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atenolol + bendroflumethiazide (TenBen / Amoretic LD / Amoretic)

✓ Approved

Warner Chilcott PLC · ADRB1 · Small Molecule

What is atenolol + bendroflumethiazide?

atenolol + bendroflumethiazide is a small molecule developed by Warner Chilcott PLC. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesTenBen, Amoretic LD, Amoretic
CompanyWarner Chilcott PLC
Drug ClassSmall Molecule
Molecular TargetADRB1, SLC12A3
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Warner Chilcott PLC

Mechanism of Action

Molecular Targets

atenolol + bendroflumethiazide acts on 2 molecular targets:

ADRB1adrenoceptor beta 1 (B1AR, RHR)
SLC12A3solute carrier family 12 member 3 (NCCT, NCC)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

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

Therapeutic AreaConditionPhase
Vascular disordersHypertension✓ Approved
Renal and urinary disordersRenal failure✓ Approved

Related Research Articles

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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PubMedSchweizer Archiv fur Tierheilkunde2026-10-06

Percutaneous balloon valvuloplasty in a small cat with pulmonary valve stenosis and concomitant tricuspid valve dysplasia.

Hipp H M HM, Schreiber N N, Wieser M L ML, Pereira N N et al.

A 14-month-old, male castrated, 3,9-kg Singapura cat was referred for treatment of severe pulmonary valve stenosis associated with tricuspid valve dysplasia. The cat was pretreated with atenolol and scheduled for pulmonary balloon valvuloplasty. Because the right femoral vein could not accommodate a 5 Fr introducer, vascular access was obtained via the left external jugular vein, followed by right ventricular catheterisation, pressure measurement and angiography. A 10 mm low pressure balloon catheter was advanced over a guidewire to the level of the pulmonary valve and inflated once, resulting in complete loss of the balloon waist. During the procedure, the cat was severely hypotensive for 30 minutes, lasting from the time of ca-theterisation of the right ventricular outflow tract until nearly the end of anaesthesia. Postoperative tachypnoea was attributed to congestive heart failure, although aspiration pneumonia could not be excluded. The patient was discharged the day after the intervention following a single dose of furosemide and received amoxicillin-clavulanate for ten days. Echocardiography after eleven days, three months and 16 months demonstrated a marked and sustained reduction of the transvalvular pressure gradient. The cat showed an improved activity level after the procedure, which persisted over the 16-month follow-up period.

PMID 42834632
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PubMedEnvironmental science and pollution research international2026-10-06

Efficient enzyme-mediated degradation of various emerging pollutants, including 2-mercaptobenzothiazole, paracetamol, and sulfamethoxazole, using HRP@UiO-66-NH2.

Al-Maqdi Khadega A KA, Alneyadi Shaikha S, Elmerhi Nada N, Siddig Lamia A LA et al.

The increasing contamination of water sources due to industrialization and population growth poses significant environmental and health risks, even at trace pollutant concentrations. Enzymatic bioremediation, particularly using horseradish peroxidase (HRP), has shown great potential in pollutant degradation due to its high selectivity and catalytic efficiency. However, limitations such as poor operational stability and reusability hinder its large-scale application. The degradation of structurally diverse emerging pollutants by UiO-66-NH2-immobilized HRP, including the influence of redox mediation, remains insufficiently investigated. This study addresses this gap by immobilizing HRP onto UiO-66-NH2, a metal-organic framework (MOF) with high stability and surface area. HRP@UiO-66-NH2 was characterized using SEM-EDX, PXRD, FTIR, TGA, and BET analyses, while pollutant degradation was quantified by LC-MS/MS. HRP loading concentrations ranging from 0.5 to 4 mg/mL were evaluated, and 1 mg/mL was selected for subsequent experiments. The immobilized HRP exhibited an optimum H2O2 concentration of 1.08 mM within the tested range of 0-2.43 mM. Both free and immobilized HRP showed maximum activity at pH 4, while the optimum temperature shifted from 30°C for free HRP to 40°C following immobilization. The immobilized enzyme also retained approximately 95% of its initial activity after four reuse cycles. HRP@UiO-66-NH2 was evaluated for the degradation of nine emerging pollutants, including 2-mercaptobenzothiazole, paracetamol, sulfamethoxazole, methylparaben, salicylic acid, lincomycin hydrochloride, atenolol, thiabendazole, and DEET. It degraded 99.7% of 2-mercaptobenzothiazole and 97.4% of paracetamol within 30 min. The addition of 1-hydroxybenzotriazole (HOBT) increased the degradation of sulfamethoxazole, methylparaben, and salicylic acid from 23.3%, 14.5%, and 12.4% to 53.1%, 57.6%, and 54.3%, respectively. The greater thermal and H2O2 tolerance of immobilized HRP suggests a protective effect of the UiO-66-NH2 framework, while the variable response to HOBT indicates pollutant-dependent redox mediation. These findings highlight HRP@UiO-66-NH2 as a promising biocatalyst for sustainable water remediation, warranting further studies to elucidate the underlying degradation mechanisms and optimize real-world applications.

