Atenolol And Chlorthalidone
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Questions & Answers
Side Effects & Adverse Reactions
Sympathetic stimulation is necessary in supporting circulatory function in congestive heart failure, and beta blockade carries the potential hazard of further depressing myocardial contractility and precipitating more severe failure. In patients who have congestive heart failure controlled by digitalis and/or diuretics, atenolol and chlorthalidone should be administered cautiously. Both digitalis and atenolol slow AV conduction.
IN PATIENTS WITHOUT A HISTORY OF CARDIAC FAILURE, continued depression of the myocardium with beta-blocking agents over a period of time can, in some cases, lead to cardiac failure. At the first sign or symptom of impending cardiac failure, patients should be treated appropriately according to currently recommended guidelines, and the response observed closely. If cardiac failure continues despite adequate treatment, atenolol and chlorthalidone should be withdrawn. (SeeDOSAGE AND ADMINISTRATION.)
Since atenolol is excreted via the kidneys, atenolol and chlorthalidone should be used with caution in patients with impaired renal function.
In patients with renal disease, thiazides may precipitate azotemia. Since cumulative effects may develop in the presence of impaired renal function, if progressive renal impairment becomes evident, atenolol and chlorthalidone should be discontinued.
In patients with impaired hepatic function or progressive liver disease, minor alterations in fluid and electrolyte balance may precipitate hepatic coma. Atenolol and chlorthalidone should be used with caution in these patients.
Following abrupt cessation of therapy with certain beta-blocking agents in patients with coronary artery disease, exacerbations of angina pectoris and, in some cases, myocardial infarction have been reported. Therefore, such patients should be cautioned against interruption of therapy without the physician’s advice. Even in the absence of overt angina pectoris, when discontinuation of atenolol and chlorthalidone is planned, the patient should be carefully observed and should be advised to limit physical activity to a minimum. Atenolol and chlorthalidone should be reinstated if withdrawal symptoms occur. Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue atenolol and chlorthalidone therapy abruptly even in patients treated only for hypertension.
Bradycardia and heart block can occur and the left ventricular end diastolic pressure can rise when beta-blockers are administered with verapamil or diltiazem. Patients with pre-existing conduction abnormalities or left ventricular dysfunction are particularly susceptible. (SeePRECAUTIONS.)
PATIENTS WITH BRONCHOSPASTIC DISEASE SHOULD, IN GENERAL, NOT RECEIVE BETA BLOCKERS. Because of its relative beta1-selectivity, however, atenolol and chlorthalidone may be used with caution in patients with bronchospastic disease who do not respond to or cannot tolerate, other antihypertensive treatment. Since beta1-selectivity is not absolute, the lowest possible dose of atenolol and chlorthalidone should be used and a beta2-stimulating agent (bronchodilator) should be made available. If dosage must be increased, dividing the dose should be considered in order to achieve lower peak blood levels.
It is not advisable to withdraw beta-adrenoreceptor blocking drugs prior to surgery in the majority of patients. However, care should be taken when using anesthetic agents such as those which may depress the myocardium. Vagal dominance, if it occurs, may be corrected with atropine (1-2 mg IV).
Beta blockers are competitive inhibitors of beta-receptor agonists and their effects on the heart can be reversed by administration of such agents; e.g., dobutamine or isoproterenol with caution (see section onOVERDOSAGE).
Atenolol and chlorthalidone may be used with caution in diabetic patients. Beta blockers may mask tachycardia occurring with hypoglycemia, but other manifestations such as dizziness and sweating may not be significantly affected. At recommended doses atenolol does not potentiate insulin-induced hypoglycemia and, unlike nonselective beta blockers, does not delay recovery of blood glucose to normal levels.
Insulin requirements in diabetic patients may be increased, decreased or unchanged; latent diabetes mellitus may become manifest during chlorthalidone administration.
Beta-adrenergic blockade may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism. Abrupt withdrawal of beta blockade might precipitate a thyroid storm; therefore, patients suspected of developing thyrotoxicosis from whom atenolol and chlorthalidone therapy is to be withdrawn should be monitored closely.
Because calcium excretion is decreased by thiazides, atenolol and chlorthalidone should be discontinued before carrying out tests for parathyroid function. Pathologic changes in the parathyroid glands, with hypercalcemia and hypophosphatemia, have been observed in a few patients on prolonged thiazide therapy; however, the common complications of hyperparathyroidism such as renal lithiasis, bone resorption, and peptic ulceration have not been seen.
Hyperuricemia may occur, or acute gout may be precipitated in certain patients receiving thiazide therapy.
Atenolol and chlorthalidone tablets should not be given to patients with untreated pheochromocytoma.
