smooth muscles of peripheral arteries, bronchi and uterus), and on carbohydrate metabolism; the severity of the atherogenic action does not differ from the action of propranolol.
To a lesser extent, it has a negative batmo-, chrono-, foreign- and dromotropic effect. When used in large doses (more than 100 mg / day), it has a blocking effect on both subtypes of beta-adrenergic receptors.
Absorption from the gastrointestinal tract - fast, incomplete (50-60%), bioavailability - 40-50%, TCmaxkrovi - 2-4 h. Poorly penetrates the blood-brain barrier, passes in small quantities through the placental barrier and into breast milk.
The connection with blood plasma proteins is 6-16%. It is practically not metabolized in the liver. T1 / 2 - 6-9 h (increases in elderly patients). It is excreted by the kidneys by glomerular filtration (85-100% unchanged).
Impaired renal function is accompanied by prolongation of T1 / 2 and cumulation: with QC below 35 ml / min / 1.73 m2 T1 / 2 is 16-27 h, with QC below 15 ml / min / 1.73 m2 - more than 27 h (dose reduction is necessary). It is excreted during hemodialysis.
Indications for use
- arterial hypertension;
- prevention of angina attacks (with the exception of Prinzmetal's angina);
- heart rhythm disorders: sinus tachycardia, prevention of supraventricular tachyarrhythmia, ventricular extrasystole.
- cardiogenic shock;
- atrioventricular (AV) blockade II-III degrees;
- severe bradycardia (heart rate less than 40 beats / min.);
- syndrome of weakness of the sinus node;
- sinoauricular blockade;
- acute or chronic heart failure in the stage of decompensation;
- cardiomegaly without signs of heart failure;
- Prinzmetal's angina;
- arterial hypotension (in case of use in myocardial infarction;
- systolic blood pressure less than 100 mm Hg);
- lactation period;
- simultaneous administration of monoamine oxidase inhibitors (MAO);
- age up to 18 years (the efficacy and safety of the drug have not been established);
- hypersensitivity to the drug.
With caution: diabetes mellitus, metabolic acidosis, hypoglycemia, allergic reactions in the anamnesis, chronic obstructive pulmonary disease (including emphysema of the lungs), AV blockade of the I degree, chronic heart failure (compensated), obliterating diseases of peripheral vessels ("intermittent" claudication, Raynaud's syndrome), pheochromocytoma, liver failure, chronic renal failure, myasthenia gravis, thyrotoxicosis, depression (including a history), psoriasis, old age, pregnancy.
Dosage and Administration
Assign inside before meals, without chewing, washed down with a small amount of liquid.
Arterial hypertension. Treatment begins with 50 mg of atenolol 1 time per day. To achieve a stable hypotensive effect, 1 -2 are required weeks of admission.
With insufficient severity of the hypotensive effect, the dose is increased to 100 mg in one dose. A further increase in the dose is not recommended, since it is not accompanied by an increase in the clinical effect.
In coronary heart disease, tachysystolic heart rhythm disorders - 50 mg 1 time per day.
Angina pectoris. The initial dose is 50 mg per day. If within a week the optimal therapeutic effect is not achieved, increase the dose to 100 mg per day.
Elderly patients and patients with impaired excretory function of the kidneys need correction of the dosage regimen.
In the presence of renal failure, dose adjustment is recommended depending on the creatinine clearance. In patients with renal insufficiency with creatinine clearance values above 35 ml / min . / 1.73 m2 (normal values are 100-150 ml / min . / 1.73 m2), significant cumulation of atenolol does not occur.
Cardiovascular system: development (aggravation) of symptoms of chronic heart failure (swelling of the ankles, feet, shortness of breath), impaired atrioventricular conduction, arrhythmias, bradycardia, a pronounced decrease in blood pressure, palpitations, weakening of myocardial contractility, orthostatic hypotension, manifestations of angiospasm (cooling of the lower extremities, Raynaud's syndrome), vasculitis, chest pain.
CNS: dizziness, decreased ability to concentrate, decreased reaction rate, drowsiness or insomnia, depression, hallucinations, fatigue, headache, weakness, "nightmare" dreams, anxiety, confusion or short-term memory loss, paresthesia in the limbs (in patients with "intermittent" claudication and Raynaud's syndrome), muscle weakness, convulsions.
Gastrointestinal tract: dry mouth, nausea, vomiting, diarrhea, abdominal pain, constipation or diarrhea, change in taste.
Respiratory system: dyspnea, bronchospasm, apnea, nasal congestion.
Hematological reactions: platelet purpura, anemia (aplastic), thrombosis.
Endocrine system: decreased potency, decreased libido, hyperglycemia (in patients with non-insulin-dependent diabetes mellitus), hypoglycemia (in patients receiving insulin), hypothyroid condition.
Skin reactions: urticaria, dermatitis, skin itching, photosensitivity, increased sweating, skin flushing, exacerbation of psoriasis, reversible alopecia.
Sensory organs: visual impairment, decreased secretion of tear fluid, dryness and soreness of the eyes, conjunctivitis.
Effect on the fetus: intrauterine growth retardation, hypoglycemia, bradycardia. Laboratory indicators: agranulocytosis, leukopenia, increased activity of "hepatic" enzymes, hyperbilirubinemia, thrombocytopenia (unusual bleeding and hemorrhage).
Other: back pain, arthrapgia, the syndrome of "withdrawal" (tachycardia, increased frequency of angina attacks, increased blood pressure, etc.).
The frequency of side effects increases with increasing dose of the drug.
In a dry, dark place at a temperature not exceeding 25 ° C. Store in places inaccessible to children.
- Dosage form
- 50 mg
- Number of tablets
- INN Russian