Tenoric is a combined antihypertensive drug that can have a prolonged hypotensive effect.
The therapeutic effect of this drug is due to its two components. Atenolol is a blocker that inhibits vascular and heart receptor activity. Chlorthalidone is a component that has a diuretic property that has a positive effect on lowering pressure.
The maximum concentration of the active components of Tenoric in the patient's blood is observed 2-3 hours after taking the pill, and its hypotensive effect persists throughout the day. The diuretic effect of the drug can be observed for about 24-48 hours.
By the end of the 2nd week of tenoric course treatment, patients have a persistent hypotensive effect.
Terms of sale from pharmacies
You can buy by prescription.
How much does tenoric in pharmacies? The average price is 190 rubles.
Composition and release form
Tenoric is produced in the form of tablets or tablets forte, film-coated: almost white or white, biconvex, round, with dividing risks on one side (10 pieces in strips, 10 strips in a cardboard box; 14 pieces in strips or blisters, 2 strips or blisters in a carton box).
The composition of 1 tablet contains the active substances:
- Atenolol - 50 (tablets) or 100 (tablets forte) mg;
- Chlorthalidone - 12.5 (tablets) or 25 (tablets forte) mg.
Auxiliary components: corn starch, lactose, polyvinylpyrrolidone, sodium lauryl sulfate, talc, isopropanol, colloidal silicon dioxide, magnesium stearate.
The composition of the film shell: methylene chloride, isopropanol, liquid paraffin, hypromellose, talc, titanium dioxide, macrogol.
Atenolol is a cardioselective β1-adrenergic blocker. Its selectivity decreases with increasing dosage. Atenolol has a negative inotropic effect, reduces the heart rate.
Chlorthalidone refers to diuretics, enhancing excretion of sodium, chlorine, potassium, magnesium and bicarbonate. Up to the end it is unclear what is the reason for its antihypertensive effect, possibly with the excretion of sodium.
Action from the drug persists throughout the day. After ingestion, 40 to 50% of atenolol is adsorbed from the digestive tract. Its maximum concentration is observed 2-4 hours after taking the pill, only 6 to 16% binds to plasma proteins. Almost 90% of atenolol from the body is excreted unchanged, its half-life can vary from 6 to 9 hours, it can increase with kidney pathologies, since atenolol is excreted mainly in the urine.
After ingestion, about 60% of chlorthalidone is adsorbed from the digestive tract, and up to 75% is bound to proteins. The maximum concentration of the diuretic is reached after 12 hours, it is excreted by the kidneys, the half-life is about 50 hours.
Indications for use
The only medical indication for using Tenoric pills is hypertension (increased systemic blood pressure).
- pheochromocytoma (without combined use with alpha-blockers);
- sick sinus syndrome;
- acute heart failure and chronic heart failure in the stage of decompensation;
- acute hepatitis;
- hereditary lactose intolerance, galactose / glucose malabsorption syndrome and lactase deficiency;
- collapse, cardiogenic shock;
- pronounced disorders of the peripheral circulation;
- arterial hypotension in severe course (with systolic pressure below 90 mmHg);
- myasthenia gravis;
- metabolic acidosis;
- refractory hypokalemia;
- atrioventricular block II and III;
- renal failure (with creatinine clearance less than 35 ml / min);
- age up to 18 years (safety profile for this group of patients has not been studied);
- individual intolerance to the components of the drug.
Relative (application of Tenoric requires caution in the presence of the following diseases / conditions):
- Prinzmetal angina pectoris;
- atrioventricular block I degree;
- chronic obstructive pulmonary disease, bronchial asthma;
- impaired renal function and water-electrolyte balance of blood;
- elderly age.
It is not recommended to assign Tenoric to lactating and pregnant women.
Appointment during pregnancy and lactation
In most cases, Tenoric is not prescribed to women during pregnancy or lactation, because its components are able to penetrate the placental barrier and into breast milk, having a negative impact on the health of the fetus or child.
