Atenolol with Magnesium Carbonate Interaction Details
Brand Names Associated with Atenolol
- Atenolol
- Tenoretic® (as a combination product containing Atenolol and Chlorthalidone)
- Tenormin®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Mar 04, 2024
Interaction Effect
Reduced effectiveness of atenolol
Interaction Summary
Studies suggest that the concurrent use of atenolol and aluminum, calcium or magnesium containing products will decrease the bioavailability of atenolol and possibly reduce its effectiveness[1][2].
Severity
Minor
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Instruct patients to avoid taking atenolol and aluminum, calcium or magnesium containing products at the same time. Atenolol should be administered two hours before or six hours after the aluminum, calcium or magnesium containing product.
Mechanism Of Interaction
Decreased atenolol absorption
Literature Reports
A) Concomitant atenolol and calcium carbonate therapy has been reported to result in significant decreases in peak plasma levels of atenolol (by 51%) following single doses. The atenolol half-life increased from 6.2 hours to 11 hours during prolonged concomitant therapy which partly compensated for the decreased plasma levels. Hemodynamic measurements were similar after 4 weeks of concurrent use. No dosage adjustment appears to be necessary in patients receiving long-term atenolol and calcium therapy. Patients with severe coronary heart disease should receive twice the normal dose of atenolol on the first day of calcium therapy [2].
B) Six healthy male volunteers fasted for ten hours and were then given atenolol 100 mg and 30 mL of an antacid containing aluminum hydroxide, magnesium hydroxide and magnesium carbonate. The systemic bioavailability of atenolol was reduced an average of 33% and the maximum plasma concentration was decreased by 37%. These results suggest that the absorption of atenolol, which normally is 50% absorbed in the gut, may be reduced enough with concomitant antacid therapy to cause a reduction in therapeutic efficacy [1].
References
1 ) Regardh CG, Lundborg P, & Persson BA: The effect of antacid, metoclopramide and propantheline on the bioavailability of metoprolol and atenolol. Biopharm Drug Dispos 1981; 2:79-87.
2 ) Kirch W, Schafer-Korting M, Axthelm T, et al: Interaction of atenolol with furosemide and calcium and aluminum salts. Clin Pharmacol Ther 1981; 30:429-435.
Atenolol Overview
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Atenolol is used alone or in combination with other medications to treat high blood pressure. It also is used to prevent angina (chest pain) and improve survival after a heart attack. Atenolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.
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High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.