Common questions about atenolol

Atenolol is a type of medicine called a beta blocker.

Like other beta blockers, atenolol works by changing the way your body responds to some nerve impulses, including in the heart.

It slows down your heart rate and makes it easier for your heart to pump blood around your body.

We do not fully understand how atenolol prevents migraines. It may work by relaxing the blood vessels involved or by reducing activity in the visual cortex. This is the part of the brain where migraines are believed to start.

Atenolol starts to work after about 3 hours to reduce high blood pressure, but it can take up to 2 weeks to reach its full effect.

You may not feel any different when you take atenolol for high blood pressure, but this does not mean it's not working. It's important to keep taking your medicine.

For migraines, it may take several weeks for atenolol to start making a real difference, so keep taking it.

Atenolol is generally safe to take for a long time.

If you're taking it for a heart condition or to prevent migraines, it works best when you take it long term.

You'll need to have your blood pressure checked regularly if you're taking atenolol for a long time for migraines.

Atenolol works as well as other beta blockers for reducing blood pressure. But it's less likely to cause side effects because it works mainly on the heart.

Other beta blockers, like propranolol, work on your heart and affect other parts of your body, too.

There are lots of other medicines to lower your blood pressure and treat chest pain. They work in a different way from beta blockers and include:

• ACE inhibitors – for example, ramipril and lisinopril
• angiotensin receptor blockers – for example, candesartan
• calcium channel blockers – for example, amlodipine
• medicines that make you pee more (diuretics) – for example, furosemide

Beta blockers are not usually the first choice treatment for high blood pressure. The medicine your doctor prescribes will depend on your age and ethnicity.

If you're under 55, and you're not of African Caribbean or Black African origin, you'll usually be offered an ACE inhibitor or an angiotensin receptor blocker.

If you're 55 or older, or you're any age and of African Caribbean or Black African origin, you'll usually be offered a calcium channel blocker.

You may have to try other medicines if you get side effects.

Many people need to take a combination of different medicines to lower their blood pressure.

Atenolol, metoprolol, propranolol and nadolol are all beta blockers, and they work well in preventing migraines. But most doctors prescribe propranolol.

There are some other medicines that are known to prevent migraines, but they're not officially approved in the UK. They include amitriptyline, sodium valproate and gabapentin, and may have different side effects.

Topiramate can also be used to prevent migraines but it has not been officially approved for migraine for children under the age of 16.

Ask your doctor or pharmacist which medicine is best for you.

Tell your doctor that you're taking atenolol if you're going to be put to sleep (using general anaesthetic) or you're having any kind of major operation.

They may advise you to stop taking atenolol for 24 hours before surgery. This is because atenolol can lower your blood pressure too much when it's combined with some anaesthetics.

Some people on atenolol say their sex drive goes down, and some men find they cannot get an erection. But this is not a common side effect and there's not enough evidence to say for sure that atenolol is causing it.

If you're having problems with your sex life, talk to your doctor.

You do not need to stop playing sports if you take atenolol. Regular exercise is good for you because it lowers blood pressure by keeping your heart and blood vessels in good condition.

Be aware, though, that in some sports atenolol is not allowed if you're competing at a high level.

Atenolol will not stop your contraception working. But some types of hormonal methods of contraception, like the combined pill and contraceptive patch, are not usually recommended if you have high blood pressure.

Talk to your doctor if you're taking or using a hormonal contraceptive.

If atenolol makes you vomit or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Atenolol can make some people feel dizzy, especially when they first start taking it or after taking a bigger dose.

If this happens to you, do not drive a car, ride a bike, or use tools or machinery until you feel better.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking atenolol. GOV.UK has more information on the law on drugs and driving.

Drinking alcohol can increase the blood pressure-lowering effect of atenolol, which can make you feel dizzy or light-headed.

During the first few days of taking atenolol or after an increase in your dose, it's best to stop drinking alcohol until you see how the medicine affects you.

If you find atenolol makes you feel dizzy, it's best to stop drinking alcohol.

You can eat and drink normally while taking atenolol.

Eating a healthy, balanced diet can help if you have high blood pressure or another heart condition.

If you have heart problems, you can boost the health of your heart by making some key lifestyle changes.

These will also help if you have high blood pressure.

• Quit smoking – smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid secondhand smoke.
• Cut down on alcohol – drinking alcohol while you're taking atenolol can make you feel dizzy or light-headed. Also, drinking too much alcohol raises blood pressure over time and makes heart failure worse. Men and women should not drink more than 14 units of alcohol a week. A standard glass of wine (175ml) is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol.
• Exercise – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic. Walking every day will help.
• Eat well – aim to eat a diet that includes plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products and lean proteins. It's a good idea to follow these tips for a lower salt diet, too. Eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
• Manage stress – when you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse, too. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help avoid stress.
• Vaccinations – if you have heart failure, it's recommended that you have the flu vaccine every year and the pneumococcal vaccine as recommended by your GP. Ask your doctor about these vaccinations. You can have them free on the NHS. COVID-19 vaccination is recommended for most people. Make sure you've had all the doses that you are eligible for. Talk to your doctor if you think you might be in one of the at risk groups.

There are a number of things you can do to help prevent migraines. This includes working out what things trigger an attack so you can avoid them.

Keeping a migraine diary may help you do this.