Patient's Query
Hello doctor,
I have been taking Atenolol for the past six years, which was prescribed to manage my high heart rate. It worked well for the first five years; however, over the past year, it has negatively impacted my life. I experience low energy levels and often feel lightheaded and dizzy. I am currently taking 100 mg daily and am unsure of what to do next.
Please help.
Hello,
Welcome to icliniq.com.
It is likely that your low heart rate and blood pressure are induced by Atenolol. First, you need to have your blood pressure and pulse rate checked. I recommend purchasing an electronic blood pressure monitor that displays both your blood pressure and pulse rate. Alternatively, you can visit a nearby physician or manually count your pulse for one minute.
The next appropriate step is to reduce your dose, especially if either or both parameters are low. Consider decreasing the dose to 50 mg once a day and monitor your response. If your blood pressure is found to be low, you may also consider taking an oral rehydration salts (ORS) solution. Please let me know if you experience any symptoms such as black, tarry stools, abdominal pain, or vomiting.
I hope this information helps, and feel free to reach out if you have any questions.
Patient's Query
Hello doctor,
Thank you for your response.
Usually, my blood pressure is around 120/75 mmHg, and sometimes it is 130/70 mmHg. My pulse is typically high in the morning, but when I take Atenolol, it decreases to about 75 beats per minute. I have had two echocardiograms in the last six years, and nothing abnormal was found. It was determined that being a larger individual, my heart just beats a bit faster. I also take Azilsartan and Chlorthalidone for my blood pressure.
Hello,
Welcome back to icliniq.com.
We need to gradually taper off or reduce the dose of Atenolol, as you are developing side effects. A pulse rate of less than 100 beats per minute (BPM) is acceptable. The pulse rate may occasionally rise, but if it is below 100 BPM most of the time, that is alright. We will also reduce the dosage to 50 mg and monitor your response for a week. If the response is satisfactory, we can continue with that dose. If not, we will discontinue Atenolol and switch to another beta-blocker for your heart rate, such as Metoprolol XR (extended-release tablets) at a dose of 25 mg once a day, which we will gradually increase to 50 mg or more if needed.
Additionally, if you have not done so already, you should have your thyroid profile checked to investigate potential causes. I also noticed that your reported weight is quite high, which could indicate that your elevated heart rate is due to obstructive sleep apnea, a condition that may require definitive treatment.
I hope this helps you.
Thank you.
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Answered byDr. Sagar Ramesh Makode
Medically reviewed byDr. K. Shobana
Same symptoms don't mean you have the same problem. Consult a doctor now!
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