DOSAGE MUST BE INDIVIDUALIZED. (See INDICATIONS AND USAGE.)
Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone tablet 50 mg/25 mg given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone tablet 100 mg/25 mg given once a day.
When necessary, another antihypertensive agent may be added gradually beginning with 50 percent of the usual recommended starting dose to avoid an excessive fall in blood pressure.
Since atenolol is excreted via the kidneys, dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs until creatinine clearance falls below 35 mL/min/1.73m2 (normal range is 100–150 mL/min/1.73m2); therefore, the following maximum dosages are recommended for patients with renal impairment.
Creatinine Clearance(mL/min/1.73m2)
Atenolol EliminationHalf-life (hrs)
Maximum Dosage
15–35
16–27
50 mg daily
<15
>27
50 mg every other day