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Atenolol vs Bystolic
Introduction
For patients dealing with high blood pressure or angina, certain medications that modulate the action of specific receptors in the heart and blood vessels can help manage these conditions. Atenolol and Bystolic are such drugs, commonly prescribed for managing hypertension and chest pain. They both target beta receptors but have slight differences in their mechanisms of action. Atenolol is a selective beta-1 receptor blocker, meaning it particularly affects the heart's beta-1 receptors to lower blood pressure by reducing heart rate and contractility. On the other hand, Bystolic (Nebivolol) acts as a selective beta-1 adrenergic antagonist like Atenolol but also exhibits nitric oxide-potentiating vasodilatory activity which helps to relax your blood vessels further lowering your blood pressure.
Atenolol vs Bystolic Side By Side
| Attribute | Tenormin | Bystolic |
|---|---|---|
| Brand Name | Tenormin | Bystolic |
| Contraindications | Exacerbation of heart failure symptoms, recent MAOI use | Exacerbation of heart failure symptoms, recent MAOI use |
| Cost | $0.15-$0.33 per day for Atenolol 50mg | $1.17-$2.67 per day for Nebivolol 5mg |
| Generic Name | Atenolol | Nebivolol |
| Most Serious Side Effect | Signs of heart failure, slow heartbeat, blue fingers/toes, easy bruising/bleeding | Allergic reaction, slow heart rate with fainting, shortness of breath, swelling in feet/ankles, numbness or cold feeling in hands and feet |
| Severe Drug Interactions | MAOIs, certain antidepressants and antipsychotics | MAOIs, certain antidepressants and antipsychotics |
| Typical Dose | 25-100 mg/day, up to 200 mg/day | 5-40 mg/day |
What is Atenolol?
Atenolol (its brand name is Tenormin) was one of the first beta-blockers developed and has been commonly used for decades. It works by blocking the effects of adrenaline on your body's beta-receptors, reducing heart rate, cardiac output, blood pressure, and anxiety levels. Atenolol is often prescribed to help manage conditions such as hypertension and angina.
Nebivolol (marketed under the trade name Bystolic) represents a newer generation of beta-blockers that provide additional benefits due to its unique pharmacological profile. Like Atenolol, Nebivolol also reduces heart rate and lowers blood pressure but does so in a more selective manner with fewer side effects. Uniquely, it enhances the production of nitric oxide leading to vasodilation - an expansion of blood vessels which further helps reduce blood pressure.
While both medications are beneficial in managing cardiovascular diseases like high blood pressure or angina pectoris, they differ in their side effect profiles and specific actions on different types of receptors within our bodies' cells.
What conditions is Atenolol approved to treat?
Atenolol is approved for treating a range of cardiovascular conditions, including:
- Hypertension or high blood pressure
- Angina pectoris (chest pain due to heart disease)
- Cardiac dysrhythmias (abnormal heart rhythms)
- Acute myocardial infarction (heart attack), as secondary prevention.
How does Atenolol help with these illnesses?
Atenolol helps manage hypertension and heart conditions by decreasing the amount of work the heart has to do. It belongs to a class of drugs known as beta blockers, which function by blocking the action of certain natural substances in your body, such as adrenaline (epinephrine), on the heart and blood vessels. This effect reduces heartbeat rate, blood pressure, and strain on the heart. Beta-blockers affect the circulation (flow of blood) through arteries and veins.
Bystolic also falls into this category but is considered a third-generation beta blocker because it causes more specific effects on receptors within certain tissues compared to first- or second-generation options like Atenolol. The result is that Bystolic may cause fewer side effects relating to metabolism and energy levels than some older medications.
Both medications help reduce high blood pressure; however, they can have different impacts depending upon each patient's specific health situation and needs.
What is Bystolic?
Bystolic, also known as nebivolol, is a beta-blocker used to treat high blood pressure. It's unique from other beta-blockers like atenolol because it not only blocks the action of adrenaline on the heart and arteries but also promotes the release of nitric oxide in the blood vessels which can help relax and widen them. This dual mechanism of Bystolic was recognized when it received FDA approval in 2007.
