INTRODUCTION

BETATROP is a combination of Atenolol and Nifedipine which belongs to the group of medicines called Antihypertensive agents. It is used in adults to manage hypertension (high blood pressure) when management with single agents is not effective. By lowering blood pressure, BETATROP can also reduce the risk of heart attack (myocardial infarction) or stroke. It can also be used to prevent angina pectoris (chest pain caused due to low oxygen supply).

Atenolol is a beta-blocker. It slows down the heartbeat and makes the heart to pump blood with a lesser force. Nifedipine is a calcium channel blocker. It relaxes the blood vessels supplying the vital organs and improves blood flow and oxygen supply across the blood vessels. Together, they help the heart to pump more blood smoothly with less pressure and reduce anginal symptoms.

BETATROP should not be used during an active anginal attack. It is only used to prevent anginal attacks from forming. In case if you experience any anginal symptoms, consult your doctor immediately.

During management with BETATROP your doctor will constantly monitor your kidney functions, blood pressure and blood sugar levels to avoid the risk of unwanted side effects. Also, avoid eating grapefruit or drinking grapefruit juice (especially within 3 days) before taking BETATROP as it may interact with BETATROP.

Before taking BETATROP, inform your doctor if you have any liver or kidney problems. You must also inform your doctor if you have diabetes, low blood volume or thyroid problems.

BETATROP is not recommended for use in patients with any other heart problems apart from hypertension and angina (such as heart failure, heart block). It is also not suitable for use in patients with very low blood pressure and in women who are pregnant or breastfeeding due to increased risk of side effects.

The most common side effects of taking BETATROP are headache, tiredness, feeling unwell, slow heartbeat and swelling of ankles. Consult your doctor if any of these side effect troubles you.

USES OF BETATROP

It is used in adults to:

• Manage hypertension (high blood pressure)
• Prevent angina pectoris (chest pain)
• Reduce the chances of heart attack or stroke

HOW BETATROP WORKS

BETATROP contains two medicines namely atenolol and nifedipine. Atenolol blocks the effects of certain hormones (adrenaline) in the body that naturally increases heart rate. This slows down the heartbeat and makes the heart to pump blood with a lesser force.

Nifedipine is a vasodilator. It relaxes the blood vessels by blocking the entry of certain ions (calcium ions) within them that causes narrowing. This allows blood to flow more smoothly across the blood vessels and increases oxygen supply. Collectively, they reduce the strain on the heart and helps the heart to pump more blood smoothly with less pressure.

DIRECTIONS FOR USE

Take BETATROP as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Try to take BETATROP at the same time each day.

Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and health condition. Continue to take BETATROP for the stipulated duration instructed by your doctor without any interruption to achieve better results.

SIDE EFFECTS OF BETATROP

HOW TO MANAGE SIDE EFFECTS

Nausea:

Take BETATROP with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food. Consult your doctor if your nausea worsens.

Dizziness:

Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol. Consult your doctor if your dizziness worsens.

Headache:

Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.

Constipation:

Eat plenty of fibre rich foods such as fresh fruits, vegetables, and cereals. Drink plenty of fluids. Exercise more regularly. Consult your doctor if this side effect bothers you.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug-Drug Interaction:

Before taking BETATROP, inform your doctor if you are taking any of the following:

• other medicines used to manage high blood pressure and angina (such as nifedipine, verapamil, diltiazem, enalapril, ramipril, metoprolol, clonidine)
• medicine used to manage irregular heartbeat (Ex. amiodarone, quinidine or disopyramide)
• adrenaline (a medicine used to stimulate the heart)
• medicines used to manage fungal infections (Ex. itraconazole, ketoconazole and fluconazole)
• medicines used to manage depression (Ex. nefazodone, fluoxetine, St, John’s Wart)
• medicines used to manage epilepsy (Ex. phenytoin, carbamazepine or valproic acid)
• medicine used to manage HIV infection (Ex. indinavir, ritonavir, saquinavir)
• rifampicin (a medicine used to manage tuberculosis)
• cimetidine (a medicine used to manage stomach ulcers)
• tacrolimus (a medicine used to prevent graft rejection)
• phenobarbital (a medicine used to manage anxiety and to induce sleep)
• digoxin (a medicine used to manage heart failure)
• indomethacin or ibuprofen (medicines used for pain relief)
• medicines used to manage diabetes (Ex. insulin, metformin, glimepiride)
• potassium supplements or potassium- sparing diuretics (such as amiloride, spironolactone)
• quinupristin/dalfopristin (an antibiotic combination used to manage severe bacterial infections)
• cisapride (a medicine used to reduce movement of stomach and gullet)
• magnesium sulphate injection during pregnancy
• medicines used to manage nose or sinus congestion and other cold remedies
• anesthetics (used to create numbness or loss of sensation) Ex. sevoflurane, enflurane, isoflurane, lignocaine, bupivacaine

B. Drug-Food Interaction:

Do not eat grapefruit or drink grapefruit juice while taking BETATROP as it may increase the risk of side effects. Also, do not take BETATROP within 3 days of eating grapefruit or drinking grapefruit juice.