Atenolol can cause fetal harm when administered to a pregnant woman. Atenolol crosses the placental barrier and appears in cord blood. Administration of atenolol, starting in the second trimester of pregnancy, has been associated with the birth of infants that are small for gestational age. No studies have been performed on the use of atenolol in the first trimester and the possibility of fetal injury cannot be excluded. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.
Neonates born to mothers who are receiving atenolol at parturition or breast-feeding may be at risk for hypoglycemia and bradycardia. Caution should be exercised when atenolol and chlorthalidone is administered during pregnancy or to a woman who is breast-feeding. (SeePRECAUTIONS, Nursing Mothers.)
Atenolol and chlorthalidone was studied for teratogenic potential in the rat and rabbit. Doses of atenolol/chlorthalidone of 8/2, 80/20 and 240/60 mg/kg/day were administered orally to pregnant rats with no evidence of embryofetotoxicity observed. Two studies were conducted in rabbits. In the first study, pregnant rabbits were dosed with 8/2, 80/20 and 160/40 mg/kg/day of atenolol/chlorthalidone. No teratogenic effects were noted, but embryonic resorptions were observed at all dose levels (ranging from approximately 5 times to 100 times the maximum recommended human dose*). In the second rabbit study, doses of atenolol/chlorthalidone were 4/1, 8/2 and 20/5 mg/kg/day. No teratogenic or embryotoxic effects were demonstrated.
Atenolol - Atenolol has been shown to produce a dose-related increase in embryo/fetal resorptions in rats at doses equal to or greater than 50 mg/kg/day or 25 or more times the maximum recommended human antihypertensive dose.* Although similar effects were not seen in rabbits, the compound was not evaluated in rabbits at doses above 25 mg/kg/day or 12.5 times the maximum recommended human antihypertensive dose.*
*Based on the maximum dose of 100 mg/day in a 50 kg patient.
Chlorthalidone - Thiazides cross the placental barrier and appear in cord blood. The use of chlorthalidone and related drugs in pregnant women requires that the anticipated benefits of the drug be weighed against possible hazards to the fetus. These hazards include fetal or neonatal jaundice, thrombocytopenia and possibly other adverse reactions which have occurred in the adult.
Legal Issues
There is currently no legal information available for this drug.
FDA Safety Alerts
There are currently no FDA safety alerts available for this drug.
Manufacturer Warnings
There is currently no manufacturer warning information available for this drug.
FDA Labeling Changes
There are currently no FDA labeling changes available for this drug.
Uses
Atenolol and chlorthalidone tablets are indicated in the treatment of hypertension. This fixed dose combination drug is not indicated for initial therapy of hypertension. If the fixed dose combination represents the dose appropriate to the individual patient’s needs, it may be more convenient than the separate components.
History
There is currently no drug history available for this drug.
Other Information
Atenolol and chlorthalidone tablets are for the treatment of hypertension. It combines the antihypertensive activity of two agents: a beta1-selective (cardioselective) hydrophilic blocking agent (atenolol), and a monosulfonamyl diuretic (chlorthalidone). Atenolol is Benzeneacetamide, 4-[2-hydroxy-3-[(1-methylethyl)amino]propoxy]-. It has the following structural formula:
C14H22N2O3 M.W. 266.34
Atenolol (free base) is a relatively polar hydrophilic compound with a water solubility of 26.5 mg/mL at 37°C. It is freely soluble in 1N HCl (300 mg/mL at 25°C) and less soluble in chloroform (3 mg/mL at 25°C).
Chlorthalidone is 2-Chloro-5-(1-hydroxy-3-oxo-1-isoindolinyl)benzenesulfonamide. Chlorthalidone has a water solubility of 12 mg/100 mL at 20°C. It has the following structural formula:
C14H11ClN2O4S M.W. 338.77
Each atenolol and chlorthalidone tablet 50 mg-25 mg for oral administration contains: atenolol USP, 50 mg and chlorthalidone USP, 25 mg.
Each atenolol and chlorthalidone tablet 100 mg-25 mg for oral administration contains: atenolol USP, 100 mg and chlorthalidone USP, 25 mg.
Atenolol and Chlorthalidone Tablets USP, 50 mg-25 mg and 100 mg-25 mg, contain the following inactive ingredients: magnesium stearate, microcrystalline cellulose, povidone and sodium starch glycolate.
Sources
Atenolol And Chlorthalidone Manufacturers
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Physicians Total Care, Inc.
![Atenolol And Chlorthalidone Tablet [Physicians Total Care, Inc.]](/wp-content/themes/bootstrap/assets/img/loading2.gif)
Atenolol And Chlorthalidone | Physicians Total Care, Inc.
