Nilol
Nilol is a fixed-dose combination of atenolol 50 mg + nifedipine 20 mg — beta-blocker plus dihydropyridine calcium-channel blocker for combined hypertension and stable angina. Complementary mechanisms; atenolol blocks reflex tachycardia from nifedipine vasodilation. Once daily, morning. Not for pregnancy.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
Frequently Asked Questions
⚡ Quick Answer — What is Nilol?
Nilol is a fixed-dose combination of atenolol (beta-blocker) + nifedipine (dihydropyridine calcium-channel blocker) from a WHO-GMP certified manufacturer — widely prescribed in India and the subcontinent for combined hypertension and angina, particularly in patients where a single-drug regimen has failed. The two drugs work via complementary mechanisms: atenolol reduces cardiac output and heart rate (beta-1 blockade); nifedipine causes direct arterial vasodilation via L-type calcium channel blockade. The beta-blocker blunts the reflex tachycardia that bare nifedipine would otherwise produce. Typical dose: one tablet once daily. Contraindications inherit from both components: asthma / severe COPD / second-third degree heart block / acute heart failure / severe aortic stenosis / recent MI / cardiogenic shock.
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What Is Nilol?
Nilol is an oral tablet from a WHO-GMP certified manufacturer containing:
- Atenolol 50 mg — a cardioselective beta-1 blocker (the same molecule in Atenheal)
- Nifedipine 20 mg — a dihydropyridine calcium-channel blocker (extended-release; same molecule in Depin, Nicardia Retard)
The combination originated in 1980s European cardiology (brand Tenif, Tenoretic) and remains popular in India for patients with both hypertension and stable angina. The two drugs target different mechanisms: atenolol for heart-rate and contractility reduction; nifedipine for direct arterial vasodilation. The beta-blocker prevents the reflex tachycardia that nifedipine monotherapy would otherwise cause.
How Nilol Works
- Atenolol — beta-1 blockade in the SA node reduces heart rate; blockade in ventricular myocardium reduces contractility. Lower cardiac output = lower blood pressure; lower myocardial oxygen demand = less angina.
- Nifedipine — L-type calcium channel blockade in arterial smooth muscle causes direct arterial dilation. Reduces systemic vascular resistance and coronary vasospasm.
- Complementary pairing — bare nifedipine would cause reflex tachycardia (sympathetic response to vasodilation); atenolol blocks that reflex, giving smoother BP control without the palpitation side effect.
Uses & Dosing
- Combined hypertension + stable angina — primary indication
- Resistant hypertension — step-up therapy when single-agent has failed
- Hypertension with coronary artery disease
Dose: one tablet once daily, usually morning. Maximum 2 tablets/day. Target BP <140/90 (or <130/80 with comorbidity).
Monitoring: baseline + periodic ECG (atenolol bradycardia / nifedipine effect on PR interval), pulse, BP, peripheral oedema (nifedipine commonly causes ankle swelling).
Side Effects
Atenolol-related: fatigue, cold extremities, bradycardia, exercise intolerance, mild fatigue, erectile dysfunction, masked hypoglycaemia in diabetics.
Nifedipine-related:
- Ankle oedema (peripheral swelling) — dose-related; occurs in up to 25% of long-term users
- Flushing, headache (vasodilation)
- Gingival hyperplasia (gum overgrowth)
- Constipation
- Hot flashes, particularly at onset of therapy
Contraindications
- Asthma / severe COPD (atenolol component)
- Second/third-degree heart block, sinus bradycardia <50, sick sinus syndrome
- Acute decompensated heart failure, cardiogenic shock
- Severe aortic stenosis (nifedipine can worsen)
- Recent myocardial infarction, unstable angina (short-acting nifedipine concern; the ER form is safer)
- Severe renal impairment (eGFR <15 — atenolol dose reduction needed; prefer non-renally-cleared beta-blocker)
- Pregnancy (both components)
- Hypersensitivity to either component
Storage
Store below 25°C; protect from light.
Why combine atenolol with nifedipine?
Complementary mechanisms and side-effect-mitigation. Bare nifedipine causes reflex tachycardia (sympathetic response to vasodilation); atenolol blocks that reflex, giving smoother BP control. For patients with both hypertension AND stable angina, the two drugs target both diseases simultaneously.
What about the ankle swelling from nifedipine?
Dose-related peripheral oedema occurs in up to 25% of long-term nifedipine users. It is NOT from fluid overload — it is from pre-capillary vasodilation increasing hydrostatic pressure in the lower legs. Treatment: dose reduction, leg elevation, compression stockings, or switch to a non-dihydropyridine CCB (verapamil, diltiazem) or a different vasodilator class (ACE inhibitor, ARB).
Why not use this in pregnancy?
Atenolol is associated with intrauterine growth restriction in pregnancy (more so than other beta-blockers) and neonatal bradycardia/hypoglycaemia. For antihypertensive use in pregnancy, labetalol, methyldopa, and nifedipine-monotherapy (not this FDC) are the preferred options.
Where can I buy Nilol online?
You can buy Nilol (atenolol + nifedipine 50 mg + 20 mg, 30-180 tablets) from MedsBase with discreet packaging and worldwide shipping.
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| Strength | 20+50 mg |
|---|---|
| Quantity | 30 Tablet/s, 60 Tablet/s, 90 Tablet/s, 180 Tablet/s |
Nilol
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