Tenif

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How does it work?

This medicine contains two active ingredients, atenolol and nifedipine. 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. The heart, therefore uses less energy and the pain of angina is prevented. Due to the heart beating more slowly and with less force, the pressure at which blood is pumped out of the heart to the rest of the body is reduced. This is just one of the ways in which beta blockers help to reduce blood pressure, however, the whole mechanism is not fully understood. Nifedipine belongs to a group of medicines called calcium channel blockers, which act on the heart and blood vessels. Nifedipine slows the movement of calcium through cells, which has two effects. Firstly, it decreases the rate at which the heart beats. As a result, the heart uses less energy and the pain of angina is prevented. Secondly, it has a widening effect on blood vessels and therefore reduces blood pressure. The combination of these two medicines is particularly useful in the treatment of angina and high blood pressure.

What is it used for?

- Angina pectoris
- High blood pressure

Warning!

- Unless your doctor or pharmacist tells you otherwise, you should avoid drinking grapefruit juice while taking this medicine, as it may affect the level of this medicine in your blood.
- 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.
- This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.
- You should not suddenly stop taking this medicine unless your doctor tells you otherwise.
- If you should require local or general anaesthesia, it is important that you inform your anaesthetist you are taking this medicine.
- This medicine should not be used to treat an angina attack, as it does not work quickly enough. It should be used regularly, as prescribed, to prevent angina attacks, and you should keep your glyceryl trinitrate (GTN) sublingual tablets or spray with you at all times to use if you do have an angina attack.

Use with caution in

- Chronic obstructive pulmonary disease
- Defects of the heart's electrical message pathways, causing irregular heartbeats (heart conduction defects)
- Diabetes mellitus
- Elderly people
- Heart failure
- History of allergies
- History of asthma or wheezing
- Hyperthyroidism
- Liver disease
- Narrowing of arteries in the extremities (peripheral arterial disease)
- Potential inability of the heart to carry out its normal function (latent cardiac insufficiency)
- Psoriasis

Not to be used in

- A problem common in the elderly, related to poor control of the working of the heart (sick sinus syndrome)
- Allergy to some other calcium channel blockers
- Angina not well controlled by medical treatment
- Breastfeeding
- Children
- 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 pressure which does not respond to treatment
- Increased acid levels in the blood (metabolic acidosis)
- Low blood pressure (hypotension)
- Narrowing of the main artery coming from the heart (aortic stenosis)
- People who have had a heart attack in the last month
- Pregnancy
- Prevention of further heart attacks following an initial heart attack
- Severe narrowing of arteries in the extremities (peripheral arterial disease)
- Severely decreased kidney function
- Slow heart rate of less than 50 beats per minute (bradycardia)
- Uncontrolled heart failure
- Untreated tumour of the adrenal gland (phaeochromocytoma)
- Women of child-bearing age

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, as it may be harmful to the foetus and may also inhibit labour.
- This medicine passes into breast milk. Breastfeeding is not recommended when taking this medicine. Seek medical advice from your doctor.

Label warnings

- Do not stop taking this medication except on your doctor's advice.
- This medication is to be swallowed whole, not chewed.

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