Can atenolol (beta blocker) tablets be split in half?

From the Guidelines

You can split atenolol tablets in half if they have a score line, but only under the guidance of a healthcare provider. Many atenolol tablets, particularly the 50mg and 100mg strengths, come with this score line specifically to allow for dose adjustments 1. To split the tablet properly, use a pill cutter for the most accurate division, or place the pill on a clean, flat surface and press down with your thumb on both sides of the score line. This allows for dose reduction when needed, such as when a doctor recommends starting at a lower dose or gradually adjusting your medication. However, splitting tablets without score lines or extended-release formulations could affect how the medication works in your body. Always consult with your doctor or pharmacist before changing how you take any prescription medication.

Some key points to consider when taking atenolol include:

• The usual dose range for atenolol is 25-100 mg per day, taken once or twice daily 1
• Atenolol is not typically recommended as a first-line agent unless the patient has ischemic heart disease or heart failure 1
• Patients with reactive airway disease should avoid certain beta blockers, but atenolol may be considered in some cases 1
• It is essential to follow the specific instructions of your healthcare provider when taking atenolol, as they can provide personalized guidance on dosage and administration.

In terms of morbidity, mortality, and quality of life, it is crucial to prioritize the management of high blood pressure and other cardiovascular conditions. The American College of Cardiology and American Heart Association have published guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults, which include recommendations for the use of beta blockers like atenolol 1. By following these guidelines and working closely with a healthcare provider, patients can minimize their risk of adverse effects and optimize their treatment outcomes.

From the FDA Drug Label

If dosage must be increased, dividing the dose should be considered in order to achieve lower peak blood levels The FDA drug label does mention that dividing the dose should be considered in certain situations, but it does not explicitly state that atenolol tablets can be split in half.

• Tablets of 50 mg are round, white, flat beveled edge tablet, scored, which implies that the 50 mg tablets are designed to be split in half. However, there is no direct information that supports splitting atenolol tablets in half as a general practice. Therefore, the answer to the question is not directly supported by the FDA drug label 2 or 2. The FDA drug label does not answer the question.

From the Research

Tablet Splitting

• Tablet splitting is a common practice to save money on prescription costs or to ease swallowing, but not all oral medications can be split safely 3.
• Splitting extended-release tablets, such as those containing beta-blockers, can be harmful and potentially dangerous 3.
• A study on tablet splitting found that 16.2% of half tablets and 15.0% of half tablets fell outside of the proxy USP specification for weight and drug content, respectively 4.
• The study also found that certain medications, such as carvedilol and bisoprolol, failed the weight and content uniformity test when split 4.

Atenolol

• Atenolol is a beta-blocker commonly used to treat hypertension, but its use as a first-line antihypertensive drug has been controversial 5, 6, 7.
• A study found that atenolol should not be used as an antihypertensive drug due to its inferiority in reducing cardiovascular events compared to other antihypertensive drugs 5.
• Another study found that initiating treatment of hypertension with beta-blockers, including atenolol, leads to modest CVD reductions and little or no effects on mortality 6.
• The mechanisms responsible for the inferiority of atenolol in preventing vascular morbidity and mortality are still being researched, and this knowledge may help design more effective antihypertensive drugs 7.

Splitting Atenolol

• There is no direct evidence on the safety and efficacy of splitting atenolol tablets.
• However, based on the studies on tablet splitting and atenolol, it is likely that splitting atenolol tablets may not be safe or effective due to the potential for uneven drug content and weight uniformity 4.
• Patients should consult their healthcare provider or pharmacist before splitting any medication, including atenolol, to ensure safe and effective use 3.