With simultaneous use of atenolol and insulin (or other oral hypoglycemic agents) masks the symptoms of hypoglycemia. In a joint application with antihypertensive agents other groups there is a strengthening of the hypotensive effect. Antihypertensive effect of weakening estrogens (sodium retention).
With the simultaneous use of atenolol and cardiac proviron side effects glycosides increase the risk of bradycardia and atrioventricular conduction disturbances. When concomitant administration of atenolol with reserpine, methyldopa, clonidine, verapamil may cause bradycardia. Patients receiving both atenolol and clonidine, clonidine overturned only after a few days after cessation of treatment with atenolol. At the same time taking atenolol with derivatives of ergotamine, xanthine – its efficiency is reduced.
Concomitant use with lidocaine may reduce its excretion and increase the risk of toxic effect.
The use of in conjunction with phenothiazine derivatives, increases the concentration of each drug in the blood serum.
Phenytoin at / in administration, funds for general anesthesia increase the severity cardiodepressive actions of atenolol. Not recommended simultaneous application with inhibitors. The allergens used for immunotherapy, or allergen extracts for skin tests and iodine-containing contrast media for the on / in the increase the risk of severe systemic allergic reactions or anaphylaxis.
Means for inhalation general anesthesia (derivatives of hydrocarbons) increase the risk of depression of myocardial function and marked reduction of blood pressure. Amiodarone increases the risk of bradycardia and depressing proviron side effects conduction. Cimetidine increases the concentration in plasma atenolol (slows metabolism).
Prolongs the effect of muscle relaxants nedepolyariziruyuschih, antikeagulyatsionny effect of coumarin.
Monitoring of patients should include monitoring of heart rate and blood pressure (at the beginning of treatment – daily, then 1 every 3-4 months), the control of blood glucose in patients with diabetes (1 every 4-5 months.). In elderly patients, it is recommended to monitor renal function (1 time in 4-5 months.).
It is necessary to train the patient’s heart rate calculation method and instruct on the need of medical advice in heart rate less than 50 / min. When thyrotoxicosis drug may mask certain clinical signs of hyperthyroidism (eg, tachycardia). Abrupt withdrawal in patients with thyrotoxicosis contraindicated because the symptoms can increase. In contrast, nonselective beta-blockers practically no increase insulin-induced hypoglycemia and delay recovery of blood glucose to normal levels.
In patients with coronary heart disease proviron side effects abrupt withdrawal of the drug may cause an increase in the frequency or severity of anginal attacks, so stopping at patients with coronary artery disease should be carried out gradually. Special attention also requires the selection of doses in patients with decompensated heart failure (compensated).
Special attention is needed in cases where the required surgery under general anesthesia. The drug should be discontinued 48 hours prior to surgery. As the anesthetic should be chosen prepazat with possible minimal negative inotropic effect. In an application with clonidine, reception Tenocheka stop for a few days before clonidine to avoid the syndrome of “cancellation” of the latter.
Perhaps increased severity of the allergic reaction and the lack of effect of conventional doses of epinephrine with aggravated allergic history. Drugs that reduce the reserves of catecholamines (eg, reserpine), may enhance the effect of beta-blockers, so patients taking these combinations of drugs should be under constant medical supervision in order to identify pronounced reduction in blood pressure and bradycardia. In the event of elderly patients with severe bradycardia proviron side effects, marked reduction of blood pressure (systolic blood pressure below 100 mm Hg, AV block, bronchospasm, ventricular arrhythmias, severe liver and kidney function, the dose should be reduced or stop treatment With the development of depression caused by drug intake -. it is recommended to discontinue therapy.
If necessary intravenous administration of verapamil, it should be done at least 48 hours after receiving Tenocheka.
When using atenolol may decrease the production of tear fluid, which is important for patients using contact lenses. Do not abruptly discontinue the treatment because of the risk of severe arrhythmias and myocardial infarction. The lifting is carried out gradually, reducing the dose for 2 weeks or more (reduce dose by 25% in 3-4 days).
It is necessary to cancel a preparation prior to the study concentration in the blood and urine catecholamines, vanillylmandelic acid. antinuclear antibody titers smokers efficacy of beta-blockers lower.
Do not abruptly cancel proviron side effects in patients with coronary heart disease.