NORMITAB PLUS
ATENOLOL AND CHLORTHALIDONE · by NABIQASIM
Composition
Tab50/12.5 mg: Atenolol 50 mg, chlorthalidone 12.5 mg. Tab100/25 mg: Atenolol 100 mg, chlorthalidone 25 mg.
Indications & Dosage
Hypertension: Adult: 50/12.5 mg tab daily, alternatively increased if necessary to 100/25 mg daily, doses higher than 50 mg atenolol rarely necessary. Angina: Adults: 100/25 mg tab once daily or 50/12.5 mg tab twice daily. Children: Not recommended.
Contraindications
Second or third degree heart block, cardiogenic shock.
Precautions
AV block, heart failure (avoid if un-controlled), peripheral arterial circulatory disorders (avoid if severe), Prinzmetals angina, myasthenia gravis, Ischaemic heart disease, withdraw gradually, history of bronchospasm, diabetes, hyperthyroidism, renal or hepatic impairment, psoriasis, elderly, consider withdrawal before elective surgery, anaphylaxis risk due to increased sensitivity to allergens, Always withdraw gradually over period of 1-2 weeks IV administration requires cardiac and blood pressure monitoring. Dose adjustment in renal impairment: with oral use max 50mg daily if eGFR15-35 ml/minute/1.73m2; max 25mg daily or 50 mg on alternate days if eGFR less than 15 ml/minute/1.73m2.With intravenous use max 10 mg on alternate days if eGFR15-35 ml/minute/1.73m2; max.10 mg every 4 days if eGFR less than 15 ml/minute/1.73m2.
Interactions
Verapamil, lithium, digitalis, or Class 1 antidys-rhythmic agents.
Pregnancy
Avoid. Use only when no safer alternative exists for a serious problem.
Lactation
Caution advised
Side Effects
Allergic interstitial nephritis, jaundice, Cold extremities, muscular fatigue, bradycardia, rashes and dry eyes (discontinue), nausea, dizziness, hyperuricaemia. Rare: Idiosyncratic reactions such as thrombocytopenia and leucopenia.