Dosage and method of use
As indicated in the instructions for use, the dosing regimen is given in terms of atenolol.
- The average dose of Tenoric for adults is 100 mg; the initial dose is 50 mg 1 time / day.
As a rule, the use of the drug in a dose corresponding to 100 mg of atenolol, gives a good clinical effect. Subsequent increase in dose or does not lead to a further decrease in blood pressure, or reduces it very slightly. If necessary, an additional antihypertensive agent may be prescribed.
- Elderly patients should be prescribed in lower doses.
- When prescribing the drug to patients with impaired renal function, reduce the frequency of taking the drug.
After long-term administration of Tenoric, the drug should be discontinued gradually.
The drug is very well tolerated, and the side effects are usually mild and transient.
When taking the drug, the following side effects are possible:
- intermittent claudication, AV blockade, arrhythmia, and Raynaud's syndrome;
- paresthesia, apathy, fatigue, blurred vision, disorientation;
- orthostatic hypotension, bradycardia, increased symptoms of heart failure, cold extremity - from the cardiovascular system;
- from the nervous system side: dizziness, confusion, mood swings, headache, hallucinations, acute psychosis, sleep disturbances;
- alopecia, photosensitivity, exacerbation of psoriasis, skin rash, dry eyes.
Sometimes taking the drug can cause side effects from the gastrointestinal tract and the hematopoietic system, but they are much less common.
The symptoms that indicate an overdose include the following:
- severe bradycardia,
- increased drowsiness,
- acute heart failure.
Symptomatic treatment, it is necessary to carefully monitor the doctor for the patient's condition, in severe cases, hospitalization, gastric lavage, taking laxatives and activated carbon are indicated.
When bronchospasm occurs, bronchodilators are used, with a significant decrease in pressure, plasma or plasma substitutes are injected, and diuresis are injected with liquid.
Before you start using the drug, read the specific instructions:
- Do not abruptly abolish Tenoric in patients with coronary heart disease.
- Reduced therapeutic effect of the drug may be observed in smokers.
- It should be borne in mind that the use of Tenorica may mask the phenomenon of hypoglycemia and thyrotoxicosis.
- With the development of bradycardia during treatment (with a heart rate of up to 50 beats per minute) with clinical symptoms, it is necessary to reduce the dose or cancel therapy.
- Reception of Tenoric should be stopped 2 days before surgery, and as an anesthetic it is recommended to choose a drug with the least possible negative inotropic effect.
- Tenoric is prescribed with caution to patients with broncho-obstructive syndrome, and with worsening bronchial conduction, beta-adrenomimetics should be prescribed.
- When using Tenoric, it is possible to reduce the production of tear fluid, which is important for patients who use contact lenses.
- Tenoric should be prescribed with caution to patients with AV block I degree, as well as with functional impairment of the kidneys.
- During therapy, there is the likelihood of impaired glucose tolerance, and therefore the drug should be used with caution in patients with a predisposition to diabetes.
- During treatment, hyperuricemia may develop, usually minor, but in some cases it may be necessary to use drugs that promote the excretion of uric acid.
- During therapy, it is possible to increase sensitivity to allergens and the development of severe anaphylactic reactions. Therefore, patients receiving desensitization therapy should take Tenoric with great care. Such patients may not respond to the average dose of epinephrine (epinephrine) used in the treatment of allergic reactions.
- When using the drug may develop hypokalemia, and therefore the need to control the content of serum potassium. This applies particularly to patients receiving cardiac glycosides for the treatment of heart failure (arrhythmias may develop), patients with an unbalanced diet (with a reduced potassium content) and patients with complaints of disorders of the gastrointestinal tract.
The question of whether it is possible to drive a car needs to be addressed after assessing the individual tolerance of Tenorica.
Interaction with other drugs
When using the drug, you must consider the interaction with other drugs:
- With the simultaneous appointment of Tenoric with reserpine, clonidine, guanfacine, the occurrence of severe bradycardia may occur.