DOSAGE MUST BE INDIVIDUALIZED (SEEINDICATIONS AND USAGE): Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone 50 mg-25 mg tablet given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone 100 mg-25 mg tablet given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73 m2 (normal range is 100-150 mL/min/1.73 m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance Atenolol Elimination (mL/min/1.73 m2) Half-life (hrs) Maximum Dosage 15-35 16-27 50 mg daily <15 >27 50 mg every other day -
Major Pharmaceutical
Atenolol And Chlorthalidone | Major Pharmaceutical
DOSAGE MUST BE INDIVIDUALIZED. (See INDICATIONS AND USAGE.)
Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone tablet 50 mg/25 mg given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone tablet 100 mg/25 mg given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50 percent of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73m2 (normal range is 100–150 mL/min/1.73m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance
(mL/min/1.73m2) Atenolol Elimination
Half-life (hrs) Maximum Dosage 15–35 16–27 50 mg daily <15 >27 50 mg every other day -
Pd-rx Pharmaceuticals, Inc.
Atenolol And Chlorthalidone | Pd-rx Pharmaceuticals, Inc.
DOSAGE MUST BE INDIVIDUALIZED (SEEINDICATIONS AND USAGE): Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone 50 mg-25 mg tablet given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone 100 mg-25 mg tablet given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73 m2 (normal range is 100-150 mL/min/1.73 m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance Atenolol Elimination (mL/min/1.73 m2) Half-life (hrs) Maximum Dosage 15-35 16-27 50 mg daily <15 >27 50 mg every other day -
Mutual Pharmaceutical Company, Inc.
Atenolol And Chlorthalidone | Mutual Pharmaceutical Company, Inc.
DOSAGE MUST BE INDIVIDUALIZED. (See INDICATIONS AND USAGE.)
Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone tablet 50 mg/25 mg given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone tablet 100 mg/25 mg given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50 percent of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73m2 (normal range is 100–150 mL/min/1.73m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance
(mL/min/1.73m2) Atenolol Elimination
Half-life (hrs)
Maximum Dosage 15–35 16–27 50 mg daily <15 >27 50 mg every other day -
Watson Laboratories, Inc.
Atenolol And Chlorthalidone | Watson Laboratories, Inc.
DOSAGE MUST BE INDIVIDUALIZED (SEE INDICATIONS AND USAGE): Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone 50 mg-25 mg tablet given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone 100 mg-25 mg tablet given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73 m2 (normal range is 100-150 mL/min/1.73 m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance Atenolol Elimination (mL/min/1.73 m2) Half-life (hrs) Maximum Dosage 15-35 16-27 50 mg daily <15 >27 50 mg every other day -
Bryant Ranch Prepack
Atenolol And Chlorthalidone | Bryant Ranch Prepack
DOSAGE MUST BE INDIVIDUALIZED (SEEINDICATIONS AND USAGE): Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone 50 mg-25 mg tablet given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone 100 mg-25 mg tablet given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73 m2 (normal range is 100-150 mL/min/1.73 m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance Atenolol Elimination (mL/min/1.73 m2) Half-life (hrs) Maximum Dosage 15-35 16-27 50 mg daily <15 >27 50 mg every other day -
Bryant Ranch Prepack
Atenolol And Chlorthalidone | Bryant Ranch Prepack
DOSAGE MUST BE INDIVIDUALIZED (SEEINDICATIONS AND USAGE): Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone 50 mg-25 mg tablet given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone 100 mg-25 mg tablet given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73 m2 (normal range is 100-150 mL/min/1.73 m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance Atenolol Elimination (mL/min/1.73 m2) Half-life (hrs) Maximum Dosage 15-35 16-27 50 mg daily <15 >27 50 mg every other day -
Mylan Pharmaceuticals Inc.
Atenolol And Chlorthalidone | Mylan Pharmaceuticals Inc.
DOSAGE MUST BE INDIVIDUALIZED (see INDICATIONS AND USAGE).
Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone tablet 50 mg/25 mg given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone tablet 100 mg/25 mg given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73m2 (normal range is 100 to 150 mL/min/1.73m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine
Atenolol
Clearance
Elimination
Maximum
(mL/min/1.73m2 )
Half-life (hrs)
Dosage
15 to 35
16 to 27
50 mg daily
< 15
> 27
50 mg every
other day -
Preferred Pharmaceuticals, Inc
Atenolol And Chlorthalidone | Preferred Pharmaceuticals, Inc
DOSAGE MUST BE INDIVIDUALIZED (SEEINDICATIONS AND USAGE): Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone 50 mg-25 mg tablet given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone 100 mg-25 mg tablet given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73 m2 (normal range is 100-150 mL/min/1.73 m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance Atenolol Elimination (mL/min/1.73 m2) Half-life (hrs) Maximum Dosage 15-35 16-27 50 mg daily <15 >27 50 mg every other day -
Preferred Pharmaceuticals, Inc
Atenolol And Chlorthalidone | Preferred Pharmaceuticals, Inc
DOSAGE MUST BE INDIVIDUALIZED (SEEINDICATIONS AND USAGE): Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone 50 mg-25 mg tablet given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone 100 mg-25 mg tablet given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73 m2 (normal range is 100-150 mL/min/1.73 m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance Atenolol Elimination (mL/min/1.73 m2) Half-life (hrs) Maximum Dosage 15-35 16-27 50 mg daily <15 >27 50 mg every other day -
Remedyrepack Inc.
