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atenolol + nifedipine (nifedipine/atenolol / Bresben / Niften)

✓ Approved

AstraZeneca UK Limited · ADRB1 · Small Molecule

What is atenolol + nifedipine?

atenolol + nifedipine is a small molecule developed by AstraZeneca UK Limited. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand Namesnifedipine/atenolol, Bresben, Niften
CompanyAstraZeneca UK Limited
Drug ClassSmall Molecule
Molecular TargetADRB1, CACNA1C
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, AstraZeneca UK Limited

Mechanism of Action

Molecular Targets

atenolol + nifedipine acts on 2 molecular targets:

ADRB1adrenoceptor beta 1 (B1AR, RHR)
CACNA1Ccalcium voltage-gated channel subunit alpha1 C (CaV1.2, CACNL1A1)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

atenolol + nifedipine is developed for 2 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
Cardiac disordersAngina pectoris✓ Approved
Vascular disordersHypertension✓ Approved

Related Research Articles

PubMedWilderness & environmental medicine2026-10-15

Silent Hypoxemia in High-Altitude Pulmonary Edema: A Case Report.

Karki Iswor I, Thapa Sabitra S, Chapagain Subodh S

We report a case of a trekker who ascended to Tilicho Lake (4919 m) from Kathmandu (1400 m) in 3 days. On day 3, he descended to Shree Kharka (4045 m). The following day, he trekked to Yak Kharka (4025 m) where, although he had no symptoms, he measured his own oxygen saturation (SpO2) at 72% in ambient air. Overnight, his SpO2 ranged from 75-80% on oxygen 2L/min via nasal cannula. The next day his SpO2 dropped to 47% while still on oxygen. He descended on horseback to Manang (3500 m), where his SpO2 was 70% on room air. He was diagnosed with high-altitude pulmonary edema (HAPE). He was treated with oxygen, 4L by nasal cannula, and nifedipine. The following day, he flew to Kathmandu, where he made a full recovery. Trekkers may develop life-threatening HAPE without obvious symptoms or signs. Slow ascent can decrease the likelihood of developing HAPE, but trekkers do not always follow the recommended ascent rate. Early detection, by history and physical examination and with point-of-care ultrasound (POCUS), if available, is critical in resource-limited regions such as ours. The keys to managing HAPE are early recognition and management, including descending to a lower altitude as soon as possible.

PMID 42878551
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PubMedBeijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences2026-10-15

[Systemic sclerosis with anti-human neutrophil cytoplasm antibody associated vasculitis: A case report].

Yang Li L, Zou Jinmei J

Systemic sclerosis (SSc) is an autoimmune disease involving microvessels and a wide range of connective tissues. Anti-human neutrophil cytoplasm antibody-associated vasculitis (AAV) is a primary, systemic necrotizing small vasculitis. The coexistence of AAV and SSc is rare. We report a case of SSc combined with AAV complicated with alveolar hemorrhage, gastrointestinal hemorrhage, and cerebral hemorrhage. The patient was a 56-year-old woman with a 20-year history of Raynaud phenomenon, skin sclerosis on the fingertip and face. She developed dry cough for 1 year and shortness of breath after activity for 1month. Blood routine test showed moderate anemia, blood biochemistry showed renal function damage, and urine routine test showed positive urine protein and occult blood. Immunological examination showed that anti-topoisomerase Ⅰ (anti-SCL-70) antibody was positive. Lung CT showed interstitial fibrosis in both lower lungs. Systemic sclerosis and chronic renal injury were diagnosed and she was treated with low-dose prednisone and nifedipine. During the treatment, the patient developed rapidly progressive renal insufficiency, immunological indicator showed positive anti-myeloperoxidase antibody (MPO), and renal pathology suggested crescentic glomerulonephritis. The renal damage was considered to be caused by vasculitis, and the diagnosis was modified as systemic sclerosis complicated with AAV, with crescentic nephritis and interstitial lung disease. She was treated with methylprednisolone 500 mg. One day later, the patient developed hemoptysis, alveolar hemorrhage was considered, and treatment was adjusted to methylprednisolone 1 g for 3 days, plasma exchange and cyclophosphamide. Three days later, she had vomiting coffee-colored gastric contents and melena. Gastrointestinal hemorrhage was considered, and methylprednisolone was reduced to 80 mg. Plasma exchange and cyclophosphamide treatment were continued, supplemented by acid suppression. The patient's condition was finally controlled, improved and discharged. One month later, the patient developed cough and sputum, and lung CT showed pulmonary infection. During anti-infection treatment, the patient developed gastrointestinal hemorrhage again, accompanied by cerebral hemorrhage, and finally died. This case shows that the incidence of SSc combined with AAV is dangerous, mainly with kidney involvement, manifested as crescents glomerulonephritis. When combined with alveolar hemorrhage, cerebral hemorrhage, the mortality rate is high. Clinicians should pay attention to it, early diagnosis and active treatment should be taken seriously.