Unlike some traditional beta-blockers that are non-selective, Bystolic specifically targets certain types of receptors found more predominantly in cardiac tissue (beta-1 receptors), reducing side effects associated with blocking other receptor types. Its potential side effects differ slightly compared to those of non-selective beta blockers such as atenolol; for instance, it less likely causes fatigue or cold hands or feet - common complaints linked with older generation drugs. However, similar to all beta blockers, nebivolol should be used cautiously by patients who have asthma or chronic obstructive pulmonary disease (COPD) due to its potential bronchoconstrictive effect.
What conditions is Bystolic approved to treat?
Bystolic, a beta blocker, is approved for the treatment of:
- Hypertension or high blood pressure The medication works by reducing the workload on the heart and helping it to beat more regularly. This decreases blood pressure, heart rate and strain on the heart.
How does Bystolic help with these illnesses?
Norepinephrine is a neurotransmitter that also functions as a hormone, and it plays pivotal roles in many bodily processes. It impacts heart rate, blood pressure regulation, attentiveness, and response to stress. Levels of norepinephrine have been implicated in conditions like hypertension and certain types of tachycardia. Bystolic works by blocking the effects of norepinephrine on beta-1 receptors predominantly found in the heart; this slows the heart rate down and lowers blood pressure. Its action may play an important role particularly for patients with concurrent cardiovascular disease or those at risk due to age or comorbidities. Atenolol operates similarly but lacks Bystolic's vasodilatory effect which might provide additional benefits such as improved kidney function or less fatigue during physical activity.
How effective are both Atenolol and Bystolic?
Both Atenolol and Nebivolol (Bystolic) are established beta-blockers used in the treatment of hypertension, angina, and arrhythmias. They were initially approved by the FDA a few decades apart, with atenolol getting approval in 1981 and nebivolol in 2007. Their mechanism of action although similar is different due to their selective nature; atenolol works on beta-1 receptors while nebivolol has a higher affinity for these same receptors but also influences nitric oxide pathway offering vasodilatory effects.
In terms of effectiveness, both drugs have shown efficacy in reducing blood pressure levels. However, studies suggest that Bystolic may be marginally better tolerated than atenoloL[1]. It's important to note that individual response varies greatly among patients due to genetic differences affecting drug metabolism.
A meta-analysis from 2012 showed that Nebivolol was as effective as other antihypertensive medications including Atenlol[2]. Moreover, it seemed to offer some benefits like lower incidence of cold extremities or sexual dysfunction which can be seen with atenlol use.
Atenlol on the other hand has been around longer hence there is vast clinical experience regarding its safety profile and efficacy. It is considered first-line therapy for conditions like stable angina pectoris.
The choice between these two medicines will often depend upon patient-specific factors such as presence of co-existing medical conditions and potential side effect profiles.
Sources: [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600795/ [2] https://pubmed.ncbi.nlm.nih.gov/22435513/
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At what dose is Atenolol typically prescribed?
Oral dosages of Atenolol range from 25-100 mg/day, but studies have indicated that 50 mg/day is usually adequate for controlling hypertension or angina in most adults. The dosage may however be increased to a maximum of 200 mg/day based on patient's response and tolerance. For Bystolic (Nebivolol), the starting dose recommended is typically 5 mg once daily, with the option to increase this after two weeks if necessary. Most patients will find their effective and tolerable dose within the range of 5–40mg per day, depending on individual response and health condition severity. It should be noted that it's critical not to exceed the maximum recommended dosage which is set at 40mg per day for Bystolic.
At what dose is Bystolic typically prescribed?
Bystolic treatment is typically initiated at a dose of 5 mg/day. If necessary, the dosage can then be increased to 10 mg/day and taken once daily. In some cases, it may be further adjusted up to a maximum dose of 40 mg per day based upon individual patient response. The increases should take place after two weeks if there's no sufficient response to the initial dosage. It's important that Bystolic doses are taken around the same time each day for optimal results and efficacy in managing hypertension or heart failure symptoms.
What are the most common side effects for Atenolol?