PMID 42834305
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PubMedMedicine2026-09-26

Comparative real-world safety profiles of selective β1-adrenergic receptor blockers: A multi-database pharmacovigilance disproportionality study.

Ren Weijie W, Zhao Haosen H, Wang Zhenzhong Z, Li Jixin J et al.

Selective β1-blockers are fundamental in managing hypertension, coronary artery disease, and heart failure. Yet, despite their widespread use, practical guidance on safe and individualized prescribing remains limited. Existing evidence is largely derived from controlled clinical trials, which may not fully capture drug-specific adverse events, sex-related susceptibility, or early-onset risks observed in routine clinical practice. To generate real-world, evidence-based recommendations for the safe use of selective β1-blockers, we compared the adverse event profiles of metoprolol, bisoprolol, and atenolol using 2 large pharmacovigilance systems. Adverse drug events reported for the 3 agents between 2004 and Q2 2025 were retrieved from the US Food and Drug Administration Adverse Event Reporting System, a spontaneous-reporting system, and compared with reports from the Canadian Vigilance Adverse Reaction Online Database. Disproportionality analyses, preferred term mapping, exploratory sex-stratified comparisons, and time-to-onset modeling were conducted to characterize shared reporting patterns, drug-specific signals, and potential patient-level modifiers. Across all 3 agents, disproportionate reporting was observed for a common cardiovascular spectrum that included bradycardia, conduction abnormalities, heart failure, and blood pressure instability. Metoprolol showed prominent reporting signals for BRASH syndrome and neuropsychiatric and suicide-related events. Bisoprolol showed signals for bradyarrhythmia, hyperkalemia, and acute kidney injury. Atenolol showed reporting patterns involving blood pressure perturbations, electrolyte imbalance, and interaction-related events. Exploratory sex-stratified analyses identified differences in the reporting distributions of several PT = preferred terms for metoprolol and atenolol, whereas bisoprolol showed a more balanced distribution. All 3 agents displayed early-failure time-to-onset patterns, supporting closer monitoring after treatment initiation. This real-world pharmacovigilance assessment identifies drug-specific patterns of disproportionate reporting that may inform hypothesis generation and individualized monitoring. Because spontaneous-reporting data cannot establish incidence or causality, the findings should complement, rather than replace, clinical judgment and confirmation in controlled or longitudinal data sources.

PMID 42798089
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PubMedFrontiers in pharmacology2026-09-24

Comparative efficacy and safety of pharmacologic, laser, and combination therapies for infantile hemangioma: a systematic review and network meta-analysis with evidence certainty assessment.

