Tenoric
Tenoric is Ipca Laboratories’ fixed-dose atenolol (25/50/100 mg) + chlorthalidone 25 mg tablets — beta-blocker + thiazide-like diuretic combination. Historical first-line combo for hypertension (Tenoretic globally, 1970s). Modern guidelines push beta-blocker-based regimens to second-line for uncomplicated HTN (LIFE/ASCOT data) — retained role for HTN with angina, AF rate control, post-MI. Monitor potassium and glucose. Never stop abruptly.
✓ Medisinsk vurdert av Morgan Ellis — Farmasøytisk forsker · 8 års erfaring · Sist gjennomgått: mai 2026
⚡ Quick Answer — What is Tenoric?
Tenoric er en 25/25 mg, 50/25 mg, 100/25 mg fixed-dose tablet kombinering atenolol (cardioselective beta-1 blocker) and chlorthalidone (long-acting thiazide-like diuretic) from Ipca Laboratories. Historical combination for hypertension — effective for BP but largely superseded by ACEi/ARB-based regimens following LIFE and ASCOT which showed atenolol-based therapy inferior to losartan-based and amlodipine-based regimens for stroke prevention and new-onset diabetes. Retains a role in patients already stable on both components, or where angina or rate-control needs make a beta-blocker rational. Typical dosing: one tablet once daily. Contraindications: second/third-degree AV block, severe asthma, anuria, symptomatic bradycardia, severe hypokalaemia, lithium co-therapy (caution). Monitor BP, HR, potassium, glucose.
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What Is Tenoric?
Tenoric is a fixed-dose combination tablet of atenolol (25-100 mg) and chlorthalidone (typically 25 mg) in a single pill, from Ipca Laboratories. Supplied in 30-90 tablets.
Atenolol was introduced by ICI in 1976 as Tenormin — a cardioselective beta-1 adrenergic blocker. Chlorthalidone is a long-acting thiazide-like diuretic introduced in 1960 and validated as first-line antihypertensive therapy in ALLHAT (2002). The fixed combination (Tenoric, Tenoretic globally) has been on formularies since the 1970s.
Why Combine a Beta-Blocker With a Thiazide?
- Complementary BP mechanisms — atenolol reduces cardiac output and renin release; chlorthalidone depletes sodium and produces mild volume contraction. Additive BP drop.
- Counter-regulation — thiazides activate the RAAS as a compensatory response (blunting their effect); beta-blockers partially suppress this by reducing renin release. The combination unlocks more of each agent’s BP potential.
- Electrolyte balance — beta-blockers slightly raise potassium; thiazides lower it. The net effect is usually mild hypokalaemia but less severe than thiazide alone.
Modern positioning: LIFE (2002), ASCOT (2005), and the INVEST (2003) trials pushed beta-blockers to second-line for uncomplicated hypertension, especially atenolol with chlorthalidone because of new-onset diabetes and inferior stroke prevention vs ARB and CCB regimens. Tenoric retains a place where beta-blockade is rational (concurrent angina, atrial fibrillation rate control, post-MI, resting tachycardia) and a diuretic is still needed.
Dosage
Standard dose: one 25/25 mg, 50/25 mg, 100/25 mg tablet once daily in the morning (chlorthalidone diuresis can disrupt sleep if dosed at night).
Titrering: higher-strength FDCs exist (e.g. 100/25 mg); for uncontrolled BP, often better to add an ACEi/ARB or CCB than to further raise atenolol or chlorthalidone.
Overvåkning: baseline BP, HR, U&E (potassium, sodium), creatinine, fasting glucose, urate, ECG if bradycardia/AV concern. Repeat U&E at 1-2 weeks, then at 4-6 weeks. Annual metabolic panel. Watch for hypokalaemia, new gout, worsening diabetic control, symptomatic bradycardia.
