Tenoren^® Plus

Tenoren ® Plus is a combination preparation of Atenolol and Chlorthalidone. Atenolol is a beta-selective (cardioselective) beta-adrenergic receptor blocking agent. Chlorthalidone is an oral diuretic with prolonged action. The diuretic action of the drug occurs within 2 hours of an oral dose. It produces diuresis with greatly increased excretion of sodium and chloride. Atenolol and Chlorthalidone have been used singly and concomitantly for the treatment of hypertension. The antihypertensive effects of these agents are additive. This combination provides a convenient formulation for the concomitant administration of these two entities.

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Tenoren ® Plus is indicated for the treatment of hypertension.

Dosage of Tenoren ® Plus must be individualized.The initial dose should be one Tenoren ® Plus tablet given once a day. If an optimal response is not achieved, the dosage should be increased to two Tenoren ® Plus tablets given once a day.

Use in elderly:
Clinical studies of Atenolol & Chlorthalidone combination did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.

Atenolol & Chlorthalidone combination can cause fetal harm to the developing baby and may appear in breast milk. So it should not be taken during pregnancy & lactation.

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Atenolol and Chlorthalidone combination should be given with caution to patients with severe renal impairment, uncontrolled heart failure, impaired hepatic function or liver disease.

Warnings
In patients receiving thiazides, sensitivity reactions may occur with or without a history of allergy or bronchial asthma. The possible exacerbation or activation of systemic lupuserythematosus has been reported. The antihypertensive effects of thiazides may be enhanced in the postsympathectomy patient.

Atenolol and Chlorthalidone combination is usually well tolerated. Most adverse effects have been mild and transient. However dizziness, fatigue, vertigo, nausea, diarrhea and bradycardia have been reported rarely.

Atenolol and Chlorthalidone combination is contraindicated in hypersensitivity to this product or to sulfonamide-derived drugs. It is also contraindicated in patients with sinus bradycardia, heart block greater than first degree, cardiogenic shock, overt cardiac failure and anuria.

Atenolol and Chlorthalidone combination may potentiate the action of other antihypertensives such as Clonidine, Diltiazem. Prostaglandin synthase inhibiting drugs e.g. Indomethacin may decrease the hypotensive effects of beta-blockers. This tablet should not be given with Lithium due to high risk of Lithium toxicity.

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Store in cool and dry place, protected from light.