Therabloc Special Precautions

Patients with bronchospastic disease should, in general, not receive β-blockers. Because of its relative β₁-selectivity, however, atenolol may be used with caution in patients with bronchospastic disease who do not respond to, or cannot tolerate other antihypertensive treatment. Since β₁-selectivity is not absolute, the lowest possible dose of atenolol should be used with therapy initiated at 50 mg and β₂-stimulating agent should be made available. Atenolol should be used with caution in patients with diabetes mellitus. The drug may mask the tachycardia but usually not the dizziness and sweating seen with insulin-induced hypoglycemia. β-Blocking agents, especially the nonselective ones, may potentially precipitate severe acute hyperglycemia.
Atenolol should be used with caution in patients undergoing major surgery involving general anesthesia. It is not advisable to withdraw β-adrenoreceptor-blocking drugs prior to surgery in the majority of patients. However, care should be exercised when using anesthetic agents eg, those which may depress the myocardium.
Atenolol should be used with caution and in reduced dosage in patients with impaired renal function, especially when creatinine clearance is <35 mL/min/1.73 m². It is recommended that patients receiving atenolol after hemodialysis be administered with Therabloc under close supervision in a hospital setting, since marked hypotension may occur.
Use in children: There is no pediatric experience with atenolol and for this reason, it is not recommended for pediatric use. Safety and efficacy of atenolol in children have not been established.