Brandon practices as a community pharmacist in MN. He started as a pharmacy tech in 2003 and received his PharmD in 2011 from the U of M.
Perhaps you use atenolol yourself. Or maybe you have a parent or friend who takes it. If so, you've probably been told that it's on back order, or that there is a shortage. What does that mean? When will it be available again? Who can you contact for information? What are your options right now? I'll take a quick look at these questions, and provide handy answers.
The short answer
Atenolol production in the United States is effectively on hold, with no estimated date when it will be available. While you might find a pharmacy that has a small supply left, at this point nearly all pharmacies are completely out. You'll need to change to a different medication, depending on what condition you're treating. It is not recommended to wait it out.
In the United States, atenolol is manufactured by 4 pharmaceutical companies. In late July 2017, production problems arose.
Three of these companies use the same distributor for the raw ingredient, atenolol itself. It is this upstream company that has failed to produce enough of the raw ingredient for the manufacturers, thereby halting production entirely.
The 4th pharmaceutical company, Zydus, uses a different supplier for the raw ingredient and is still in production. However, at the time of the shortage, Zydus only held about 7% market share. This means their atenolol business is small, and ramping up to supply the entire country will take a long time, if it's even possible for them to do at all.
What do I do now?
No pharmaceutical companies are currently reporting a date when atenolol will be available again.
For now, the best option is to work with your pharmacist and prescriber to find an alternative medication. Whether a new medication can permanently replace atenolol, or only be used while atenolol is unavailable, will depend on your condition and prescriber preference.
In some cases, the atenolol shortage might be a blessing in disguise, because atenolol might not be the be the best medication for everyone who takes it. In some cases, atenolol was chosen out of convenience. Prescribers are familiar with it, as it's been around a very long time, it's cheap, and it's taken only once daily. However, in some studies, it fails to prove mortality benefits over other, similar medications. You should view this shortage as an opportunity to reevaluate the appropriateness of atenolol for you.
Most people will be changed to metoprolol succinate, as it is clinically the closest alternative to atenolol. Keep in mind, however, that each person's situation is different, and your clinicians will find the best alternative for you.
Alternative medications to atenolol
|Drug name||Usual dosing||Big differences versus atenolol|
25mg to 100mg once daily
More expensive. Has evidence for reducing mortality.
25mg to 100mg twice daily
Twice daily dosing
2.5mg to 10mg once daily
More side effects. Might be more appropriate for patients with more severe cardiac conditions.
2.5mg to 10mg once daily
Variable absorption. Dilates blood vessels.
3.125mg to 25mg twice daily
Not cardiac selective, meaning it has more side effects. Has evidence for reducing mortality.
In most cases, the alternative chosen will provide the same benefits of atenolol, and no new side effects will be experienced. This is because there are many alternatives, and many years of experience with them, so there is almost always a very good second choice.
However, you should keep an eye on the new medications effects and safety. If possible, you should monitor your blood pressure at home for a week or 2 after changing to a new medication. If your blood pressure is higher or lower than your goal, let your prescriber know.
You should also report any new or worsening side effects you experience. The most common side effects from alternatives to atenolol are low blood pressure, slow pulse, tiredness, reduced exercise tolerance, and headache.
Again, most people will not notice any differences with an alternative to atenolol, but everyone is unique, and the best way to protect yourself is to stay vigilant.
Where do I get more, ongoing information about the shortage?
The most official information can be found at the FDA Shortage website. Keep in mind that they report on information provided to them through the official channels, usually from directly from the pharmaceutical companies themselves. As such, their information might not be the most up to date.
You can contact the pharmaceutical companies directly. You'll find contact information near the bottom of this article.
Your pharmacist should have good information, as they are the ones on the front lines. If you use a larger, corporate pharmacy, they'll also have information from their purchasing teams. From a sales standpoint, it's your pharmacy that is losing out, so you can be sure they'll be looking for solutions. They also work with wholesalers and distributors and will have more up to date information.
Pharmaceutical companies that manufacture atenolol
|Company||Customer service phone number||Availability as of 9/19/2017|
No estimated availability date.
No estimated availability date.
Reporting supply available in quarter 4 of 2017.
Zydus Pharmaceuticals USA
In production, but only produces a small market share. No estimated date for increased supply.
Hold on, my new medication costs more!
Unfortunately, many of the alternatives to atenolol cost more than atenolol did. In most cases, even the copay is higher, as many insurance companies place the alternatives in a higher tier.
The most common example is metoprolol succinate. For many, it is a tier higher than atenolol, and will have a higher copay than atenolol did. Keep in mind that the alternative was probably chosen based on clinical effectiveness. If cost is a factor, or if it is prohibitory, work with your pharmacist to find an alternative that is affordable.
The information provided on this page is intended for general educational and informational use only. It is not specific, personalized healthcare advice for you. For healthcare advice regarding your particular situation, talk to members of your healthcare team.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.