Increased risk of hypotension, and/or bradycardia, when used with catecholamine-depleting drugs If used clonidine, atenolol.an worsen rebound HTN following clonidine withdrawal

Hypotensive effect of atenolol is reduced when usedd with protagladin synthase inhibitors Nifedipine may incresae serum digoxin levels.

Cimetidine may increase peak plasma levels and area-under-curve of nifedipine

Reduced efficacy of nifedipine with phenytoin or rifampicin.

Calcium chan blockers may reduce clearance of nifedipine Increased plasma level of nifedipine with cisapride, quinupristin, or dalflopristin.

Concurrent use of nifedipine with MAOIs , nor-adrenaline or adrenaline may cause excessive increase in BP.

Cadiac depressants may be additive when used with narcotics or antiarrhythmics May potentiate action of non-deploarising muscle relxants

Hypetension

Angina pectoris

Headache, palpitation, flushing, depression,

wheezing, dizziness, hypotension,

GI upsets, fatigue, vertiigo,

warmth and swelling, Itching,

muscle cramps, and cold extremities

Hypersensitivity

CCF , sinus bradycardia, heart block > 1st degree

Hypotension, overt cardiac failure,

Aortic stenosis, unstable angina, acute attacks of angina

Acute MI or secondary prevention of cardiogenic shock Lactation

Special precaution-

Peripheral vascular disease, hepatic or renal dysfunction, malignant hypertension,

Fixed left ventricular obstruction. Withdrawal should be gradual

Execessive drop in BP may occur in some patients, especially elderly, when used in patients with airway obstruction.

Caution in diabetics as it may mask hypoglycemia

Continued depression of myo-cardium by beta blocker may lead to cardiac failures

Nifedipine may cause severe chest pain, increased severity duration or frequency of angina May mask signs of hypothyroidism

Not to be used in patients with untreated photochromocytoma

Caution when used in patients with peripheral circulatary disorders

Pregnancy

Indication-

Hypertension

Angina pectoris

Dosage-

Adults- atenolol 50mg + nifedipine sr 20mg 1 cap once or twice daily

Elderly- 1 cap once daily

Contraidicated for use during pregnancy and laction.

Observe caution