Suggest Treatment For Tiredness After Increasing The Dosage Of Atenolol

Posted on Fri, 28 Oct 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 28 Oct 2016 Answered on

Thu, 17 Nov 2016 Last reviewed on

Question : Taking budesonide, 12mg, in the morning. Recently jumped atenolol from 50 mg to 100mg. Always tired in the afternoon. Dramatic increase in tiredness with increase of atenolol . Yesterday dropped bedesonide, now on merhyipredbisolone 4mg 7 day pack, thinking it would give me energy. I don't know, but I think that the atenolol is the culprit . Now 3:25 am and can't sleep. What do you think? DOB 11/7/41

Answered by Dr. Panagiotis Zografakis (5 hours later)

Brief Answer:
could be atenolol

Detailed Answer:
Hello,

atenolo is well known for causing tiredness. It does so in 1 out of 4 patients using it particularly in the high dose range. So if all else is the same, atenolol could be the cause. You can find out by reducing the dosage unless there are serious reasons to avoid doing so. If you're taking it for the blood pressure only then there are better alternatives like calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers and diuretics.

I wouldn't suspect atenolol for the sleep disturbances though because - although it may cause them - it's involved in very few cases only. Methylprednisolone sounds more suspicious in this regard.

Before attributing anything to drugs you should make sure that other causes have been excluded. Some common causes include anemia, electrolyte disorders, infections, etc. Checking your temperature and some basic lab tests will help to find out. A complete blood count, urea, creatinine, serum electrolytes, and liver function tests should be enough for the most common causes.

I hope it helps!
Kind Regards!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Panagiotis Zografakis (7 minutes later)

On my own this morning, prior to your report, I used my pill cutter and reduced atenolol to 12.5 mg from 100mg. Would you comment?

Answered by Dr. Panagiotis Zografakis (11 minutes later)

Brief Answer:
I wouldn't go that low...

Detailed Answer:
Gradual reduction is recommended because abrupt changes in dosage may result in fast heart rate. The body needs to adjust to the new dosage. Getting back to 50mg first sounds more reasonable.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Panagiotis Zografakis (1 hour later)

Atenolol pills are 50mg, my mistake, actual reduction was to 25mg and take pressure periodically. 50mg is my normal dose for many years. 100mg only for a week. Stay at 25 for at least a week then 12.5mg + one of other replacements you offered. What do you think?

Answered by Dr. Panagiotis Zografakis (2 hours later)

Brief Answer:
it depends on your blood pressure

Detailed Answer:
I agree with a more gradual approach. Adding another pill depends on your blood pressure though. If you're not within target levels (less than 140/90mmHg) with atenolol then adding another agent will lower your blood pressure more than doubling atenolol dose.

Kind Regards!

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar