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How does it work?

This medicine contains two active ingredients, atenolol and bendroflumethiazide (previously called bendrofluazide in the UK). Atenolol belongs to a group of medicines called beta-blockers, which block beta receptors in the heart, lungs and other organs of the body. Blocking these receptors prevents the action of two chemicals called noradrenaline and adrenaline that occur naturally in the body. These are often referred to as the 'fight or flight' chemicals as they are responsible for the body's reaction to stressful situations. Blocking the beta receptors in the heart causes the heart to beat more slowly and with less force. This reduces the pressure at which blood is pumped out of the heart to the rest of the body. This is just one of the ways in which beta blockers help to reduce blood pressure, however, the whole mechanism is not fully understood. Bendroflumethiazide is a type of medicine called a thiazide diuretic. Thiazide diuretics act in the kidney to remove water from the blood into the urine, by causing an increase in the removal of salts such as potassium and sodium from the blood. This removal of salts causes water to be drawn out of the blood and into the kidneys, where it is then excreted in the urine. Removing water from the blood decreases the volume of fluid circulating through the blood vessels. The drop in fluid volume results in a drop in the pressure of the fluid within the blood vessels, which helps to lower high blood pressure. It also decreases the effort required by the heart to pump blood around the body. The combination of these two medicines is particularly useful in treating high blood pressure.

What is it used for?

- High blood pressure

Warning!

- This medicine may mask the symptoms of low blood sugar such as increased heart rate, tremor and nausea. People with diabetes should carefully monitor their blood sugar.
- You should not suddenly stop taking this medicine unless your doctor tells you otherwise.
- It is recommended that individuals taking this medicine have their fluid and salt (electrolyte) balance monitored regularly.
- If you experience any of the following symptoms while taking this medicine you should inform your doctor promptly, so that the amount of fluids and salts in your body can be checked: thirst, lethargy, confusion, weakness, drowsiness, muscle cramps, scanty production of urine, abnormal heart rhythm, seizures, nausea and vomiting.
- As diuretics cause your kidneys to produce more urine, you may prefer to take this medicine in the morning rather than before going to bed, as this will reduce the likelihood of you needing to get up in the night to visit the toilet. Seek further advice from your doctor or pharmacist.
- If you should require local or general anaesthesia, it is important that you inform your anaesthetist you are taking this medicine.

Use with caution in

- Abnormal muscle weakness
- Asthma
- Diabetes
- Elderly people
- Gout
- History of chronic obstuctive pulmonary disease
- Kidney disease
- Life long inherited blood diseases which can cause a variety of symptoms, including mental health problems (porphyrias)
- Liver disease
- Long-term inflammation of skin and some internal organs (systemic lupus erythematosus)

Not to be used in

- A problem common in the elderly, related to poor control of the working of the heart (sick sinus syndrome)
- Defect of the heart's electrical message pathways resulting in decreased function of the heart (heart block)
- Failure of the heart to maintain adequate circulation of blood (cardiogenic shock)
- High blood uric acid which is causing symptoms (hyperuricaemia)
- High levels of calcium in the blood (hypercalcaemia)
- Inadequate production of natural steroid hormones by the adrenal glands
- Low blood sodium levels (hyponatraemia)
- Low potassium blood levels that cannot be corrected (refractory hypokalaemia)
- Severe kidney disease
- Severe liver disease
- Tumour of the adrenal gland (phaeochromocytoma)
- Uncontrolled heart failure

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- This medicine should not be used in pregnancy. Seek medical advice from your doctor.
- This medicine should not be used by breastfeeding mothers. Discuss this with your doctor.

Label warnings

- Do not stop taking this medication except on your doctor's advice.

The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care or attention by a qualified practitioner. The materials in this web site cannot and should not be used as a basis for diagnosis or choice of treatment. Conditions for use

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