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propranolol and atenolol differences


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  • propranolol and atenolol differences


    I am keen on finding out from this forum if anybody has tried propranolol and atenolol beta-blockers. I would like to find out in simple English what are the differences between the two medications and which one is a better for treating HOCM.
    I have visited two cardiologists and one says to me to take propranolol and the other to take atenolol. I am not sure who to believe?
    My main interest is to find out the differences between the two (how they work) for treating the HOCM symptoms.



  • #2
    Both are beta blockers and have similar effects on HCM. They soften the heart beat and can lower blood pressure. Propanolol is an older drug, I think. I've used both myself and I can't say that either was better for me than another but I don't have HCM. I had another arrhythmia problem. Maybe others who've tried both will speak up soon.


    Husband has HCM.
    3 kids - ages 23, 21, & 19. All presently clear of HCM.


    • #3
      Reenie is correct in that propranolol is the older drug. Propranolol is actually the first, or one of the very first, beta-blocker drugs.

      I'll give you personal experience and research on this one.

      First, my mom calls propranolol "End-it-all" as a play on the brand name it has of Inderal. That is how miserable it made her. I know someone who would beat her boyfriend in the middle of the night because she was having nightmares that there were giant spiders in the bed while she was on it. Some people can tolerate it, but no one I know personally.

      I've not taken it myself, since I was offered Tenormin/atenolol as the first beta-blocker I ever took. I was ok with it but when I got to larger doses, my short term memory was reduced to ten minutes and I felt like I had two states of being: happy zombie and sad zombie. Now, obviously my mom and I have some issues with the beta-blockers. But I have to tell you, I've been on atenolol, nadolol, metroprolol, and a couple calcium channel blockers and I would have to say nadolol was the one I tolerated best. Now I'm metroprolol b/c I need the long-acting kind but if I kick my dose high enough (300mg), I lose some emotional range and thinking.

      There are two kinds of beta-blockers: selective and non-selective. Here is an EXCELLENT explanation (in English):

      http://www.answers.com/topic/beta-blocker --you need to scroll down about 3/4 of the way to get to the selective/non-selective part.

      In a nutshell, atenolol is selective and propranolol is non-selective. Selective means it only attaches to the beta-receptors on the heart instead of all the beta-receptors in the body and should therefore have fewer side effects or be better tolerated.

      Please be aware that I haven't even listed all of the beta-blockers out there, either. You should google beta-blockers and especially check out the Wikipedia, mayoclinic.com, and medline for more info. And you can use the search function on this board to mine our treasure chest of info as well.

      The reality is that the only way to know what you tolerate best is to take it. Personally, however, you couldn't make me take propranolol to save my life (well, maybe, but it would have to be the only option).



      • #4
        Which beta blocker is right for YOU is what is important and often it takes trial and error to find the best one. Both of them are good - and both have potential side effects. I have been on both and perfer the atenolol - but that is ME - not YOU.

        Knowledge is power ... Stay informed!
        YOU can make a difference - all you have to do is try!

        Dx age 12 current age 46 and counting!
        lost: 5 family members to HCM (SCD, Stroke, CHF)
        Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
        Therapy - ICD (implanted 97, 01, 04 and 11, medication
        Currently not obstructed
        Complications - unnecessary pacemaker and stroke (unrelated to each other)


        • #5
          Hi Oliver, I took Propranolol for over 25 years, started around 1979, yes it is one of if not the first Beta Blockers.
          Several years ago my HCM Doc suggested I switch to Atenolol because it was newer and he felt better suited to me.
          I have to admit, I felt quite a bit better on Atenolol, didn't really realize I was feeling not as well on Inderal because I took it for so long and thought this is the way I should feel.
          The worst side affect on Inderal for me was Diarrhea and it went away as soon as I switched, again I didn't even realize Inderal was causing the problem.
          I have since been switched to Monocor as Atenolol slowed my heart rate down too much.
          But of the three I preferred Atenolol.


          • #6
            I've taken both, although the period of time on each was separated by several years on a calcium channel blocker, so its hard to compare the experiences. As far as I'm concerned, they BOTH made me feel like the "sad zombie" that Sarah mentioned. (which is why I was switched to the ccb instead. not sure it was much better...but certainly, it was a different "effect"). there was no "happy zombie" involved. And I was on the lowest dose. in fact, w/ the atenolol, (most recently), I was taking half a pill. Doc wanted to increase that slowly, and switch me over to "toprol". I was not a happy camper doing this. I started with half a pill, 2x per day...that was bad. but then when it was time to go to "3 halfs of a pill per day" (1 whole pill in the am; 1/2 pill in the pm, or vice-versa), I couldn't function. I switched to taking the full pill at bed time, so I could sleep most of it off, but my heart simply wouldn't beat fast enough to function. Most of us are probably familiar with getting a little head rush when picking something up off of the floor....I was getting that just by getting up out of a chair.

            anyway...toprol is better, for me. not that its "great". it just doesn't suck as bad.


            • #7


              I have been reading all the replies here and I can,t believe what I am reading, I thought I was truly alone. I have been taking inderal for more than 28 yrs and I got the scars to prove it. When I first started I had really really bad nightmares and ended up going through a plate glass window. It took a long time but I did manage to get them under control to a point. I do have a lot of problems diarrhea and moods swings, feelings of always being warm and uncomfortable( like I can,t breathe), and I have no short-term memory and the ability to concentrate is a joke.

              I can,t help but think maybe there is something out there that might be better with a little easier side effects. One time I was taken off my meds to try another and I had to be completely off inderal to do so. As I was coming off the drug it was like a heavy vale was slowly being lifted off me . A vale I never knew existed. I ended up having to go back on because the other drug did not work for me.


              • #8
                There are lots of drugs out there that might be something you can take. Please talk to your doctor about finding one that works for you. If one doesn't work, try another. It's a trial-and-error way to do things, but it's sometimes all you've got. I hope you can find one soon.


                Husband has HCM.
                3 kids - ages 23, 21, & 19. All presently clear of HCM.


                • #9

                  I had similar problems recently, I stopped propranolol recently and tried atenolol, I noticed a definite difference, the atenolol felt like a heavy vale was slowly being lifted off me. I felt more energetic and active and able to breath better but the down side was that it did not control my heart beat and rhythm the same way propranolol did. I also became more alert and more edgy with atenolol. On the other hand when compared to the propranolol, the propranolol use to make me more relaxed and controlled my heart beat and rhythm in a more evenly way, however my concentration with propranolol is shocking and is a joke, I can barley concentrate on a simple conversation. So, as you can see my Atenolol adventure is short lived (only one week). Now I am back on propranolol.


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