Kong Mingxuan M, Zhang Shijie S, Ren Dan D, Chang Jian J

Infantile hemangiomas (IH) are the most common childhood vascular tumors, potentially complicated by ulceration and permanent functional or aesthetic sequelae. Current treatments include corticosteroids, β-blockers, and lasers, among others, existing evidence relies predominantly on direct pairwise comparisons. Consequently, the relative benefits and risks across these modalities remain inadequately defined. We conducted a systematic review and network meta-analysis (NMA) evaluating pharmacologic, laser, and combination therapies for IH to establish treatment hierarchies and inform clinical practice and future guidelines. Following a PROSPERO-registered protocol (CRD420261388356), we searched PubMed, Embase, the Cochrane Library, and Web of Science from inception to 1 March 2026, for randomized controlled trials comparing various interventions for IH. The primary endpoint was excellent response rate. Secondary outcomes included other response rates, VAS/HAS changes, healing time, treatment emergent adverse events, and recurrence. After independent risk-of-bias assessment (RoB2) and data extraction, we performed a random-effects NMA. Treatments were ranked using SUCRA probabilities, and evidence certainty was appraised via GRADE and CINeMA. The synthesis comprised 25 trials (2044 patients) evaluating 16 distinct interventions. Risk of bias was low in six trials, raised "some concerns" in 14, and high in 5. Overall, the evidence body was of moderate certainty. Regarding the primary endpoint, intralesional bleomycin combined with oral propranolol yielded significantly higher excellent response rates than oral propranolol alone (RR = 1.55, 95% CI 1.28-1.89; high certainty). Topical timolol with intralesional lauromacrogol (RR = 7.98, 95% CI 1.52-41.79) and oral propranolol with corticosteroids (RR = 2.00, 95% CI 1.03-3.88) showed higher excellent response rates, supported by moderate-certainty evidence. No statistically significant differences in adverse-event incidence were detected across evaluated regimens, but the safety data were limited. Oral atenolol was associated with numerically lower recurrence rates compared to oral propranolol, but the difference did not reach statistical significance (RR = 0.64, 95% CI 0.32-1.28; moderate certainty). Oral propranolol remains the standard of care for IH. However, our analysis shows that some combination regimens showed favorable efficacy for excellent clinical response. Still, sparse comparative data and low-certainty evidence currently obscure the optimal combination strategy. Defining precise risk-benefit profiles requires rigorous head-to-head trials utilizing uniform outcome measures. https://www.crd.york.ac.uk/PROSPERO/view/CRD420261388356; Identifier: CRD420261388356.

PMID 42780340
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PubMedNEJM evidence2026-09-22

Atenolol or Bisoprolol after Myocardial Infarction without Recorded Heart Failure.

Laurenceau Thomas T, Meli Ugo U, Wang Louise Z LZ, Chocron Richard R et al.

Beta-blockers are a cornerstone of therapy following myocardial infarction. The effect of different β-blockers on the outcomes of patients without heart failure after myocardial infarction is not well-studied. This observational cohort study used administrative data from French National Health Data System. Eligible patients were 18 years of age or older, hospitalized in the Paris area between January 1, 2008, and December 31, 2018, with a new myocardial infarction, and were dispensed either atenolol or bisoprolol within 2 days of hospital discharge. Patients prescribed β-blockers or loop diuretics or with a recorded diagnosis of heart failure (based on International Classification of Diseases, 10th Revision codes) during the 2 years preceding hospital discharge were excluded. Outcomes were followed for up to 2 years following hospital discharge and included major adverse cardiovascular events (cardiac arrest, all-cause mortality, reinfarction, stroke, or hospitalization for heart failure) (primary outcome) and all-cause mortality (secondary outcome). Targeted maximum likelihood estimation was used to estimate the average treatment effects (ATEs) comparing patients initiated on atenolol versus bisoprolol. Among 11,558 patients, 1523 (13.2%) initiated atenolol and 10,035 (86.8%) initiated bisoprolol within 2 days of discharge. Comparing the atenolol group to the bisoprolol group, the ATE was 2.9 percentage points (95% confidence interval [CI], 1.1-4.7) for major adverse cardiovascular events and 0.6 percentage points (95% CI, -0.2 to 1.3) for all-cause mortality. The weighted proportions of patients experiencing major adverse cardiovascular events were 10.8% and 14.1% in the atenolol and bisoprolol groups, respectively. The weighted proportions of patients experiencing all-cause mortality were 1.4% and 2.2% in the atenolol and bisoprolol groups, respectively. Among patients without recorded characteristics in an administrative database suggesting the presence of heart failure, initiation of atenolol after myocardial infarction was associated with a lower risk of major adverse cardiovascular events, but not all-cause mortality, at 2 years compared with bisoprolol. (Funded by PRAIRIE and others.).

PMID 42770784
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