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About Dr. Shabbir Baldiwala
Expertise
I can answer questions pertaining to maintenance of optimum blood pressure control, drugs to be used in different clinical settings, precautions and side effects to watch out for while using these drugs. Hypertension is the single largest killer disease affecting all organ systems.

Experience
5 years of training and 5 years of Clinical Practice.

Education/Credentials
MD (Internal Medicine)

 
   

You are here:  Experts > Health/Fitness > Diabetes > Hypertension > Atenolol...skipped dose questions

Hypertension - Atenolol...skipped dose questions


Expert: Dr. Shabbir Baldiwala - 9/24/2006

Question
I was put on Atenolol (50 mg daily) to treat my high blood pressure, PVC's and tacycardia nearly 4 months ago. The Atenolol worked very well until about 2 weeks ago. It brought my BP down from around 174/118 to 136/78 and nearly stopped my PVC's and racing heart. But a couple weeks ago I missed my regular dose for the first time (taken evenings around 8:30) and woke up the next morning realizing what I'd done. On the advice of an Advice Nurse I took the missed dose around 7:30 that morning. I felt fine all that day but the next night I woke up (around 3:00 am) with my heart racing, feeling flushed, shaky, and generally unwell. I got up and splashed cool water on my face and sat down and drank ice water which seemed to help a little. I took my next dose of Atenolol at 7:00 am the next morning. I felt better a couple hours later and slept well the next night. I felt okay the following day but once again I woke up in the middle of the night with the same symptoms. This went on for at least a week with one night sleeping well and the following waking up with symptoms, again the next night sleeping well, then the next waking with symptoms. These episodes lessened in severity as the week went by. It was as if missing that one dose and changing it to morning really messed me up. To make matters worse it doesn't seem to be handling my BP as well. I've been checking it the past couple weeks and it's high again. Usually in the area of 148/96. I also seem to be having some mild side effects I didn't have when taking it in the evening. Slight dizziness, foggy thinking...not constant and not severe. I'd like to start taking the medication in the evening again, but to be honest, I'm afraid to re-adjust it after going through the past symptoms of the missed dose. My doctor has been away on vacation but is due back next week. In the meantime I'm hoping you can shed some light on this. Can Atenolol work well for awhile then stop working? And, can skipped doses cause these kinds of problems?

Thank you so much!
Judy

I should let you know I am also having some problems with anxiety (which is what prompted me to seek help 4 months ago) and I'm in perimenopause. At this time I am not on any other medications.  

Answer
You can take the atenolol in the evening. Dont skip the morning dose that day. 2 doses in a day will not cause any harm. From next day onwards, yu can take in eveenings only. It is surprising but definitely 1 missed dose of atenolol cannot cause so much of problems.  

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