Co-tenidone should be used with caution in:
- patients with a history of allergy e.g. to insect stings, liver or kidney disease, the elderly, the skin condition psoriasis, poor blood circulation, heart failure that is controlled, first-degree heart block, high blood sugar (diabetes), overactive thyroid (thyrotoxicosis), low potassium diet, stomach upsets, the muscle condition myasthenia gravis, patients receiving treatment with digitalis medicines such as digoxin.
It should not be used in:
- children, wheezing, asthma or other similar breathing problems, history of lung disease including asthma or wheezing, severe liver or kidney disease, patients who are allergic to co-tenidone, atenolol or chlortalidone or to any other ingredients in the medicine, heart failure which is not under control, a type of chest pain (angina) called Prinzmetal's angina, second- or third-degree heart block, slow or uneven heart rate, the heart condition cardiogenic shock, disturbance of blood potassium levels or any disturbance of other blood electrolytes (salts) including sodium or calcium, very low blood pressure or very poor circulation, a type of tumour called a phaeochromocytoma that is not being treated, unusually high levels of acid in your blood (metabolic acidosis), abnormal heart rhythm (sick sinus syndrome), patients with symptoms caused by high levels of uric acid in the blood, disease of the adrenal glands (Addison's disease), pregnancy, breast feeding or women who are trying to become pregnant.
Also see list of precautions and interactions
Do not store above 25ºC.
What is it used for?
- Co-tenidone is used to reduce high blood pressure. It contains two different medicines atenolol and chlortalidone which work together to reduce your blood pressure. Atenolol works by making your heart beat more slowly with less force and chlortalidone increases the amount of urine produced by your kidneys.
- It is a combination of a beta-blocker and a water tablet (diuretic), sometimes known as an antihypertensive.
- In general this drug is used for high blood pressure (hypertension).
- Benefits of being on this drug can include a reduction in blood pressure which is associated with a reduction in the risk of stroke, heart attack, heart failure or kidney failure.
Listed below are the typical uses of co-tenidone.
On occasion your doctor may prescribe this medicine to treat a condition not on the above list.
HOW TO USE/TAKE
How often do I take it?
- Take this medication by mouth usually once daily, preferably first thing in the morning, with or without food. Swallow your tablets whole with a drink of water.
- Use this medication regularly in order to get the most benefit from it.
- Remember to use it at the same time each day - unless specifically told not to by your doctor.
- It may take up to some days before the full benefit of this drug takes effect.
- Certain medical conditions may require different dosage instructions as directed by your doctor.
- Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.
Do I need to avoid anything?
- Co-tenidone is unlikely to affect you being able to drive or operate machinery. However, you may feel dizzy or tired while taking this medicine. Therefore, you should wait to see how your medicine affects you before driving or operating machinery. Consult your doctor or pharmacist for more details.
When can I stop?
- It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.
CO-TENIDONE SIDE EFFECTS
- Cold hands and feet
- Slow pulse rate
- Feeling sick
- Feeling tired
- High levels of sugar in the blood
- Low levels of sodium in the blood which may cause weakness, being sick and cramps
- Low levels of potassium in the blood
- Increase in the amount of uric acid in the blood
- Disturbed sleep
- Heart block
- Numbness and spasm in the fingers which is followed by warmth (Raynaud's disease)
- Feeling confused
- Changes in personality
- Imagining that you can see and hear things that aren't really there (hallucinations)
- Mood changes
- Dry mouth
- Hair thinning
- Dry eyes
- Skin rash
- Tingling of the hands
- Problems with eyesight
- Bruising more easily or purplish marks on the skin
- Unable to get an erection (impotence)
If any of these persist or you consider them severe then inform your doctor or pharmacist.
Further information about other side effects can be found in the patient information leaflet.
Tell your doctor immediately if you develop any of the following symptoms:
- Raised lumps on your skin or swelling of your face, lips, mouth, tongue or throat (this may be a sign of an allergic reaction).
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.
Before taking co-tenidone, tell your doctor or pharmacist if you are allergic to it; or to other beta-blockers or water tablets (diuretics); or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist in case of: breathing problems including wheezing, asthma or similar, a history of lung disease including asthma or wheezing, severe liver or kidney disease, an allergy to co-tenidone, atenolol or chlortalidone or to any other ingredients in the medicine, heart failure which is not under control, second- or third-degree heart block which may be treated by a pacemaker, slow or uneven heart rate, the heart condition cardiogenic shock, a type of chest pain (angina) called Prinzmetal's angina, disturbance of blood potassium levels or any disturbance of other blood electrolytes (salts) including sodium or calcium, very low blood pressure or very poor circulation, a type of tumour called a phaeochromocytoma that is not being treated, unusually high levels of acid in your blood (metabolic acidosis), abnormal heart rhythm (sick sinus syndrome), symptoms caused by high levels of uric acid in the blood, disease of the adrenal glands (Addison's disease), you are pregnant, breast feeding or are trying to become pregnant.
Before using this medication tell your doctor or pharmacist your medical history, especially any of the following history of allergy e.g. to insect stings, liver or kidney disease, the skin condition psoriasis, poor blood circulation, heart failure that is controlled, first-degree heart block, high blood sugar (diabetes), overactive thyroid (thyrotoxicosis), low potassium diet, stomach upsets, the muscle condition myasthenia gravis, you are taking digitalis medicines such as digoxin.
Before having surgery, tell your doctor or dentist that you are taking this medication.
Does alcohol intake affect this drug?
- You should avoid alcohol while taking this medicine.
The elderly: co-tenidone should be used with caution in the elderly as it may cause low potassium levels (hypokalaemia)
Pregnancy and breastfeeding - please ensure you read the detailed information below
Co-tenidone is not safe to take if you are, or are planning to become, pregnant.
It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Co-tenidone is not safe to take if you are breastfeeding.
It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:
- Other medicines for high blood pressure
- ACE inhibitors
- Adrenergic neurone blockers
- Alpha blockers
- Angiotensin II receptor antagonists
- Medicines for abnormal heart rhythm (anti-arrhythmics)
- Medicines for anxiety
- Medicines to help you sleep (hypnotics)
- Calcium channel blockers
- Medicines for depression
- Calcium salts
- Monoamine-oxidase inhibitors (MAOIs)
- Platinum drugs
- Water tablets
- Adrenaline (also known as epinephrine)
- Beta2-agonists such as salbutamol
- Lidocaine (also known as lignocaine)
- Medicines for diabetes including insulin
- Non-steroidal anti-inflammatory drugs (NSAIDs) including indometacin
- Medicines to treat nose or sinus congestion or other cold remedies (including those that can be bought from pharmacies)
- Sodium nitroprusside
- Vitamin D
This information does not contain all possible interactions. Therefore, before using co-tenidone, tell your doctor or pharmacist of all the products you use.
Taking too much co-tenidone may cause the following: slow heart rate, low blood pressure (hypotension), dizziness, heart problems and difficulty breathing (bronchospasm).
People who have taken too much co-tenidone, should talk to a doctor or go to a hospital straightaway. Take the medicine pack with you so that the tablets can be identified.
If you think you, or someone you care for, might have accidentally taken more than the recommended dose of co-tenidone or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.