Atenolol

 Risk Factor: DM
 Class: CARDIOVASCULAR DRUGS / Antihypertensives / Other Antihypertensives

Contents of this page:

Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers

Fetal Risk Summary

Atenolol is a cardioselective b-adrenergic blocking agent used for the treatment of hypertension. The drug did not cause structural anomalies in pregnant rats and rabbits, but a dose-related increase in embryo and fetal resorptions in rats was observed at doses up to and greater than 25 times the maximum recommended human dose (MRHD) (1). This effect was not seen in rabbits at doses up to 12.5 times the MRHD.

Atenolol readily crosses the placenta to the fetus, producing steady state fetal levels that are approximately equal to those in the maternal serum (2,3,4,5,6,7,8 and 9). Atenolol transfer was one third to one fourth the transfer of the more lipid-soluble b-blockers propranolol, timolol, and labetalol in an in vitro experiment using perfused human placentas (10). In 11 pregnant patients treated with 100 mg/day, the serum half-life (8.1 hours) and the 24-hour urinary excretion (52 mg) were similar to those in nonpregnant women (7).

In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 105 newborns had been exposed to atenolol during the 1st trimester (F. Rosa, personal communication, FDA, 1993). A total of 12 (11.4%) major birth defects were observed (4 expected). Specific data were available for six defect categories, including (observed/expected) 3/1 cardiovascular defects, 1/0 oral clefts, 0/0 spina bifida, 0/0 polydactyly, 1/0 limb reduction defects, and 4/0 hypospadias. Only with the latter defect is there a suggestion of a possible association, but other factors, including the mother's disease, concurrent drug use, and chance, may be involved.

A 1997 abstract (11) and later full report (12) described a case of retroperitoneal fibromatosis in a fetus exposed in utero to atenolol from the 2nd month of gestation through delivery at 37 weeks. The obese (134 kg at term), 25-year-old mother, in her third pregnancy, was treated for hypertension with 100 mg atenolol daily until giving birth to the 3790-g male infant. Other drug therapy included magnesium supplements and occasional metoclopramide. The mother had no familial history of cancer and both of her other children were normal. Treatment of the tumor with chemotherapy during the first 3 months of life was successful, but a severe scoliosis was present in the child at 4 years of age. The authors attributed the rare tumor to the drug because, among other reasons, the location of the mass was similar to fibroses reported in adults exposed to atenolol (11,12).

Use of atenolol for the treatment of hypertension in pregnant women has been described by several investigators (6,9,13,14,15,16,17,18, 19,20,21 and 22). No fetal malformations attributable to atenolol were reported in these trials, but treatment with atenolol in most cases did not occur during the 1st trimester. Intrauterine growth retardation and persistent b-blockade in the newborn have been observed after atenolol exposure. In one study in which therapy for mild essential hypertension was begun at a mean gestational age of 15.9 weeks, the newborns in the treated group (N=15) had a significantly lower birth weight (2620 g vs. 3530 g) than untreated controls (N=14) (20). Moreover, in the treated group, 5 of the newborns had weights below the 5th percentile and 10 were below the 10th percentile, compared with 1 newborn below the 25th percentile in controls.

A 1992 report described the outcomes of 29 women with pregnancy-induced hypertension in the 3rd trimester (23). The women were randomized to receive either the cardioselective b-blocker, atenolol (N=13), or the nonselective b-blocker, pindolol (N=16). The decrease in mean maternal arterial blood pressure in the two groups did not differ statistically, 9 and 7.8 mm Hg. In comparing before and after therapy, several significant changes were measured in fetal hemodynamics with atenolol but, except for fetal heart rate, no significant changes were measured with pindolol. The atenolol-induced changes included a decrease in fetal heart rate, increases in the pulsatility indexes (and thus, the peripheral vascular resistance) of the fetal thoracic descending aorta, the abdominal aorta, and the umbilical artery, and a decrease in the umbilical venous blood flow (23). Although no difference was observed in the birth weights in the two groups, the placental weight in atenolol-treated pregnancies was significantly less, 529 g vs. 653 g, respectively.

