Atenolol

Atenolol tablets are an additional treatment to standard coronary care unit therapy. Elderly Patients or Patients with Renal Impairment Atenolol tablets are excreted by the kidneys; consequently dosage should be adjusted in cases of severe impairment of renal function. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Evaluation of patients with hypertension or myocardial infarction should always include assessment of renal function. Atenolol excretion would be expected to decrease with advancing age. No significant accumulation of atenolol tablets occur until creatinine clearance falls below 35 mL/min/1.73 m 2 . Accumulation of atenolol and prolongation of its half-life were studied in subjects with creatinine clearance between 5 mL/min and 105 mL/min.

Peak plasma levels were significantly increased in subjects with creatinine clearances below 30 mL/min. The following maximum oral dosages are recommended for elderly, renally-impaired patients and for patients with renal impairment due to other causes: Atenolol Creatinine Clearance (mL/min/1.73m 2 ) Elimination Half-Life (h) Maximum Dosage 15-35 16-27 50 mg daily < 15 > 27 25 mg daily Some renally-impaired or elderly patients being treated for hypertension may require a lower starting dose of atenolol tablets: 25 mg given as one tablet a day.

Patients on hemodialysis should be given 25 mg or 50 mg after each dialysis; this should be done under hospital supervision as marked falls in blood pressure can occur. Cessation of Therapy in Patients with Angina Pectoris If withdrawal of atenolol tablets therapy is planned, it should be achieved gradually and patients should be carefully observed and advised to limit physical activity to a minimum.

Dilutions of atenolol I.V. injection in Dextrose Injection USP, Sodium Chloride Injection USP, or Sodium Chloride and Dextrose Injection may be used. These admixtures are stable for 48 hours if they are not used immediately. In patients who tolerate the full intravenous dose (10 mg), atenolol tablets 50 mg should be initiated 10 minutes after the last intravenous dose followed by another 50 mg oral dose 12 hours later.