Bivirkninger
Combines profiles of both components. Common:
- Fatigue, reduced exercise tolerance (atenolol)
- Cold extremities (atenolol peripheral vasoconstriction)
- Hypokalaemia, mild hyponatraemia (chlorthalidone)
- Hyperuricaemia and gout precipitation (chlorthalidone)
- Modest worsening of glucose tolerance (both components)
- Erektil dysfunksjon
- Bradycardia, mild
- Photosensitivity rash (thiazide)
- Mild lipid changes
Uncommon but serious: severe hyponatraemia, symptomatic bradycardia/AV block, decompensated HF, severe bronchospasm, pancreatitis (thiazide), Stevens-Johnson syndrome.
Kontraindikasjoner
- Second or third-degree AV block (without pacemaker)
- Severe bradycardia, cardiogenic shock
- Acute decompensated HF
- Anuria or severe renal impairment (eGFR <30 — thiazide loses efficacy)
- Sulfonamide hypersensitivity (chlorthalidone)
- Severe asthma, severe COPD
- Symptomatic hyponatraemia or hypokalaemia at baseline
- Hyperkalsemi
- Untreated phaeochromocytoma
- Pregnancy (atenolol — fetal growth restriction; thiazide — neonatal jaundice/thrombocytopenia)
Legemiddelinteraksjoner
- Lithium — chlorthalidone reduces lithium clearance; precipitate toxicity. Monitor weekly; reduce lithium 25-50%.
- Verapamil or diltiazem — additive bradycardia with atenolol; avoid.
- NSAID-er — reduce antihypertensive effect; triple-whammy AKI if combined with ACEi/ARB.
- Digoxin — additive bradycardia; hypokalaemia potentiates digoxin toxicity.
- Insulin, sulfonylureas — atenolol masks hypoglycaemia; thiazide worsens glucose tolerance. Monitor diabetics carefully.
- Oral corticosteroids, amphotericin B — additive hypokalaemia.
- Cholestyramine / colestipol — reduce chlorthalidone absorption. Separate by 4 hours.
- Clonidine — always stop beta-blocker first; reverse order worsens clonidine withdrawal.
- Alkohol — additive orthostatic hypotension.
Oppbevaring
Store Tenoric below 25°C. Keep out of reach of children.
Vanlige spørsmål
Is Tenoric a first-line BP drug today?
No — modern guidelines reserve beta-blocker-based regimens as second or third-line for uncomplicated hypertension, largely because of LIFE, ASCOT, and INVEST data showing inferior stroke prevention and increased new-onset diabetes vs ARB and CCB regimens. Tenoric retains a role where beta-blockade is specifically indicated (angina, AF rate control, post-MI).
Can I stop Tenoric abruptly?
No — the atenolol component can rebound (tachycardia, BP surge, angina in CAD patients) if stopped abruptly. Taper over 1-2 weeks.
Will I need potassium on Tenoric?
Sometimes. Chlorthalidone can drive potassium below 3.5 mmol/L; atenolol slightly raises potassium, partially offsetting. Check at baseline, 1-2 weeks, then periodically. Hypokalaemia is usually corrected by adding an ACEi/ARB (blunts thiazide-induced K loss) rather than potassium supplements.
Can I take Tenoric in pregnancy?
No — atenolol is linked with fetal growth restriction; thiazides in pregnancy can cause neonatal jaundice and thrombocytopenia. Switch to methyldopa, labetalol, or nifedipine.
Where can I buy Tenoric online?
You can buy Tenoric (atenolol + chlorthalidone 25/25 mg, 50/25 mg, 100/25 mg, 30-90 tablets) from MedsBase with discreet packaging and worldwide shipping.
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Rangert etter nylig bestillingsvolum på MedsBase — hva andre kunder i denne kategorien velger.
| Styrke | 25 mg, 50 mg, 100 mg |
|---|---|
| Antall | 30 Tablett/er, 60 Tablett/er, 90 Tablett/er |
| Farmasøytisk form | Tablet/t |
| Produsent | Ipca Laboratories |
| Behandling | HEART & BLOOD PRESSURE |
| Generisk merke | Atenolol + Chlorthalidone |
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