DESCRIPTION
id: 0088ed6b-1c5d-44a5-8445-aae2d9104933
displayName: DESCRIPTION SECTION
FDA Article Code: 34089-3
Atenolol, USP, a synthetic, beta1-selective (cardioselective) adrenoreceptor blocking agent, may be chemically described as Benzeneacetamide, 4-[2′-hydroxy-3′-[(1-methylethyl)amino]propoxy]-. The molecular and structural formulas are:
Atenolol (free base) has a molecular weight of 266.34. It is a relatively polar hydrophilic compound with a water solubility of 26.5 mg/mL at 37°C and a log partition coefficient (octanol/water) of 0.23. It is freely soluble in 1N HCl (300 mg/mL at 25°C) and less soluble in chloroform (3 mg/mL at 25°C).
Each tablet for oral administration contains 25 mg, 50 mg or 100 mg of atenolol, USP and the following inactive ingredients: colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose, sodium lauryl sulfate and sodium starch glycolate.
CLINICAL PHARMACOLOGY
id: 0f9b4daf-d578-476f-a79f-068361e4722c
displayName: CLINICAL PHARMACOLOGY SECTION
FDA Article Code: 34090-1
Atenolol is a beta1-selective (cardioselective) beta-adrenergic receptor blocking agent without membrane stabilizing or intrinsic sympathomimetic (partial agonist) activities. This preferential effect is not absolute, however, and at higher doses, atenolol inhibits beta2-adrenoreceptors, chiefly located in the bronchial and vascular musculature.
CONTRAINDICATIONS
id: c193e158-3409-4f5c-842a-cfdaffb50cb6
displayName: CONTRAINDICATIONS SECTION
FDA Article Code: 34070-3
Atenolol tablets are contraindicated in sinus bradycardia, heart block greater than first-degree, cardiogenic shock and overt cardiac failure. (See WARNINGS.)
Atenolol is contraindicated in those patients with a history of hypersensitivity to the atenolol or any of the drug product’s components.
ADVERSE REACTIONS
id: 0d2d74bf-4f15-4ff4-81fe-fbe94cbf94c9
displayName: ADVERSE REACTIONS SECTION
FDA Article Code: 34084-4
Most adverse effects have been mild and transient.
The frequency estimates in the following table were derived from controlled studies in hypertensive patients in which adverse reactions were either volunteered by the patient (U.S. studies) or elicited, e.g., by checklist (foreign studies). The reported frequency of elicited adverse effects was higher for both atenolol and placebo-treated patients than when these reactions were volunteered. Where frequency of adverse effects of atenolol and placebo is similar, causal relationship to atenolol is uncertain.
|
Volunteered (U.S. Studies) |
Total-Volunteered and Elicited (Foreign + U.S. Studies) |
|
Atenolol (n = 164) % |
Placebo (n = 206) % |
Atenolol (n = 399) % |
Placebo (n = 407) % |
CARDIOVASCULAR
|
|
|
Bradycardia
|
3
|
0
|
3
|
0
|
Cold Extremities
|
0
|
0.5
|
12
|
5
|
Postural Hypotension
|
2
|
1
|
4
|
5
|
Leg Pain
|
0
|
0.5
|
3
|
1
|
CENTRAL NERVOUS SYSTEM/NEUROMUSCULAR
|
|
|
Dizziness
|
4
|
1
|
13
|
6
|
Vertigo
|
2
|
0.5
|
2
|
0.2
|
Light-Headedness
|
1
|
0
|
3
|
0.7
|
Tiredness
|
0.6
|
0.5
|
26
|
13
|
Fatigue
|
3
|
1
|
6
|
5
|
Lethargy
|
1
|
0
|
3
|
0.7
|
Drowsiness
|
0.6
|
0
|
2
|
0.5
|
Depression
|
0.6
|
0.5
|
12
|
9
|
Dreaming
|
0
|
0
|
3
|
1
|
GASTROINTESTINAL
|
|
|
Diarrhea
|
2
|
0
|
3
|
2
|
Nausea
|
4
|
1
|
3
|
1
|
RESPIRATORY (see WARNINGS)
|
|
|
Wheeziness
|
0
|
0
|
3
|
3
|
Dyspnea
|
0.6
|
1
|
6
|
4
|
OVERDOSAGE
id: 35f3cba1-6d54-4bce-b5a6-18a8bbfcb013
displayName: OVERDOSAGE SECTION
FDA Article Code: 34088-5
Overdosage with atenolol has been reported with patients surviving acute doses as high as 5 g. One death was reported in a man who may have taken as much as 10 g acutely.
The predominant symptoms reported following atenolol overdose are lethargy, disorder of respiratory drive, wheezing, sinus pause and bradycardia. Additionally, common effects associated with overdosage of any beta-adrenergic blocking agent and which might also be expected in atenolol overdose are congestive heart failure, hypotension, bronchospasm and/or hypoglycemia.
Treatment of overdose should be directed to the removal of any unabsorbed drug by induced emesis, gastric lavage or administration of activated charcoal. Atenolol can be removed from the general circulation by hemodialysis. Other treatment modalities should be employed at the physician’s discretion and may include:
Bradycardia: Atropine intravenously. If there is no response to vagal blockade, give isoproterenol cautiously. In refractory cases, a transvenous cardiac pacemaker may be indicated.
Heart Block (second or third degree): Isoproterenol or transvenous cardiac pacemaker.
Cardiac Failure: Digitalize the patient and administer a diuretic. Glucagon has been reported to be useful.
Hypotension: Vasopressors such as dopamine or norepinephrine (levarterenol). Monitor blood pressure continuously.
Bronchospasm: A beta2 stimulant such as isoproterenol or terbutaline and/or aminophylline.
Hypoglycemia: Intravenous glucose.
Based on the severity of symptoms, management may require intensive support care and facilities for applying cardiac and respiratory support.
HOW SUPPLIED
id: 3b7b6143-e11a-4efa-8211-4dfc7345426e
displayName: HOW SUPPLIED SECTION
FDA Article Code: 34069-5
Atenolol Tablets, USP are available containing 25 mg, 50 mg or 100 mg of atenolol, USP.
The 25 mg tablets are white to off-white round, unscored tablets debossed with A2 on one side of the tablet and M on the other side.
The 50 mg tablets are white round, scored tablets debossed with 231 above the score on one side of the tablet and M on the other side. They are available as follows:
NDC 0615-3532-39
blistercards of 30 tablets
NDC 0615-3532-31
blistercards of 31 tablets
NDC 0615-3532-05
blistercards of 15 tablets
NDC 0615-3532-30
unit-dose boxes of 30 tablets
The 100 mg tablets are white round, unscored tablets debossed with M on one side of the tablet and 757 on the other side.
Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]
Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.
Mylan Pharmaceuticals Inc.
Morgantown, WV 26505 U.S.A.
REVISED JANUARY 2013
ATEN:R25
PRINCIPAL DISPLAY PANEL
id: 746c72fd-93ef-441a-9586-caa3ff58aeb6
displayName: PACKAGE LABEL.PRINCIPAL DISPLAY PANEL
FDA Article Code: 51945-4