Atenolol and Nifedipine

Nifedipine reduces hypertension due to peripheral vasodilation and atenolol complements this action by reducing cardiac output, counter-acting tachycardia and also by reducing renin release. The anti-hypertensive efficacy of nifedipine is clearly potentiated by combination with atenolol. Nifedipine reduces angina due to coronary vasodilation and atenolol complements this action by reducing heart rate and cardiac output. The side effects of nifedipine are due to its vasodilatory effects whereas those associated with atenolol result from its cardiac effects. This complimentary pharmacodynamic interaction leads to a reduction in some of the adverse reactions of the monotherapies.

Indications

Hypertension, angina pectoris.

Dosage

Atenolol 50 mg, nifedipine 20 mg (sustained release) each capsule once daily increased to twice daily gradually.

Contra-Indications

Sinus bradycardia, heart block greater than first degree, cardiogenic shock, cardiac failure, anuria.

Special Precautions

Diabetics, bronchospastic disease, general anesthesia. Paediatrics: Not recommended. Pregnancy: Contraindicated. Lactation: Contraindicated. Elderly: Reduce the dose.

Side Effects

Same as for Atenolol & Nifedipine, they are minimised by providing nifedipine in sustained release tablet form and by combining it with Atenolol.

Drug Interactions

Reduced clearance of disopyramide, antacids reduces bioavailability, ampicillin reduces atenolol levels leading to excessive nifedipine effects, additive vasodilation effects with nitrates.