Overdosage:

If you or anyone else accidentally took more BETATROP, consult your doctor immediately. Overdosage may cause low blood pressure, abnormal heartbeat, fainting, increased blood glucose levels, drowsiness, nausea, vomiting or confusion.

SYNOPSIS

MORE INFORMATION

• Keep BETATROP out of reach of children
• Store BETATROP at room temperature

FAQs ABOUT BETATROP

What are the uses of BETATROP?

BETATROP is used to manage hypertension. It can also be used to prevent angina and other heart problems such as heart attack or stroke.

What type of a medicine is BETATROP?

BETATROP is an antihypertensive medicine. It is used to manage hypertension and to prevent angina and other heart problems such as heart attack or stroke. It is a combination of two medicines namely atenolol and nifedipine. Atenolol is a beta-blocker and nifedipine is a calcium channel blocker. They both reduces strain on the heart, relaxes blood vessels and makes the heart to pump more blood with lesser force.

What happens when I stop taking BETATROP?

Do not stop taking BETATROP without consulting your doctor as your blood pressure may raise once again. Make sure to take BETATROP for the stipulated duration recommended by your doctor to achieve maximum results.

What is the best time to take BETATROP?

BETATROP can be taken with or without meals. Your doctor will decide the best time for you to take BETATROP based on your age, body weight and disease condition.

What to do if I forgot to take a dose of BETATROP?

If you have missed a dose of BETATROP, take it as soon as you remember. However, if it is time for the next dose of BETATROP, skip the missed dose and take the next one regularly. Do not take a double dose of BETATROP to compensate the missed ones.

What precautions should be followed while taking BETATROP?

Before taking BETATROP, inform your doctor if you have any liver or kidney problems. You must also inform your doctor if you have diabetes, low blood volume, thyroid problems, or any other heart problems apart from hypertension and angina. Stop taking BETATROP and consult your doctor immediately if you become pregnant. Regularly visit your doctor and take all the necessary blood test recommended by your doctor without fail.

Can I consume alcohol while taking BETATROP?

Avoid consumption of alcohol while taking BETATROP as it might make you feel dizzier and drowsier.

What happens if I accidentally take more BETATROP?

If you or anyone else accidentally took more BETATROP, consult your doctor immediately. Overdosage may cause low blood pressure, abnormal heartbeat, fainting, increased blood glucose levels, drowsiness, nausea, vomiting or confusion.

Can I take BETATROP daily?

Take BETATROP as advised by your physician. Your doctor will evaluate your health condition and suggests whether can you take BETATROP every day or not.

Is BETATROP safe to use in diabetic patients?

BETATROP may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking BETATROP as a precaution. Your doctor will closely monitor you blood sugar levels to avoid the risk of side effects.

What are the side effects of BETATROP?

The most common side effects of taking BETATROP are headache, tiredness, feeling unwell, slow heartbeat and swelling of ankles. Consult your doctor if any of these side effect troubles you.

Can I stop taking BETATROP once my symptoms subside?

No. Do not stop taking BETATROP without consulting your doctor. As hypertension is a chronic condition, long term management may be necessary to control its symptoms. Therefore, take BETATROP as advised by your doctor for the stipulated duration. Premature discontinuation of therapy may increase your blood pressure once again.

Can BETATROP be taken during pregnancy?

BETATROP is generally not recommended for use in pregnant women as it may cause serious harm to the growing foetus. Therefore, inform your doctor before taking BETATROP if you are pregnant, think you may be pregnant or planning to have a baby.

REFERENCES

1. KD. Tripathi. Antihypertensive Drugs & Antianginal and Other Anti-ischaemic Drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page – 551, 552, 563 & 573.

2. Nguyen Phong Chau, Xavier Chanudet, GerardNguyen. Effects of a combination of atenolol and nifedipine on ambulatory and office blood pressure and heart rate. Current Therapeutic Research. ScienceDirect. December 1992. [Accessed on 1st March 2022] https://www.sciencedirect.com/science/article/abs/pii/S0011393X05800633

3. I N Findlay, K MacLeod, M Ford, G Gillen, A T Elliott, and H J Dargie. Management of angina pectoris with nifedipine and atenolol: efficacy and effect on cardiac function. NCBI; PMC US National Library of Medicine, National Institute of Health. March 1986. [Accessed on 1st March 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232159/

4. Accord Healthcare Limited, Electronic Medicines Compendium (EMC). [Revised in October 2021] [Accessed on 1st March 2022] https://www.medicines.org.uk/emc/files/pil.6024.pdf

5. UCB Pharma Ltd, Electronic Medicines Compendium (EMC). [Revised in September 2017] [Accessed on 1st March 2022] https://www.medicines.org.uk/emc/files/pil.2143.pdf

6. Wellona Pharma. Wellnift-AT Tablet (Nifedipine and Atenolol). [Accessed on 1st March 2022] https://wellonapharma.com/product/finished/nifedipine-and-atenolol-tablets

7. United Pharmacies. Nilol. Atenolol and Nifedipine. [Accessed on 14th July 2022] https://www.unitedpharmacies.md/Nilol-Nifedipine-Atenolol.html

USEFUL DIAGNOSTIC TESTS

• Kidney function test