Common side effects of Atenolol include:
- Tiredness
- Dizziness or lightheadedness (especially when standing up)
- Depression
- Nausea, diarrhea
- Cold hands and feet
- Insomnia, nightmares
- Slow heartbeat
On the other hand, Bystolic may cause side effects such as:
- Headache
- Fatigue, drowsiness
- Diarrhea
- Stomach pain or discomfort
-Nausea
-Slow heart rate
-Dizziness on standing up
-Breathing problems in people with asthma or chronic obstructive pulmonary disease (COPD)
Both medications are beta blockers used for treating high blood pressure; however the choice between them depends on individual medical history and needs. Always consult with a healthcare provider before making any medication decisions.
Are there any potential serious side effects for Atenolol?
Atenolol and Bystolic are both beta blockers used to treat high blood pressure, but they can cause different side effects in some people. With Atenolol, watch for:
- Signs of allergic reaction: hives, difficulty breathing or swallowing, swelling in the face or throat
- Symptoms of heart failure: shortness of breath (especially when lying down), swelling ankles/feet, unusual tiredness
- Slow heartbeat, lightheadedness or fainting
- Blue fingers/toes
- Easy bruising/bleeding
With Bystolic:
- Allergic reactions like skin rash or hives; swelling of the lips, tongue or face
- Cold hands and feet
- Depression-like symptoms such as feelings of sadness/worthlessness and loss of interest in daily activities
- Breathing problems like shortness of breath with exertion
- Light-headed feeling like you might pass out.
If you notice any severe adverse effects while taking either medication, seek medical help immediately.
What are the most common side effects for Bystolic?
Bystolic, a beta-blocker used for managing hypertension, may trigger some side effects including:
- Headache or dizziness
- Fatigue or lack of energy
- Nausea and upset stomach
- Slow heartbeat
- Difficulty sleeping (insomnia)
- Breathlessness on exertion
- Swelling in your hands or feet.
Please note that while these side effects are common, they usually tend to be mild and temporary. However, if any of these persist or worsen, it's crucial to notify your healthcare provider promptly.
Are there any potential serious side effects for Bystolic?
Bystolic, like all medications, can have side effects. Although the majority of people tolerate this medication well, in some cases it may cause serious reactions. Should you experience any of the following symptoms while taking Bystolic:
- An allergic reaction: signs include hives; difficulty breathing; swelling of your face, lips, tongue or throat
- A slow heart rate with fainting spells
- Shortness of breath even with mild exertion or at rest
- Swelling in your feet or ankles
- Numbness or cold feeling in your hands and feet
- Signs suggesting an imbalance in electrolytes such as severe thirst, increased urination, leg discomforts, muscle weakness or limp feeling
If you observe any of these symptomatic reactions to Bystolic usage promptly seek medical attention.
Contraindications for Atenolol and Bystolic?
Both Atenolol and Bystolic, as with other beta-blockers, may exacerbate symptoms of heart failure in some individuals. If you notice any worsening signs like weight gain, increased shortness of breath, or swelling of your ankles/feet, please seek immediate medical attention.
Neither Atenolol nor Bystolic should be taken if you are taking or have recently been taking certain medications such as MAOIs (monoamine oxidase inhibitors), some types of antidepressants or antipsychotics. Always inform your physician about all the medications you are currently on; drugs like MAOIs will require a period of approximately two weeks to clear from your system to prevent dangerous interactions with Atenolol and Bystolic.
How much do Atenolol and Bystolic cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Bystolic (5 mg) averages around $180, which works out to approximately $6 per day.
- The price of 60 tablets Atenolol (50mg) is about $10-$20, working out to roughly $0.15-$0.33 per day.
Thus, if you are in the range for a higher dosage of Bystolic such as 40 mg/day or higher, then brand-name Atenolol would be less expensive on a daily treatment basis. Please remember that cost should not be your primary consideration when deciding which drug to take; efficacy and side effects must also be considered.
In terms of generic pricing for both atenolol and nebivolol (Bystolic):
- Generic atenolol is cheaper with prices averaging between $4 and $10 for thirty 50mg tablets depending on where it's bought from. That comes down to an approximate daily cost ranging from around $0.13 to about $.033.
