β-Blockers and Renal Function

Abstract

Blood and urine levels of atenolol were measured in subjects with a wide range of renal function in order to calculate dose recommendations which should avoid excessive blood atenolol levels in patients with renal failure. The recommended average daily dose of atenolol in subjects with a creatinine clearance of more than 35 ml/min/1.73m² is 100mg, while in subjects with a creatinine clearance in the range 15–35 ml/min/1.73m² it is 50mg, and in subjects with a creatinine clarance of less than 15 ml/min/1.73m² the recommended dose is 25mg (50mg every second day).

To confirm that these recommended doses produced similar blood levels of atenolol when given to subjects with the appropriate level of renal failure, we carried out a dose validation study in which the recommended doses were given to subjects with renal disease. Whole blood atenolol curves were very similar in subjects at each creatinine clearance level and suggest that the above dose recommendations would successfully avoid excessive blood atenolol levels.