PMID 42880933
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PubMedInternational journal of reproductive biomedicine2026-10-13

Comparison of indomethacin and nifedipine regarding ductus arteriosus Doppler findings after laser therapy for monochorionic diamniotic twin-to-twin transfusion syndrome: A retrospective cohort study.

Mokhtari Sareh S, Eslamian Laleh L, Marsoosi Vajiheh V, Golbabaei Alireza A et al.

Indomethacin is administered to reduce preterm labor after fetoscopic laser photocoagulation (FLP) of placental anastomoses. To compare ductus arteriosus (DA) Doppler findings in monochorionic diamniotic twin pregnancies complicated by twin-to-twin transfusion syndrome following FLP between cases treated with indomethacin and those treated with nifedipine. In this retrospective cohort study, data of 86 pregnant women aged 17-41 yr who underwent FLP in Shariati hospital, Tehran, Iran from October 2024-November 2025 were extracted from medical records and then followed up. In the study, based on pulse rate, the cases were placed in one of 2 groups: nifedipine (pulse rate < 100) and indomethacin (pulse rate > 100) for 48 hr. In cases receiving indomethacin, 6 cases developed DA constriction. A comprehensive fetal echocardiography was performed to assess the status of the DA before and after FLP. Peak systolic velocity was higher in both donor (145.7 ± 32.2, p = 0.012) and recipient twins (147.2 ± 23.6, p = 0.010) in the constricted group compared with the non-constricted groups. In recipient twins, end-diastolic velocity mean was also significantly increased (32.0 in the constricted, 19.9 in the indomethacin, and 18.7 in the nifedipine group, p = 0.012), while pulsatility index mean was significantly lower in the constricted group (1.8, 2.6, 2.5, respectively, p = 0.010). DA constriction is associated with significant changes in blood flow indices, a higher incidence of right ventricular dysfunction, and a greater prevalence of valvular regurgitation. In this study, fetal DA constriction resolved during the short-term follow-up period.

PMID 42865976
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PubMedCase reports in urology2026-10-13

Catecholamine-Secreting Retroperitoneal Paraganglioma: A Case Report and Literature Review.

Felício Eduardo E, Gião Nuno N, Bernardo Guilherme G, Barcelos André A et al.

Paragangliomas are rare neuroendocrine tumors arising from autonomic paraganglia. These tumors have metastatic potential, and histopathological findings alone cannot reliably predict their biological behavior. Clinical manifestations range from the classic triad of headache, diaphoresis, and palpitations to incidental findings in asymptomatic patients. A 75-year-old man was incidentally found to have a 5 cm retroperitoneal mass adjacent to the right renal hilum. Biochemical testing confirmed marked catecholamine hypersecretion, and 18F-FDOPA PET/CT demonstrated isolated uptake within the lesion without additional disease. Preoperative preparation included progressive alpha-adrenergic blockade with doxazosin for approximately 1 month, followed by atenolol for heart rate control. An open approach through a right subcostal hemichevron incision was selected because the tumor was located between the right renal artery and vein and lateral to the inferior vena cava. During dissection, an iatrogenic renal artery injury with intraoperative hemorrhage occurred, necessitating en bloc removal of the tumor, right kidney, and right adrenal gland. Histopathological examination confirmed a paraganglioma with a Ki-67 proliferation index below 1%, focal nuclear atypia, no mitotic figures, no tumor necrosis, no vascular invasion, and microscopic margin involvement. Immunohistochemistry was positive for Chromogranin A, synaptophysin, GATA-3, and S100. Germline testing using a 14-gene pheochromocytoma-paraganglioma panel identified no reported pathogenic or likely pathogenic variants. At 6 months, contrast-enhanced thoracoabdominopelvic computed tomography showed no evidence of local recurrence or metastatic disease, and plasma and urinary metanephrines had normalized, consistent with postoperative biochemical remission. The patient remains under joint endocrinology and urology follow-up with lifelong annual clinical and biochemical surveillance. This case highlights the diagnostic and surgical challenges of a functioning perihilar retroperitoneal paraganglioma. Careful endocrine preparation, vascular planning, multidisciplinary management, and lifelong surveillance are essential, particularly when the surgical margin is microscopically involved.