Interestingly, a 1987 study had used Doppler ultrasound to evaluate maternal and fetal circulation during atenolol therapy in 14 women with pregnancy-induced hypertension at a mean gestational age of 35 weeks (range 3338 weeks) (24). The results suggested that peripheral vascular resistance was increased on both the maternal and fetal sides of the placenta. However, the study design and techniques used have been criticized based on concerns for reproducibility, including day-to-day variability in Doppler measurements, the lack of controls in the study, and the uncertainty of the clinical significance of velocity waveform measurements (25).

A 1997 report described an open, prospective survey on the use of antihypertensives in 398 consecutive pregnant women who attended an antenatal hypertension clinic between 1980 and 1995 (26). Atenolol was used by 76 of the women and compared to those using calcium channel blockers (N=22), diuretics (N=26), methyldopa (N=17), other b-blockers (N=12), or no drug therapy (N=235). The newborns exposed in utero to atenolol had the lowest mean birth weight (p<0.001), and, along with those who received calcium channel blockers, the lowest mean ponderal index and mean placental weight.

In a group of pregnant women with symptomatic mitral valve stenosis, 11 were treated with atenolol and 14 with propranolol (27). The mean birth weight of the 25 infants was 2.8 kg (range 2.13.5 kg). Atenolol, 25 mg twice daily, was administered from 18 weeks' gestation to term in a normotensive woman who had suffered a myocardial infarction (28). She delivered a 2720-g infant with normal Apgar scores and blood gases.

In a nonrandomized study comparing atenolol with two other b-blockers for the treatment of hypertension during pregnancy, the mean birth weight of atenolol-exposed babies was markedly lower than infants exposed in utero to either acebutolol or pindolol (2745 g vs. 3160 g vs. 3375 g) (18,29). A similar study comparing atenolol with labetalol found a significant difference in the birth weights of the two groups, 2750 g vs. 3280 g (p<0.001) (5). No difference was found in the birth weights of atenolol- vs. placebo-exposed infants (2961 g vs. 3017 g) in a randomized, double blind investigation of 120 pregnant women with mild to moderate hypertension (16). Additionally, in a prospective randomized study comparing 24 atenolol-treated women with 27 pindolol-treated women, no differences between the groups were found in gestational length, birth weight, Apgar scores, rates of cesarean section, or umbilical cord blood glucose levels (30). Treatment in both groups started at about 33 weeks gestation. Intrauterine fetal deaths have been observed in women with severe hypertension treated with atenolol, but this has also occurred with other b-blockers and in hypertensive women not treated with drugs (5,16,31).

In eight mothers treated with atenolol or pindolol, a decrease in the basal fetal heart rate was noted only in atenolol-exposed fetuses (32). Before and during treatment, fetal heart rates in the atenolol patients were 136 and 120 beats/minute, respectively, whereas the rates for the pindolol group were 128 and 132 beats/minute, respectively. In 60 patients treated with atenolol for pregnancy-induced hypertension, no effect was observed on fetal heart rate pattern in response to uterine contractions (33). Accelerations, variables, and late decelerations were all easily distinguishable.

Persistent b-blockade was observed in a newborn whose mother was treated with atenolol, 100 mg/day, for hypertension (3). At 15 hours of age, the otherwise normal infant developed bradycardia at rest and when crying, and hypotension. Serum atenolol was 0.24 g/ml. Urinary excretion of the drug during the first 7 days ranged from 0.0850.196 g/mL. In another study, 39% (18 of 46) of the newborns exposed to atenolol developed bradycardia compared to only 10% (4 of 39) of placebo-exposed newborns (p<0.01) (16). None of the infants required treatment for the lowered heart rate.

In summary, exposure to atenolol in utero may result in intrauterine growth retardation. The reduced fetal growth appears to be related to increased vascular resistance in both the mother and the fetus and is a function of the length of drug exposure. Treatment starting early in pregnancy, such as in the 2nd trimester, is associated with the greatest decrease in fetal and placental weights. In comparison, when therapy is initiated in the 3rd trimester, only placental weight appears to be significantly affected. Although growth retardation is a serious concern, the benefits of maternal therapy with b-blockers may, in some cases, outweigh the risks to the fetus and must be judged on a case-by-case basis. Infant behavior is apparently not affected by atenolol exposure as no differences were noted in the development at 1 year of age of offspring from mothers treated during the 3rd trimester for mild to moderate pregnancy-induced hypertension with either bed rest alone or rest combined with atenolol (34). The mean duration of therapy in the atenolol-treated patients was 5 weeks. Because only one case has been reported, an association between atenolol and fetal retroperitoneal fibromatosis requires confirmation.