- Simultaneous use of tenoric with dihydropyridine derivatives (nifedipine) may increase the risk of arterial hypotension, in patients with latent heart failure, signs of circulatory disorders may appear.
- Cardiac glycosides in combination with beta-blockers may increase AV conductivity time.
- Preparations containing lithium should not be used with diuretics, since they can reduce the renal clearance of lithium.
- The use of beta-blockers together with general anesthesia can lead to an increased risk of arterial hypotension and the summation of the negative inotropic effect of both drugs (anesthetic should be used with minimal negative inotropic effect). It is also possible to enhance the action of curare-like muscle relaxants.
- When using the drug Tenoric with MAO inhibitors, it is possible to increase blood pressure (this combination should be avoided).
- With simultaneous use of the drug Tenoric with ACE inhibitors (captopril, enalapril) at the beginning of therapy, a sharp increase in the antihypertensive effect is possible.
- When combined with tenoric GCS, amphotericin B, furosemide may increase excretion of potassium.
- When combined with Tenoric, the effect of insulin and oral hypoglycemic agents may decrease (the level of glucose in the blood should be monitored).
- Tricyclic antidepressants, barbiturates, phenothiazines, diuretics, vasodilators, and other antihypertensive drugs may enhance the anti-hypertensive effect of Tenoric.
- Beta-blockers may exacerbate ricochet hypertension, which may occur after clonidine withdrawal. If both drugs are prescribed, taking a beta-blocker should be stopped a few days before discontinuing clonidine. If it is necessary to replace clonidine with a beta-blocker, the latter should be prescribed a few days after discontinuation of therapy with clonidine.
- It is necessary to carefully appoint a beta-blocker in combination with class I antiarrhythmic agents (disopyramide), since cardiodepressive effect can be added up.
- The concomitant use of sympathomimetic drugs, such as epinephrine (adrenaline), norepinephrine (norepinephrine), can neutralize the effect of beta-blockers and lead to a significant increase in blood pressure.
- Salicylates and NSAIDs (ibuprofen, indomethacin), estrogens can reduce the hypotensive effect of beta-blockers, and the use of salicylates in a high dose may increase the toxic effect of salicylates on the central nervous system.
- The use of beta-blockers in combination with calcium channel blockers that have a negative inotropic effect, such as verapamil, diltiazem, can lead to an increase in this effect, especially in patients with reduced myocardial contractility and / or with impaired sinoatrial or AV conduction, which can be the cause of severe arterial hypotension, severe bradycardia and heart failure (calcium channel blocker should not be used in / for 48 hours after withdrawal of the beta-blocker) .
We offer you to read the reviews of people who used the drug Tenoric:
- Olga Saw tenoric 7 years old everything is fine now high sugar memory is not in the chest presses shorter than all symp. which in anotation and so I took them pressure 130 90 pulse 60 I was assigned to them at the Institute of Cardiology, the professor said they were taken only by those who had a high pulse and I took the second digits in total for the quarter.
- Alexander. After treating a stroke, Tenorik was prescribed to the mother by the attending doctor, recommended as the most effective and in her situation a vital medicine for the normalization of pressure. The course has been drunk for several years, and, I must say, the doctor was right, a very effective drug.
- Lyudmila. It was a very good drug. It took tenorics for a long time, but then He disappeared from the sale in Kazakhstan. She was forced to stop taking these pills. And she went and left. The doctors prescribed some pills, then others. They try to prescribe expensive medications now the income of their patients. Just some business has become and not a treatment from doctors. I am very sad that I think that not only me.
Structural analogues of the active substance:
- Atehexal Compositum;
- Atenolol compositum;
Before buying an analogue, consult your doctor.
Shelf life and storage conditions
Tenoric tablets shelf life is 3 years. They should be stored in the original factory packaging, in a dark, dry, out of the reach of children place at an air temperature not higher than + 25 ° C.