Tenoren Plus

Indications

Tenoren Plus is prescribed for managing hypertension to effectively lower blood pressure. Reducing blood pressure decreases the likelihood of cardiovascular events, particularly fatal and non-fatal strokes and heart attacks.
Use as directed by a registered healthcare professional.

Pharmacology

Atenolol and chlorthalidone are both commonly used, either individually or in combination, for hypertension treatment. Clinical studies confirm that when taken together as a single tablet, there is no interference in their bioavailability, making this combination a convenient treatment option for patients.

• Atenolol: A selective beta1-adrenergic blocker that works by:
  • Reducing heart rate and cardiac output at rest and during physical exertion
  • Lowering systolic and diastolic blood pressure
  • Preventing reflex orthostatic tachycardia
• Chlorthalidone: A long-acting diuretic that increases the excretion of sodium and chloride in the distal convoluted tubules of the nephron, effectively reducing blood pressure.

Dosage & Administration

The recommended initial dose is 50 mg of Atenolol and 25 mg of Chlorthalidone taken once daily. If the desired blood pressure reduction is not achieved, additional antihypertensive medication may be introduced gradually to avoid a significant drop in blood pressure. Atenolol is primarily excreted through the kidneys, so dosage adjustments are necessary in cases of severe renal dysfunction.

Use in the Elderly: Clinical trials involving the combination of Atenolol and Chlorthalidone have not included a sufficient number of elderly patients (aged 65 and above) to determine if their response differs from younger individuals.
Follow the instructions of a registered healthcare professional.

Interactions

• Tenoren Plus may enhance the effects of other antihypertensive medications when taken together.
• Concurrent use with catecholamine depleting drugs (e.g., reserpine) may lead to hypotension and/or significant bradycardia.
• Drugs like calcium channel blockers or Amiodarone may have an additive effect when combined with Tenoren Plus.
• Prostaglandin synthase inhibitors (e.g., indomethacin) may reduce the blood pressure-lowering effects of Atenolol.
• Both digitalis glycosides and beta-blockers slow atrioventricular conduction and heart rate, increasing the risk of bradycardia when used together.

Contraindications

Tenoren Plus should not be used in individuals who are hypersensitive to any of its components, including sulfonamide-derived drugs. It is also contraindicated in patients with:

• Sinus bradycardia
• Heart block greater than first degree
• Cardiogenic shock
• Overt heart failure
• Anuria

Side Effects

The side effects of Tenoren Plus are similar to those of its individual components:

• Atenolol: Bradycardia, cold extremities, postural hypotension, dizziness, fatigue, drowsiness, depression, nausea, wheezing, shortness of breath.
• Chlorthalidone: Orthostatic hypotension, anorexia, gastric irritation, vomiting, constipation, muscle weakness, photosensitivity, rash, hyperglycemia, and muscle cramps.

Pregnancy & Lactation

• Pregnancy Category D: The use of Tenoren Plus during pregnancy is not recommended unless clearly necessary.
• Caution is advised when administering to breastfeeding mothers.

Precautions & Warnings

• Tenoren Plus may exacerbate peripheral arterial circulatory issues.
• Regular monitoring of serum electrolytes is recommended to detect potential electrolyte imbalances.

Overdose Effects

While there is no specific information regarding overdose with Tenoren Plus, treatment should focus on supportive care. Any unabsorbed drug may be removed through induced vomiting or activated charcoal. Atenolol can be cleared from the bloodstream by hemodialysis. Care should also be taken to address dehydration, electrolyte disturbances, and hypotension.

Therapeutic Class

This medication is classified under combined antihypertensive preparations.

Storage Conditions

Store in a cool, dry place away from direct light.