Newborns exposed to atenolol near delivery should be closely observed during the first 2448 hours for signs and symptoms of b-blockade. Although the results of the study cited above are reassuring, the long-term effects of prolonged in utero exposure to this class of drugs have not been studied but warrant evaluation.

Breast Feeding Summary

Atenolol is excreted into breast milk (4,7,9,35,36,37,38 and 39). The drug is a weak base, and accumulation in the milk occurs with concentrations significantly greater than corresponding plasma levels (4,35,36,37 and 38). Peak milk concentrations after single (50 mg) and continuous dosing (25100 mg/day) regimens were 3.6 and 2.9 times greater than simultaneous plasma levels (37). Atenolol has been found in the serum and urine of breast-fed infants in some studies (4,7,35). Other studies have been unable to detect the drug in the infant serum (test limit 10 ng/mL) (36,37).

Symptoms consistent with b-adrenergic blockade were observed in a breast-fed, 5-day-old, full-term female infant, including cyanosis, hypothermia (35.5C rectal), and bradycardia (80 beats/minute) (39). Blood pressure was 80/40 mm Hg. Except for these findings, physical examination was normal and bacterial cultures from various sites were negative. The mother had been treated orally with atenolol, 50 mg every 12 hours, for postpartum hypertension. Breast feeding was stopped 3 days after onset of the symptoms and 6 hours later the infants symptoms had resolved. A milk sample, collected 10 days postpartum and 1.5 hours after a 50 mg dose, contained 469 ng/ml of atenolol. Concentrations in the infant's serum, 48 and 72 hours after breast feeding, were 2010 ng/mL and 140 ng/mL, respectively. The calculated serum half-life in the infant was 6.4 hours. By extrapolation, the minimum daily dose absorbed by the infant was estimated to be 8.97 mg, approximately 9% of the mothers daily dose (39). (These calculations have been questioned and defended [40,41].) In a 1994 Reference, the American Academy of Pediatrics classified atenolol as compatible with breast feeding, although the above adverse reaction report was not cited (42). This was called to their attention in two 1995 letters to the editor (43,44), and elicited a response that atenolol would be reclassified in a later revision (45).

Except for the single case cited above, adverse reactions in other infants have not been reported. However, because milk accumulation occurs with atenolol, nursing infants must be closely monitored for bradycardia and other signs and symptoms of b-blockade. Moreover, one author has recommended that water-soluble, low-protein-bound, renally excreted b-blockers, such as atenolol, should not be used during lactation (44). Because of the availability of safer alternatives (e.g., propranolol), this seems to be good advice. Long-term effects on infants exposed to b-blockers from breast milk have not been studied but warrant evaluation.

