Atenolol + nifedipine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult: PO Angina pectoris Per cap contains atenolol 50 mg and nifedipine (sustained release) 20 mg: 1 cap 2 times/day. Hypertension Per cap contains atenolol 50 mg and nifedipine (sustained release) 20 mg: 1 cap 1-2 times/day.
Contraindications
History of wheezing, asthma, obstructive respiratory disease, pronounced bradycardia (resting heart rate <50 beats/min prior to treatment), 2nd or 3rd degree heart block, sick sinus syndrome, SA block, systolic pressure <90 mmHg, overt or decompensated cardiac failure (NYHA grades III & IV), aortic stenosis, unstable angina, acute attacks of angina, acute MI or within 1 mth of MI, or for secondary prevention of MI, cardiogenic shock, severe peripheral arterial circulatory disorders, acidosis, severe renal impairment, untreated phaeochromocytoma, malignant hypertension. Lactation, pregnancy, women of child-bearing age.
Special Precautions
Conduction defects, poor cardiac reserve, controlled CHF, peripheral circulatory disorders, 1st degree heart block, mild heart failure (NYHA grade II), Prinzmetal's angina, renal or hepatic impairment. Discontinue use if heart rate is reduced at a dose of 1 capsule daily or if there is ischaemic pain within 1-4 hr of initiation of therapy. Withdraw gradually in patients with ischaemic heart disease. Adjustment in diabetic control may be required; may mask signs of thyrotoxicosis and modifies tachycardia of hypoglycaemia. Family history of psoriasis.
Adverse Reactions
Headache, flushing, purpura, impotence, dizziness, GI upsets, oedema, fatigue.
Drug Interactions
If used with clonidine, atenolol can worsen rebound hypertension following clonidine withdrawal. Reduced hypotensive effect of atenolol with ibuprofen and indometacin. May increase digoxin level and AV conduction time. Theophylline levels may be increased. Reduced efficacy of nifedipine with phenytoin, carbamazepine or phenobarbital. Increased plasma levels of nifedipine with cisapride, quinupristin/dalfopristin, nefazodone, valproic acid and other CYP3A4 enzyme inhibitors (e.g. erythromycin, ketoconazole, itraconazole, fluconazole, fluoxetine, protease inhibitors). May potentiate the action of non-depolarising muscle relaxants. Vagal dominance may occur with anaesthetic agents with cardiac depressant effects. Increased antihypertensive effect with cimetidine, TCAs, narcotics, barbiturates, nitrates or phenothiazines. Additive myocardial depression with lidocaine, chloroform, procainamide, β-adrenoceptor stimulants (e.g. isoprenaline) and α-adrenoceptor stimulants (e.g. noradrenaline). Nifedipine may reduce quinidine levels and increase tacrolimus levels. Marked heart rate reduction with reserpine, methyldopa, clonidine, guanethidine. Increased hypoglycaemia with insulin and oral antidiabetics. Potentiation of atrial conduction time and -ve inotropic effect with class I anti-arrhythmics (e.g. disopyramide and amiodarone).
ATC Classification
C07AB03 - atenolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.
C08CA05 - nifedipine ; Belongs to the class of dihydropyridine derivative selective calcium-channel blockers with mainly vascular effects. Used in the treatment of cardiovascular diseases.
Disclaimer: This information is independently developed by CIMS based on atenolol + nifedipine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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