- Nebivolol costs significantly more in its generic form compared to atenolol with average prices floating around the mark off approximatley$35 - $80 for thirty 5mg tablets resulting in a daily dosing cost between approximately from as low as ~$1.17 going upto ~$2.67 per day.
Popularity of Atenolol and Bystolic
Atenolol, in its generic form and under brand names such as Tenormin, was estimated to have been prescribed to about 11 million people in the US in 2020. Atenolol accounted for just over 6% of beta-blocker prescriptions in the US. It appears to be a common choice among first-generation beta-blockers due to its less complex daily dosing schedule with once-daily administration.
Nebivolol, including brand versions like Bystolic, was prescribed to approximately 3.5 million individuals in the USA within the same year. In relation to all beta-blocker prescriptions across the country, nebivolol accounts for roughly 2%. This drug is considered a third-generation beta blocker known for being highly selective and also having additional vasodilatory properties which can benefit certain patients at risk of peripheral vascular diseases. The prevalence of nebivolol has been steadily increasing since its introduction into mainstream medicine around late-2007.
Conclusion
Both Atenolol and Bystolic (Nebivolol) are beta-blockers that have proven efficacy in the treatment of hypertension, with numerous clinical studies indicating their effectiveness. They can be used independently or sometimes may be combined with other blood pressure medications depending on the patient's condition and physician discretion. Their mechanisms differ somewhat; atenolol primarily blocks beta-1 receptors decreasing the heart's workload, while Bystolic acts similarly but also has some vasodilatory properties due to its interaction with nitric oxide pathways.
Atenolol is often considered a first-line treatment option for hypertension, whereas Bystolic might be preferred in patients where an additional need for arterial dilation is beneficial. Both drugs come in generic forms which can provide significant cost savings especially for those paying out-of-pocket.
A period of adjustment may be required when starting either medication as it takes time to see their full effects on blood pressure control. The side effect profiles are similar between both drugs including potential fatigue, dizziness or lightheadedness; however, nebivolol tends to have fewer traditional side effects associated with beta blockers such as sexual dysfunction and mental cloudiness. As always it’s crucially important under these medications for patients to monitor their health status regularly and consult healthcare providers promptly if any concerning symptoms arise.
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Refrences
- Cruickshank, J. M., R.C.P. London, F., & McAinsh, J. (1991, January). Atenolol and ischaemic heart disease: an overview. Current Medical Research and Opinion. Informa Healthcare.http://doi.org/10.1185/03007999109111659
- Dimenas, E., Dahlof, C., Olofsson, B., & Wiklund, I. (1989, November). CNS‐related subjective symptoms during treatment with beta 1‐ adrenoceptor antagonists (atenolol, metoprolol): two double‐blind placebo controlled studies. British Journal of Clinical Pharmacology. Wiley.http://doi.org/10.1111/j.1365-2125.1989.tb03538.x
- Lewis, R., Jackson, P., & Ramsay, L. (1985, February). Side‐effects of beta‐adrenoceptor blocking drugs assessed by visual analogue scales. British Journal of Clinical Pharmacology. Wiley.http://doi.org/10.1111/j.1365-2125.1985.tb02639.x
- Badar, V., Hiware, S., Shrivastava, M., Thawani, V., & Hardas, M. (2011). Comparison of nebivolol and atenolol on blood pressure, blood sugar, and lipid profile in patients of essential hypertension. Indian Journal of Pharmacology. Medknow.http://doi.org/10.4103/0253-7613.83117
- Pedersen, M. E., & Cockcroft, J. R. (2006, July). The latest generation of beta-blockers: New pharmacologic properties. Current Hypertension Reports. Springer Science and Business Media LLC.http://doi.org/10.1007/s11906-006-0065-0
- Weiss, R. (2006, August). Nebivolol: a novel beta-blocker with nitric oxide-induced vasodilatation. Vascular Health and Risk Management. Informa UK Limited.http://doi.org/10.2147/vhrm.2006.2.3.303