PMID 42865698
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PubMedBritish journal of pharmacology2026-10-13

High-resolution pressure myography reveals pressure-dependent local contractile and geometric dynamics in the renal pelvis and ureter.

Chu Zhugang Z, Zhai Qidi Q, Lu Liming L, Gollasch Maik M et al.

Coordinated peristalsis between the renal pelvis and ureter is critical for effective urine transport. However, intraluminal pressure impact on upper urinary tract (UUT) contractility and pharmacologic responsiveness remains poorly understood due to absence of suitable investigative methods. This study introduces the first application of high-resolution pressure myography to UUT, establishing a novel ex vivo platform enabling simultaneous, intraluminal pressure-controlled local measurement of renal pelvic contraction frequency and amplitude and ureteral inner diameter, outer diameter, and wall thickness. To define contribution of specific Ca2+ signaling pathways, we pharmacologically examined Cav1.2 L-type, Cav3.x T-type, and ryanodine receptor channels, as well as sarco/endoplasmic reticulum Ca2+-ATPase (SERCA) and neuronal involvement. Elevating intraluminal pressure from 4 to 20 mmHg increased renal pelvic contraction frequency, while amplitude markedly decreased. Ureteral wall thinning was the main structural adaptation. Nifedipine reduced renal pelvic contraction amplitude and frequency and suppressed ureter peak contraction, all with reduced efficacy under high-pressure conditions. Ni2+ affected renal pelvic contractility only at high concentrations and had no effect on ureteral dynamics. Ryanodine did not alter measured parameters, and Na+ and N-type Ca2+ channels were not involved. High-resolution pressure myography reveals pressure-dependent local contractile and geometric responses in UUT, including altered contraction dynamics, ureteral geometric remodeling, and specific Ca2+ channel contributions. Cav1.2 channels modulate both amplitude and frequency, with wall thinning as principal acute structural adaptation. Reduced drug efficacy at high pressure highlights necessity to investigate possible pressure-adapted therapies in obstructive uropathy.

PMID 42865197
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PubMedPLoS medicine2026-10-12

Comparative effectiveness of amlodipine versus nifedipine prescribed at discharge in patients with ischemic stroke or transient ischemic attack: A nationwide 5-year follow-up registry study.

Li Xinya X, Xia Xue X, Gao Meng M, Xu Qin Q et al.

Amlodipine and nifedipine are the most commonly prescribed calcium channel blockers (CCB) for patients suffering from ischemic stroke or transient ischemic attack (TIA). Nevertheless, there is a scarcity of direct comparative evidence on their effectiveness. This study aimed to compare the effectiveness of amlodipine and nifedipine in patients with ischemic stroke or TIA. This observational study was based on the Third China National Stroke Registry, which recruited consecutive adult patients with ischemic stroke or TIA from 2015 to 2018. In this study, ischemic stroke or TIA patients were prescribed either amlodipine or nifedipine at discharge. The primary outcome was the distribution of modified Rankin Scale (mRS) score, which assesses functional outcomes in patients with stroke, at 5 years. The intergroup differences were examined using ordinal logistic regression, yielding odds ratios (OR) and 95% confidence intervals (CI). Patient age, gender, body mass index, systolic blood pressure at admission, and onset date were adjusted. To improve baseline characteristic balance, inverse probability of treatment weighting (IPTW) was implemented. A total of 2,859 eligible patients were included, and there were 1847 patients in the amlodipine group and 1,058 patients in the nifedipine group after IPTW. The amlodipine group demonstrated significantly lower 5-year mRS scores in comparison to the nifedipine group, with an OR of 0.76 (95% CI [0.65, 0.89]; p < 0.001). A total of 956 (51.76%) amlodipine users and 632 (59.74%) nifedipine users achieved a mRS score > 0 at 5 years, with an OR of 0.71 (95% CI [0.61, 0.83]; p < 0.001). The sensitivity analyses yielded consistent results. The main limitations include the inherent observational design, the exclusive reliance on registry data, and relatively high loss-to-follow-up rate at 5 years. This study revealed that amlodipine, compared to nifedipine, may be associated with improved functional recovery in ischemic stroke or TIA patients. Randomized controlled trials are warranted to confirm these findings and refine CCB therapy.

PMID 42862855
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