References

1. Product information. Tenormin. Zeneca Pharmaceuticals, 1997.
2. Melander A, Niklasson B, Ingemarsson I, Liedholm H, Schersten B, Sjoberg NO. Transplacental passage of atenolol in man. Eur J Clin Pharmacol 1978;14:934.
3. Woods DL, Morrell DF. Atenolol: side effects in a newborn infant. Br Med J 1982;285:6912.
4. Liedholm H. Transplacental passage and breast milk accumulation of atenolol in humans. Drugs 1983;25(Suppl 2):2178.
5. Lardoux H, Gerard J, Blazquez G, Chouty F, Flouvat B. Hypertension in pregnancy: evaluation of two beta blockers atenolol and labetalol. Eur Heart J 1983;4(Suppl G):3540.
6. Liedholm H. Atenolol in the treatment of hypertension of pregnancy. Drugs 1983;25(Suppl 2):20611.
7. Thorley KJ. Pharmacokinetics of atenolol in pregnancy and lactation. Drugs 1983;25(Suppl 2):2167.
8. Boutroy MJ. Fetal and neonatal effects of the beta-adrenoceptor blocking agents. Dev Pharmacol Ther 1987;10:22431.
9. Fowler MB, Brudenell M, Jackson G, Holt DW. Essential hypertension and pregnancy: successful outcome with atenolol. Br J Clin Pract 1984;38:734.
10. Schneider H, Proegler M. Placental transfer of B-adrenergic antagonists studied in an in vitro perfusion system of human placental tissue. Am J Obstet Gynecol 1988;159:427.
11. Satge D, Sasco AJ, Col JY, Lemonnier PG, Hemet J, Robert E. Antenatal exposure to atenolol and retroperitoneal fibromatosis (abstract). Teratology 1997;55:103.
12. Satge D, Sasco AJ, Col J-Y, Lemonnier PG, Hemet J, Robert E. Antenatal exposure to atenolol and retroperitoneal fibromatosis. Reprod Toxicol 1997;11:53941.
13. Dubois D, Petitcolas J, Temperville B, Klepper A. Beta blockers and high-risk pregnancies. Int J Biol Res Pregnancy 1980;1:1415.
14. Thorley KJ, McAinsh J, Cruickshank JM. Atenolol in the treatment of pregnancy-induced hypertension. Br J Clin Pharmacol 1981;12:72530.
15. Rubin PC, Butters L, Low RA, Reid JL. Atenolol in the treatment of essential hypertension during pregnancy. Br J Clin Pharmacol 1982;14:27981.
16. Rubin PC, Butters L, Clark DM, Reynolds B, Sumner DJ, Steedman D, Low RA, Reid JL. Placebo-controlled trial of atenolol in treatment of pregnancy-associated hypertension. Lancet 1983;1:4314.
17. Rubin PC, Butters L, Low RA, Clark DC, Reid JL. Atenolol in the management of hypertension during pregnancy. Drugs 1983;25(Suppl 2):2124.
18. Dubois D, Peticolas J, Temperville B, Klepper A. Treatment with atenolol of hypertension in pregnancy. Drugs 1983;25(Suppl 2):2158.
19. Frishman WH, Chesner M. Beta-adrenergic blockers in pregnancy. Am Heart J 1988;115:14752.
20. Butters L, Kennedy S, Rubin PC. Atenolol in essential hypertension during pregnancy. Br Med J 1990;301:5879.
21. Fabregues G, Alvarez L, Varas Juri P, Drisaldi S, Cerrato C, Moschettoni C, Pituelo D, Baglivo HP, Esper RJ. Effectiveness of atenolol in the treatment of hypertension during pregnancy. Hypertension 1992;19(Suppl II):II129II31.
22. Bakri YN, Ingemansson SE, Ali A, Parikh S. Pheochromocytoma and pregnancy: report of three cases. Acta Obstet Gynecol Scand 1992;71:3014.
23. Montan S, Ingemarsson I, Marsal K, Sjoberg N-O. Randomized controlled trial of atenolol and pindolol in human pregnancy: effects on fetal haemodyndamics. Br Med J 1992;304:9469.
24. Montan S, Liedholm H, Lingman G, Marsal K, Sjoberg N-O, Solum T. Fetal and uteroplacental haemodynamics during short-term atenolol treatment of hypertension in pregnancy. Br J Obstet Gynaecol 1987;94:3127.
25. Rubin PC. Beta blockers in pregnancy. Br J Obstet Gynaecol 1987;94:2923.
26. Lip GYH, Beevers M, Churchill D, Shaffer LM, Beevers DG. Effect of atenolol on birth weight. Am J Cardiol 1997;79:14368.
27. Al Kasab SM, Sabag T, Al Zaibag M, Awaad M, Al Bitar I, Halim MA, Abdullah MA, Shahed M, Rajendran V, Sawyer W. b-Adrenergic receptor blockade in the management of pregnant women with mitral stenosis. Am J Obstet Gynecol 1990;163:3740.
28. Soderlin MK, Purhonen S, Haring P, Hietakorpi S, Koski E, Nuutinen LS. Myocardial infarction in a parturient. Anaesthesia 1994;49:8702.
29. Dubois D, Petitcolas J, Temperville B, Klepper A, Catherine P. Treatment of hypertension in pregnancy with B-adrenoceptor antagonists. Br J Clin Pharmacol 1982;13(Suppl):375S8S.
30. Tuimala R, Hartikainen-Sorri A-L. Randomized comparison of atenolol and pindolol for treatment of hypertension in pregnancy. Curr Ther Res 1988;44:57984.
31. Lubbe WF. More on beta-blockers in pregnancy. N Engl J Med 1982;307:753.
32. Ingemarsson I, Liedholm H, Montan S, Westgren M, Melander A. Fetal heart rate during treatment of maternal hypertension with beta-adrenergic antagonists. Acta Obstet Gynecol Scand 1984;118(Suppl):957.
33. Rubin PC, Butters L, Clark D, Sumner D, Belfield A, Pledger D, Low RAL, Reid JL. Obstetric aspects of the use in pregnancy-associated hypertension of the B-adrenoceptor antagonist atenolol. Am J Obstet Gynecol 1984;150:38992.
34. Reynolds B, Butters L, Evans J, Adams T, Rubin PC. First year of life after the use of atenolol in pregnancy associated hypertension. Arch Dis Child 1984;59:10613.
35. Liedholm H, Melander A, Bitzen PO, Helm G, Lonnerholm G, Mattiasson I, Nilsson B, Wahlin-Boll E. Accumulation of atenolol and metoprolol in human breast milk. Eur J Clin Pharmacol 1981;20: 22931.
36. Kulas J, Lunell NO, Rosing U, Steen B, Rane A. Atenolol and metoprolol. A comparison of their excretion into human breast milk. Acta Obstet Gynecol Scand 1984;118(Suppl):659.
37. White WB, Andreoli JW, Wong SH, Cohn RD. Atenolol in human plasma and breast milk. Obstet Gynecol 1984;63:42S4S.
38. White WB. Management of hypertension during lactation. Hypertension 1984;6:297300.
39. Schmimmel MS, Eidelman AJ, Wilschanski MA, Shaw D Jr, Ogilvie RJ, Koren G. Toxic effects of atenolol consumed during breast feeding. J Pediatr 1989;114:4768.
40. Diamond JM. Toxic effects of atenolol consumed during breast feeding. J Pediatr 1989;115:336.
41. Koren G. Toxic effects of atenolol consumed during breast feeding. J Pediatr 1989;115:3367.
42. Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:13750.
43. Eidelman AI, Schimmel MS. Drugs and breast milk. Pediatrics 1995;95:9567.
44. Anderson PO. Drugs and breast milk. Pediatrics 1995;95:957.
45. Berlin CM Jr. Drugs and breast milk. Pediatrics 1995;95:9578.
    