Atenolol And Chlorthalidone | Remedyrepack Inc.
DOSAGE MUST BE INDIVIDUALIZED (see INDICATIONS AND USAGE).
Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone tablet 50 mg/25 mg given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone tablet 100 mg/25 mg given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73m2 (normal range is 100 to 150 mL/min/1.73m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine
Atenolol
Clearance
Elimination
Maximum
(mL/min/1.73m2 )
Half-life (hrs)
Dosage
15 to 35
16 to 27
50 mg daily
< 15
> 27
50 mg every
other day -
Remedyrepack Inc.
Atenolol And Chlorthalidone | Remedyrepack Inc.
DOSAGE MUST BE INDIVIDUALIZED (SEE INDICATIONS AND USAGE): Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone 50 mg-25 mg tablet given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone 100 mg-25 mg tablet given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73 m2 (normal range is 100-150 mL/min/1.73 m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance Atenolol Elimination (mL/min/1.73 m2) Half-life (hrs) Maximum Dosage 15-35 16-27 50 mg daily <15 >27 50 mg every other day -
Lake Erie Medical Dba Quality Care Products Llc
Atenolol And Chlorthalidone | Lake Erie Medical Dba Quality Care Products Llc
DOSAGE MUST BE INDIVIDUALIZED (see INDICATIONS AND USAGE).
Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone tablet 50 mg/25 mg given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone tablet 100 mg/25 mg given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73m2 (normal range is 100 to 150 mL/min/1.73m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine
Atenolol
Clearance
Elimination
Maximum
(mL/min/1.73m2 )
Half-life (hrs)
Dosage
15 to 35
16 to 27
50 mg daily
< 15
> 27
50 mg every
other day -
Aidarex Pharmaceuticals Llc
Atenolol And Chlorthalidone | Aidarex Pharmaceuticals Llc
DOSAGE MUST BE INDIVIDUALIZED (SEE INDICATIONS AND USAGE): Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone 50 mg-25 mg tablet given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone 100 mg-25 mg tablet given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73 m2 (normal range is 100-150 mL/min/1.73 m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance Atenolol Elimination (mL/min/1.73 m2) Half-life (hrs) Maximum Dosage 15-35 16-27 50 mg daily <15 >27 50 mg every other day -
Aphena Pharma Solutions – Tennessee, Llc
Atenolol And Chlorthalidone | Aphena Pharma Solutions - Tennessee, Llc
DOSAGE MUST BE INDIVIDUALIZED (SEE INDICATIONS AND USAGE): Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone 50 mg-25 mg tablet given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone 100 mg-25 mg tablet given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73 m2 (normal range is 100-150 mL/min/1.73 m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance Atenolol Elimination (mL/min/1.73 m2) Half-life (hrs) Maximum Dosage 15-35 16-27 50 mg daily <15 >27 50 mg every other day
![Atenolol And Chlorthalidone Tablet [Major Pharmaceutical]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=424a34e0-9100-4232-8de6-bc90c21e6b3f&name=atenolol-03.jpg)
![Atenolol And Chlorthalidone Tablet [Pd-rx Pharmaceuticals, Inc.]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=78b374f8-0e16-4c15-85c1-16609ac3aca2&name=55289993.jpg)
![Atenolol And Chlorthalidone Tablet [Mutual Pharmaceutical Company, Inc.]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=b4cfa459-c1c3-4fe2-ac2d-afeea2b96cca&name=atenolol-03.jpg)
![Atenolol And Chlorthalidone Tablet [Watson Laboratories, Inc.]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=a6794dfa-adbb-491b-9d48-f89a44e866c5&name=atenolol-and-chlorthalidone-tabs-3.jpg)
![Atenolol And Chlorthalidone Tablet [Bryant Ranch Prepack]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=b5de77fc-8b73-44eb-ab0f-27422a8d60b4&name=29091.jpg)
![Atenolol And Chlorthalidone Tablet [Bryant Ranch Prepack]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=1c3c2cbf-e307-4327-a044-69451aef66ae&name=37381.jpg)
![Atenolol And Chlorthalidone Tablet [Mylan Pharmaceuticals Inc.]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=99ae0271-47d8-4321-96e0-55124811df1a&name=a21ca876-4636-47e5-8c7b-9d23134f61bc-03.jpg)
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