Atenolol/Chlorthalidone, Oral a-TEN-oh-lole klor-THAL-i-done

What are other names for this medicine?

Type of medicine: beta blocker; diuretic

Generic and brand names: atenolol and chlorthalidone, oral; Tenoretic-50; Tenoretic-100

What is this medicine used for?

This medicine is a combination of a beta blocker and a diuretic (water pill). It is taken by mouth to treat high blood pressure.

It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a tumor of the adrenal gland
• asthma, emphysema, or other lung problems
• depression
• diabetes
• glaucoma
• gout
• heart disease
• high cholesterol or high triglyceride levels in the blood
• imbalances of sodium, potassium, magnesium, or calcium in the blood
• liver or kidney problems
• lupus
• problems with blood circulation such as Raynaud's syndrome
• thyroid problems

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are taking this medicine.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Take it regularly, even if you feel better, to control your blood pressure.

The diuretic in this medicine may increase how much and how often you urinate. You may need to take the last dose of the day by 6Â PM to avoid interrupting your sleep at night.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: extreme tiredness, trouble breathing, wheezing, slow heartbeat, chest pain, swelling, lightheadedness, fainting, nausea, weakness, dizziness.

What should I watch out for?

Do not stop taking this medicine without your healthcare provider's approval. You must reduce your dosage gradually to avoid serious heart-related effects.

You need check your pulse and blood pressure regularly so you can report any unusual slowing of your heart rate or other side effects. You also need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may cause eye problems that could lead to vision loss. Contact your healthcare provider right away if you have eye pain or a decrease in vision.

This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or operate machinery unless you are fully alert.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help. If you feel dizzy or faint while you are standing, lie down for a while and then get up slowly. Also, drinking alcohol may make it worse. Do not drink alcohol unless your healthcare provider approves.

Be careful when exercising, especially in hot weather. Talk with your provider about this.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist that you are taking this medicine.

Talk with your healthcare provider about whether you should eat foods high in potassium such as bananas, melons, raisins, and dates while taking this medicine. Follow the diet and exercise program your healthcare provider recommends.

This medicine may make your skin more sensitive to the sun, which may lead to painful sunburns. While you are taking this medicine, avoid long exposure to the sun. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. Do not use a sunlamp. If you get a severe sunburn, contact your healthcare provider right away.

Diabetics: This medicine may affect your blood sugar levels and change the amount of insulin or other diabetes medicines you may need. Also, it may be harder to tell if your blood sugar level is too low. Talk with your healthcare provider about this. Be sure you understand how this medicine might affect you and what to do if you have a problem.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives, itching, rash, tightness in your chest, trouble breathing, swelling of your face, throat, or tongue).

Serious (report these to your healthcare provider right away): Trouble breathing; chest pain; cold hands or feet; confusion; depression; eye pain; decrease in vision; skin rash; slow or irregular heartbeat; yellowish eyes or skin; muscle cramps; swelling of legs or ankles; unexplained weakness; severe stomach pain; severe nausea or vomiting.

Other: Dizziness, drowsiness, lightheadedness, tingling in your fingers or toes, loss of appetite, nausea, constipation, diarrhea, tiredness trouble sleeping, loss of sexual desire, impotence, dry mouth.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Zestril, Prinivil), quinapril (Accupril) and ramipril (Altace)
• amifostine (Ethyol)
• amphetamines such as amphetamine sulfate, amphetamine mixtures (Adderall), dextroamphetamine (Dexedrine), and methamphetamine (Desoxyn)
• angiotensin receptor II blockers (ARBs) such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• antacids (take them at least 2 hours before or after this medicine)
• anti-gout medicines such as allopurinol (Zyloprim)
• antimalaria medicines such as hydroxychloroquine (Plaquenil)
• antipsychotic medicines such as chlorpromazine, haloperidol (Haldol), perphenazine, prochlorperazine, thioridazine, and trifluoperazine
• barbiturates such as butabarbital (Butisol) and phenobarbital
• calcium channel blockers such as diltiazem (Cardizem, Dilacor, Tiazac) and verapamil (Calan, Isoptin, Verelan)
• cholesterol medicines such as cholestyramine (Questran) and colestipol (Colestid)
• corticosteroids such as betamethasone (Celestone), cortisone, dexamethasone, fludrocortisone (Florinef), hydrocortisone, methylprednisolone (Medrol), prednisone, prednisolone, and triamcinolone (Aristospan, Kenalog)
• cyclosporine (Neoral, Gengraf, Sandimmune)
• diuretics such as amiloride, amiloride/hydrochlorothiazide, bumetanide, furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), spironolactone/hydrochlorothiazide (Aldactazide), torsemide (Demadex), triamterene (Dyrenium), and triamterene/hydrochlorothiazide (Dyazide, Maxzide)
• diazoxide (Proglycem)
• digoxin
• insulin and medicines taken by mouth to treat diabetes such as glipizide (Glucotrol), glyburide (DiaBeta, Glynase), metformin (Glucophage), pioglitazone (Actos), and rosiglitazone (Avandia)
• lithium (Lithobid)
• MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• medicines used to control irregular heart rhythms such as amiodarone (Cordarone), digoxin (Lanoxin), disopyramide (Norpace), dofetilide (Tikosyn), propafenone (Rythmol), and quinidine
• methenamine (Hiprex, Urex)
• narcotics such as codeine, hydrocodone (Vicodin), morphine, and oxycodone (Percocet, Tylox)
• natural remedies such as dong quai, ephedra, ginseng, garlic, licorice, St. John's wort, and yohimbe
• NSAIDs such as ibuprofen (Motrin, Advil), indomethacin (Indocin), ketoprofen, nabumetone (Relafen), and naproxen (Naprosyn, Aleve)
• other beta blockers such as acebutolol (Sectral), betaxolol, carteolol, carvedilol (Coreg), esmolol (Brevibloc), labetalol, pindolol, sotalol (Betapace), and timolol
• other blood pressure medicines such as clonidine (Catapres), doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin)
• methyldopa
• phenytoin (Dilantin)
• reserpine
• rifampin (Rifadin)
• ritonavir (Norvir)
• SSRI antidepressants such as fluoxetine (Prozac, Sarafem), paroxetine (Paxil), and sertraline (Zoloft)
• theophylline
• warfarin (Coumadin)

Do not drink alcohol while you are taking this medicine unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.