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Atenolol decreases the total peripheral resistance and as a result the blood pressure falls. It reduces the noradrenaline release from the sympathetic terminals due to beta-receptor blockade. The beta-receptor inhibition can cause a decrease in rennin release from kidney.

The common side effects reported with Tenormin are bradycardia, cold extremities, postural hypotension, leg pain, dizziness, vertigo, light headedness, tiredness, fatigue, lethargy, drowsiness, diarrhea, nausea and dyspepsia.

The dosage should be adjusted in patients with severe renal impairment. Reserpine can potentiate postural hypotension in patients on Tenormin therapy. Atenolol and disopyramide should never be administered together as it can cause severe bradycardia and heart failure. Atenolol is safe in asthmatics. Tenormin should be used with caution along with clonidine as it can cause rebound hypertension. Atenolol is not safe for pregnant women, nursing mothers and in pediatric patients. Tenormin is contraindicated in sinus bradycardia, sick sinus syndrome and second or third degree heart block. The patient should be advised to avoid activities that require alertness while using Tenormin. The patient should be advised of cold hands and feet during Tenormin treatment due to reduced blood flow.

The recommended starting dosage of Tenormin is 50mg once daily. The maximum dosage used is 100mg/day in adults. The dosage should be titrated slowly over a period of 1 to 2 weeks.