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Atenolol + chlortalidone

Co-tenidone

Brand names: Tenoretic

Co-tenidone is a fixed-dose combination of atenolol (a cardioselective beta-blocker) and chlortalidone (a thiazide-like diuretic), used in the management of hypertension.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Atenolol blocks beta-1 adrenoceptors to lower heart rate and cardiac output, while chlortalidone reduces distal tubular sodium reabsorption to promote diuresis and lower blood pressure.

Prescribing in practice

  • Avoid abrupt withdrawal of the beta-blocker component, which can precipitate rebound angina, arrhythmia or myocardial infarction; taper gradually.
  • The combination of a beta-blocker and a thiazide-like diuretic may increase the risk of new-onset diabetes and is generally avoided in patients at risk.
  • Use with caution in asthma or obstructive airways disease and monitor electrolytes for thiazide-induced disturbances such as hypokalaemia.

Monitoring

Monitor blood pressure, heart rate, serum electrolytes and blood glucose where relevant.

Counselling the patient

  • Do not stop this medicine abruptly without medical advice.
  • Take it in the morning to limit night-time urination.
  • Report wheeze, breathlessness, a very slow pulse or marked dizziness.

Evidence & guidelines

NICE guidance generally reserves beta-blocker plus thiazide-type combinations for later-line use given the associated metabolic risk.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways