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Lopressor vs Atenolol
Introduction
For patients with high blood pressure (hypertension) or other heart-related conditions, certain medications known as beta-blockers can help in managing symptoms and reducing the risk of complications. Lopressor and Atenolol are two such drugs that are commonly prescribed for these conditions. These medicines work by blocking the effects of the hormone adrenaline, also known as epinephrine, on your body's beta receptors to slow heart rate and reduce blood pressure. Lopressor, which is a brand name for metoprolol tartrate, affects both parts of the heart while Atenolol only targets one part. Although they have similar functions in controlling hypertension and angina pains, their dosages may vary depending on individual patient needs and responses.
Lopressor vs Atenolol Side By Side
| Attribute | Lopressor | Atenolol |
|---|---|---|
| Brand Name | Lopressor | Atenolol |
| Contraindications | May worsen symptoms of heart failure in some people. Should not be taken with calcium channel blockers like verapamil or diltiazem due to risk of dangerous interactions. | May worsen symptoms of heart failure in some people. Should not be taken with calcium channel blockers like verapamil or diltiazem due to risk of dangerous interactions. |
| Cost | For brand name: around $200 for 60 tablets of 50 mg. For generic metoprolol: ranges from approximately $0.20 to $1.00 per day. | For brand name: about $150 for 30 capsules of 50 mg. For generic atenolol: starts at just under $.10/day, typically not exceeding about $.70/day. |
| Generic Name | Metoprolol | Atenolol |
| Most Serious Side Effect | Symptoms of heart problems (slow or uneven heartbeat, shortness of breath, swelling in ankles or feet), severe skin reactions, symptoms related to low blood sugar levels. | Signs of an allergic reaction, cold feeling in hands and feet, slow heart rate, symptoms related to low blood sugar, trouble sleeping, unusual mood changes. |
| Severe Drug Interactions | Calcium channel blockers such as verapamil or diltiazem. | Calcium channel blockers such as verapamil or diltiazem. |
| Typical Dose | Oral dosages range from 25-100 mg/day, with 50 mg/day being sufficient for most patients. Maximum daily dosage should not exceed 400 mg. | Therapy typically starts with a dosage of 50 mg per day, can be increased to 100 mg/day. Maximum recommended daily dose is 200 mg. |
What is Lopressor?
Metoprolol (the generic name for Lopressor) was one of the earliest beta blockers approved by the FDA in 1978. It works by blocking the effects of adrenaline on your heart, which slows the heartbeat and helps to control high blood pressure. Metoprolol is prescribed primarily for hypertension, angina, and heart failure. On the other hand, Atenolol is another beta blocker that was later approved by the FDA in 1981 with similar actions as metoprolol but with a longer elimination half-life due to its lower lipid solubility. This results in less frequent dosing compared to metoprolol. Both medications have selective influence on beta-1 receptors (found mostly in heart muscle), which leads them having fewer side effects than non-selective beta-blockers that can also affect beta-2 receptors found predominantly within lung tissues.
What conditions is Lopressor approved to treat?
Lopressor is approved for the treatment of different cardiovascular conditions:
- Hypertension, also known as high blood pressure
- Angina pectoris, a condition characterized by chest pain due to reduced blood flow to the heart
- Heart failure (for stabilization after an acute episode)
- Myocardial infarction or heart attack (to reduce cardiovascular mortality)
How does Lopressor help with these illnesses?
Lopressor and Atenolol both help manage conditions such as high blood pressure, angina (chest pain), and irregular heart rhythms by decreasing the workload on the heart. They do this by blocking the action of certain natural chemicals in your body, like adrenaline on the heart and blood vessels. This effect reduces strain on the heart, decreases heart rate, lowers blood pressure levels, and helps prevent future cardiovascular problems such as strokes or myocardial infarctions (heart attacks). Lopressor is a short-acting beta-blocker while Atenolol is long-acting; thus providing sustained control over symptoms throughout the day with less frequent dosing. The choice between these two medications often depends on individual patient factors like their overall health condition, lifestyle choices, and specific medical needs.
What is Atenolol?
Atenolol, sold under the brand name Tenormin among others, is a beta blocker that can be used to treat high blood pressure and prevent chest pain in people with coronary artery disease. It functions by inhibiting the action of adrenaline on specific beta receptors in your heart which slows down your heartbeat and lowers your blood pressure. Atenolol was first approved by the FDA in 1981.
Unlike Lopressor (metoprolol), Atenolol does not readily pass through the blood-brain barrier which results in fewer central nervous system side effects such as depression or confusion. This makes it a preferable choice for patients who may be sensitive to these potential side effects.
The most common side effects of Atenolol include fatigue and cold hands or feet but serious side effects are rare. The impact of Atenolol on controlling heart rate and reducing chest pain can be advantageous especially for individuals with cardiovascular conditions.
What conditions is Atenolol approved to treat?
Atenolol is approved for the treatment of conditions including:
- High blood pressure (Hypertension)
- Angina pectoris related to coronary artery disease
- Heart rhythm disorders, particularly supraventricular tachycardia In addition, it can also be used post-heart attack (myocardial infarction) to improve the chances of survival.
How does Atenolol help with these illnesses?
Atenolol is a beta-blocker, which functions by slowing the heart rate and reducing the force of heartbeat. It achieves this by blocking norepinephrine's effects on beta-1 receptors, found primarily in the heart. As a result, it can help manage conditions such as hypertension (high blood pressure), angina (chest pain), and irregular heartbeat rhythms. Unlike Lopressor (metoprolol), Atenolol does not easily cross into the brain due to its low lipid solubility; therefore it has less impact on CNS related side-effects like fatigue or depression. This makes it potentially a better choice for those who may be sensitive to these types of side effects associated with other beta-blockers like Lopressor.
How effective are both Lopressor and Atenolol?
Both metoprolol (Lopressor) and atenolol are beta-blockers, meaning they work by blocking the effects of the hormone adrenaline on your body's beta receptors. This helps to slow down your heart rate, decrease blood pressure, and reduce strain on the heart. Both medications have been widely prescribed for many years and have a well-established safety profile.
Metoprolol was directly compared with atenolol in a double-blind clinical trial conducted in 2005; both drugs showed similar efficacy in managing symptoms of hypertension and angina pectoris while also demonstrating comparable safety profiles. In this study, none of the different metrics studied to measure efficacy in treating these conditions differed significantly between patients receiving metoprolol and those receiving atenolol.
A 2010 review concluded that metoprolol is effective from the first week of treatment, has an acceptable side effect profile when compared to other beta-blockers, and is generally well-tolerated even among elderly populations or those with liver or kidney disease. The same report noted that despite its effectiveness as an antihypertensive drug, it may not be as beneficial for preventing strokes or coronary events as some other treatments like ACE inhibitors. The optimal dosage tends to vary depending upon individual patient factors but often ranges from 50-100mg once daily.
AtenoloI remains a commonly-prescribed medication due to its affordable cost and proven effectiveness against high blood pressure (hypertension), irregular heartbeat (arrhythmias), chest pain (angina), tremors, migraine prevention, anxiety relief before surgery etc., indicating widespread acceptance within medical community. However AtenoloI usually isn't considered first-line therapy for hypertension anymore because newer research suggests it doesn't lower blood pressure as effectively as newer types of medications such as calcium channel blockers do. Nonetheless due to its unique pharmacology particularly regarding selectivity towards β1-adrenergic receptors located mainly within cardiac tissues making it more cardioselective than non-selective counterparts such as propranolol which could lead lesser bronchial side effects thus proving advantageous especially for asthmatics who need beta blocker therapy.
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At what dose is Lopressor typically prescribed?
Oral dosages of Lopressor range from 25-100 mg/day, but most patients have found that 50 mg/day is sufficient for managing hypertension. Adults may be started on a dose of 50 mg/day. Depending on the patient's response, the dosage can be increased after one or two weeks if necessary. However, the maximum daily dosage should not exceed 400 mg under any circumstances.
On the other hand, Atenolol also has an oral dosage that ranges from 25-100mg per day with most patients finding relief at around 50mg per day for controlling blood pressure and angina symptoms. It can also be started at a lower dose and then gradually increased over several weeks depending upon how well it is tolerated and its effectiveness in individual cases. The maximum daily limit for Atenolol too is capped at 200mg to ensure safety.
At what dose is Atenolol typically prescribed?
Atenolol therapy typically commences with a dosage of 50 mg per day. If necessary, the dose can be increased to 100 mg/day taken as one dose or divided into two doses spaced 12 hours apart. The maximum recommended daily dose is 200 mg, which may be trialed if there's no response to treatment at the lower doses over a period of time. As always, any changes in medication and dosages should be guided by your healthcare provider.
What are the most common side effects for Lopressor?
Common side effects of Lopressor (Metoprolol) may include:
- Fatigue, tiredness
- Dizziness or lightheadedness
- Decreased heart rate
- Depression
- Shortness of breath
- Dry mouth
- Stomach pain, nausea, diarrhea or constipation
- Cold hands and feet
- Sleep disturbances, nightmares
Atenolol also presents a range of potential side effects such as:
- Tiredness and fatigue
- Cold fingers and toes
- Nausea
- Slow heartbeat
- Diarrhea or constipation
The severity and frequency of these side effects can vary between individuals. It's important to discuss any concerns with your healthcare provider.
Are there any potential serious side effects for Lopressor?
While both Lopressor and Atenolol are beta blockers used to treat high blood pressure, they may cause different side effects:
- Symptoms of heart problems: slow or uneven heartbeat, shortness of breath, swelling in your ankles or feet
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Vision changes such as blurred vision
- Symptoms related to low blood sugar levels like dizziness, sweating and shaking
- Severe skin reactions including rash that can be with itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
In addition to these potential side effects，some patients might experience symptoms due to a decrease in blood flow to the hands and feet. These include feeling cold in your hands and feet，numbness/tingling/swelling/pain. If you notice any significant changes while taking either medication，it is important to contact a health professional immediately.
What are the most common side effects for Atenolol?
Atenolol, another beta-blocker similar to Lopressor, has a range of potential side effects that can include:
- Fatigue or drowsiness
- Cold hands and feet
- Dizziness or lightheadedness
- Nausea, vomiting, or diarrhea
- Shortness of breath
- Sleep disturbances including insomnia and nightmares
- Slow heartbeat (bradycardia)
- Depression symptoms such as feeling anxious or sad.
It's important to note that while Atenolol can help manage high blood pressure and heart conditions effectively, it may not suit everyone. Always consult with your healthcare provider for the best treatment options for you.
Are there any potential serious side effects for Atenolol?
Atenolol, while generally well-tolerated, may cause serious side effects in certain cases. If any of the following symptoms are experienced, it is recommended to seek immediate medical attention:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Cold feeling in hands and feet
- Slow heart rate
- Symptoms related to low blood sugar: headache, hunger, sweating
- Trouble sleeping
- Unusual mood changes or behaviors including confusion or hallucinations
- Shortness of breath (even with mild exertion), swelling in ankles or feet. These conditions could be indicative that atenolol might not be the right medication for you and a consultation with a healthcare professional would be necessary.
Contraindications for Lopressor and Atenolol?
Both Lopressor and Atenolol, like many other beta-blockers, may worsen symptoms of heart failure in some people. If you notice your condition worsening or an increase in chest pain, shortness of breath, fainting spells, or irregular heartbeat, please seek immediate medical attention.
Neither Lopressor nor Atenolol should be taken if you are taking calcium channel blockers such as verapamil or diltiazem due to the risk of dangerous interactions that can lead to excessively slow heart rates and severe hypotension (low blood pressure). Always tell your physician which medications you are currently on; it is important to gradually decrease the dose of these drugs under a doctor's guidance rather than stopping abruptly.
How much do Lopressor and Atenolol cost?
For the brand name versions of these drugs:
- The price for 60 tablets of Lopressor (50 mg) averages around $200, which works out to approximately $3-$6 per day, depending on your dose.
- The price for 30 capsules of Atenolol (50 mg) is about $150, working out to roughly $5/day.
Thus, if you are in the higher dosage range for Lopressor (i.e., 100 mg/day or higher), then brand-name Atenolol is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
For generic versions of Lopressor (metoprolol) and Atenolol:
-
Metoprolol can be obtained in packs from 30 tablets upwards, with costs ranging from approximately $0.20 to $1.00 per day if taking typical dosages between 50mg and 200mg daily.
-
Generic atenolol also comes in packs starting from as low as 15 up to several hundred tablets, with prices starting at just under $.10/day (if buying larger quantities upfront), and typically not exceeding about $.70/day even when taking larger doses such as 100mg daily.
Popularity of Lopressor and Atenolol
Metoprolol, available under the brand name Lopressor among others, was estimated to have been prescribed to about 37.2 million people in the US in 2017. Metoprolol accounted for just over 15% of beta-blocker prescriptions in the US. It's a selective β1 receptor blocker used primarily to manage symptoms of heart disease such as high blood pressure and angina but is also utilized after heart attacks to improve survival rates. The prevalence of metoprolol has been steadily increasing since its introduction.
Atenolol, on the other hand, was prescribed to approximately 15 million people in the USA during that same year (2017). In America alone, Atenolol accounts for around 6% of all beta-blocker prescriptions indicating it is less commonly used than Metoprolol overall. Despite this difference in prescription rates between these two medications there are some clinical situations where atenolol may be preferred due to its slightly better kidney excretion rate which can be beneficial for certain patients with compromised renal function.
Conclusion
Both Lopressor (metoprolol) and atenolol have long-standing records of usage in patients with hypertension, angina pectoris, and heart rhythm disorders. They are backed by numerous clinical studies indicating that they effectively lower blood pressure more than placebo treatments. The drugs can sometimes be used together but this is subject to careful consideration by a physician as they may intensify each other's effects on the heart rate.
Their different pharmacokinetic profiles influence their prescription under different circumstances - metoprolol has a shorter half-life and thus requires twice-daily dosing while atenolol only needs once-daily dosing due to its longer half-life. Metoprolol is often considered for those who have concurrent cardiac issues such as heart failure since it demonstrated benefits in these conditions.
Both medications are available in generic forms which represent significant cost savings especially for patients who must pay out of pocket. Both Lopressor and atenolol may require an adjustment period, meaning that their full effect on blood pressure control may not be noticeable right away.
Side effects between the two drugs are similar given their shared mechanism of action as beta blockers; common ones include fatigue, cold hands or feet, weight gain etc., but metoprolol tends to cause fewer side effects related to peripheral vasoconstriction compared to atenololo because it primarily blocks beta-1 receptors found mostly in the heart. Patients should closely monitor their response particularly when starting treatment or adjusting doses – if there are symptoms like worsening chest pain or slow heartbeat, immediate medical attention should be sought.
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Refrences
- Rasmussen, S., Arnung, K., Eskildsen, P., & Nielsen, P. (1981, December). A comparative study of atenolol and metoprolol in the treatment of hypertension. British Journal of Clinical Pharmacology. Wiley.http://doi.org/10.1111/j.1365-2125.1981.tb01326.x
- Brogden, R. N., Heel, R. C., Speight, T. M., & Avery, G. S. (1977, November). Metoprolol. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-197714050-00001
- Krittayaphong, R., Bhuripanyo, K., Punlee, K., Kangkagate, C., & Chaithiraphan, S. (2002, December). Effect of atenolol on symptomatic ventricular arrhythmia without structural heart disease: A randomized placebo-controlled study. American Heart Journal. Elsevier BV.http://doi.org/10.1067/mhj.2002.125516
- Heel, R. C., Brogden, R. N., Speight, T. M., & Avery, G. S. (1979, June). Atenolol. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-197917060-00001
- Scott, A. K., Rigby, J. W., Webster, J., Hawksworth, G. M., Petrie, J. C., & Lovell, H. G. (1982, May 22). Atenolol and metoprolol once daily in hypertension. Bmj. BMJ.http://doi.org/10.1136/bmj.284.6328.1514
- 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