Atenolol in renal failure
One must use caution while prescribing atenolol to patients with renal insufficiency. The elimination half-life of atenolol is extensively prolonged in patient with renal failure. The normal half life of atenolol is 6 to 7 hours; however, in renal failure patients the half-life may be extended to more than 100 hours 2.
The recommended dosage are following:
- CrCl 35 mL/min or greater - normal dosing
- CrCl 15 - 35 mL/min - MAX. dose 50 mg orally QD
- CrCl less than 15 mL/min - MAX. dose 25 mg orally QD
- Hemodialysis: 25-50 mg orally after each dialysis session.
Treatment of atenolol overdose in a patient with renal failure is recommended with serial hemodialysis and charcoal hemoperfusion 3. On the contrary, metoprolol is extensively metabolized via the hepatic system.
References:
1.Atenolol-DOSAGE AND ADMINISTRATION - rxlist.com
2.Atenolol kinetics in renal failure - Clin Pharmacol Ther. 1980 Sep;28(3):302-9
3. Treatment of atenolol overdose in a patient with renal failure using serial hemodialysis and hemoperfusion and associated echocardiographic findings Vet Hum Toxicol. 2000 Aug;42(4):224-5.
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