Note: This document contains side effect information about atenolol / chlorthalidone. Some dosage forms listed on this page may not apply to the brand name Tenoretic.

Applies to atenolol / chlorthalidone: oral tablet.

Serious side effects of Tenoretic

Along with its needed effects, atenolol/chlorthalidone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking atenolol / chlorthalidone:

More common

• Cold arms or legs
• difficult or labored breathing
• shortness of breath
• tightness in chest
• wheezing

Less common

• Chest pain or discomfort
• chills
• cold sweats
• confusion
• dizziness, faintness, or lightheadedness when getting up from lying or sitting position
• leg pain
• lightheadedness, dizziness, or fainting
• slow or irregular heartbeat
• unusual tiredness or weakness

Incidence not determined

• Black, tarry stools
• bleeding gums
• blood in urine or stools
• feeling that others are watching you or controlling your behavior
• feeling that others can hear your thoughts
• fever
• general feeling of discomfort, illness, or weakness
• paleness or cold feeling in fingertips and toes
• pinpoint red spots on skin
• seeing, hearing, or feeling things that are not there
• severe mood or mental changes
• skin irritation or rash, including rash that looks like psoriasis
• tingling or pain in fingers or toes when exposed to cold
• unusual behavior
• unusual bleeding or bruising

Get emergency help immediately if any of the following symptoms of overdose occur while taking atenolol / chlorthalidone:

Symptoms of overdose

• Blurred vision
• decreased urination
• dry mouth
• increase in heart rate
• muscle cramps or pain
• numbness, tingling, pain, or weakness in hands or feet
• rapid breathing
• seizures
• sunken eyes
• sweating
• thirst
• trembling
• weakness and heaviness of legs
• wrinkled skin

Other side effects of Tenoretic

Some side effects of atenolol / chlorthalidone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Discouragement
• feeling sad or empty
• irritability
• lack of appetite
• loss of interest or pleasure
• tiredness
• trouble concentrating
• trouble sleeping

Less common

• Diarrhea
• feeling of constant movement of self or surroundings
• nausea
• sensation of spinning
• unusual drowsiness, dullness, or feeling of sluggishness

Incidence not determined

• Decreased interest in sexual intercourse
• disturbed color perception
• double vision
• hair loss, thinning of hair
• halos around lights
• headache
• inability to have or keep an erection
• loss in sexual ability, desire, drive, or performance
• loss of vision
• night blindness
• overbright appearance of lights
• pain of penis on erection
• tunnel vision

For Healthcare Professionals

Applies to atenolol / chlorthalidone: oral tablet.

General

The most common adverse reactions were bradycardia, cold extremities, gastrointestinal disturbances, fatigue, hyperuricemia, hyponatremia, hypokalemia, and impaired glucose tolerance.^[Ref]

Metabolic

Common (1% to 10%): Hyperuricemia, hyponatremia, hypokalemia, impaired glucose tolerance

Chlorthalidone (chlortalidone):

Frequency not reported: Anorexia, hyperglycemia, hyperuricemia^[Ref]

Cardiovascular

Common (1% to 10%): Bradycardia, cold extremities

Rare (less than 0.1%): Heart failure deterioration, heart block precipitation, postural hypotension, intermittent claudication increased, Raynaud's phenomenon

Atenolol:

Very common (10% or more): Cold extremities (up to 12%)

Common (1% to 10%): Bradycardia, postural hypotension

Postmarketing reports: Sick sinus syndrome, Raynaud's phenomenon

Chlorthalidone (chlortalidone):

Frequency not reported: Orthostatic hypotension, necrotizing angiitis^[Ref]

Gastrointestinal

Common (1% to 10%): Gastrointestinal disturbances

Rare (less than 0.1%): Dry mouth

Frequency not reported: Constipation

Atenolol:

Common (1% to 10%): Diarrhea, nausea

Postmarketing reports: Dry mouth

Chlorthalidone (chlortalidone):

Frequency not reported: Gastric irritation, vomiting, cramping, constipation, pancreatitis^[Ref]

Other

Common (1% to 10%): Fatigue

Atenolol:

Very common (10% or more): Tiredness (up to 26%)

Common (1% to 10%): Fatigue, lethargy

Chlorthalidone (chlortalidone):

Frequency not reported: Weakness^[Ref]

Psychiatric

Uncommon (0.1% to 1%): Sleep disturbances

Rare (less than 0.1%): Mood changes, nightmares, confusion, psychoses, hallucinations

Atenolol:

Very common (10% or more): Depression (up to 12%)

Common (1% to 10%): Dreaming

Postmarketing reports: Hallucinations, psychoses

Chlorthalidone (chlortalidone):

Frequency not reported: Restlessness^[Ref]

Hepatic

Uncommon (0.1% to 1%): Transaminase levels increased

Rare (less than 0.1%): Hepatic toxicity

Atenolol:

Postmarketing reports: Liver enzymes elevated, bilirubin elevated

Chlorthalidone (chlortalidone):

Frequency not reported: Intrahepatic cholestatic jaundice^[Ref]

Dermatologic

Rare (less than 0.1%): Purpura, alopecia, psoriasiform skin reaction, psoriasis exacerbation, skin rashes

Frequency not reported: Angioedema, urticaria

Atenolol:

Postmarketing reports: Psoriasiform rash, psoriasis exacerbation, purpura, reversible alopecia

Chlorthalidone (chlortalidone):

Frequency not reported: Purpura, photosensitivity, rash, urticaria, cutaneous vasculitis, toxic epidermal necrolysis^[Ref]

Nervous system

Rare (less than 0.1%): Dizziness, headache, paresthesia

Atenolol:

Very common (10% or more): Dizziness (up to 13%)

Common (1% to 10%): Vertigo, lightheadedness, drowsiness

Postmarketing reports: Headache

Chlorthalidone (chlortalidone):

Frequency not reported: Vertigo, paresthesia^[Ref]

Hematologic

Rare (less than 0.1%): Thrombocytopenia, leukopenia

Atenolol:

Postmarketing reports: Thrombocytopenia

Chlorthalidone (chlortalidone):

Frequency not reported: Leukopenia, agranulocytosis, thrombocytopenia, aplastic anemia^[Ref]

Ocular

Rare (less than 0.1%): Dry eyes, visual disturbances

Atenolol:

Postmarketing reports: Visual disturbance

Chlorthalidone (chlortalidone):

Frequency not reported: Xanthopsia^[Ref]

Respiratory

Rare (less than 0.1%): Bronchospasm

Atenolol:

Common (1% to 10%): Wheeziness, dyspnea^[Ref]

Genitourinary

Rare (less than 0.1%): Impotence

Atenolol:

Postmarketing reports: Impotence, Peyronie's disease

Chlorthalidone (chlortalidone):

Frequency not reported: Glycosuria^[Ref]

Immunologic

Very rare (less than 0.01%): Antinuclear antibodies increased

Frequency not reported: Hypersensitivity reactions

Atenolol:

Postmarketing reports: Development of antinuclear antibodies^[Ref]

Musculoskeletal

Frequency not reported: Lupus-like syndrome

Atenolol:

Common (1% to 10%): Leg pain

Postmarketing reports: Lupus syndrome

Chlorthalidone (chlortalidone):

Frequency not reported: Muscle spasm^[Ref]