    

Questions and Answers

Has anyone out there ever been put on Atenolol(for high blood pressure), while pregnant?

Instructions say to tell doctor if you are pregnant

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use atenolol if you are pregnant. Tell your doctor if you become pregnant during treatment.

Do not stop taking atenolol without first talking to your doctor. Stopping suddenly may make your condition worse.

Good luck

How do I relieve swelling of my legs and ankles? I am not pregnant.?

Not normal swelling down legs and feet. Retaining fluids. Do not use salt. Am taking atenolol for high blood pressure and that is considered great with the results achieved. Help please...

Go to your local pharmacy and purchase an over the counter water pill. It sounds like your body is just in shock from the water you are intaking. Your body thinks it won't be getting much fluid and it doesn't want to lose it, so your body is retaining the fluid. A water pill will work just fine.....just be sure to drink plenty of water, so your body will start getting used to this and will learn that it doesn't need to retain the fluids you are intaking.

heart medicine Atenolol and Pregnancy?

Did you or anyone you know take Atenolol while pregnant? did it cause any harm to your baby?

Jules, Sometimes Mom's-to-be HAVE to take medicine for their health! There's side effects for even Aspirins. Only you can decide. Good Luck!
Here's some info: Use of some beta-blockers during pregnancy has been associated with low blood sugar, breathing problems, a lower heart rate, and low blood pressure in the newborn infant. Other reports have not shown unwanted effects on the newborn infant.

What am I facing if Im pregnant?

I am overweight 245 lbs.
I have High blood pressure controlled with Atenolol 25MG.
I also take water pills Hydrochlorothiazide 25mg.

If I am pregnant can I still take these medications while pregnant?
I have changed the way I eat and other stuff.
Just wanted to know if any one knew of what I would be facing.
thanks and please NO RUDE COMMETS!

I think you need to speak with your doctor, I had high blood pressure when I was pregnant and I couldn't take anything but I was also put on bedrest at 7 months. Good luck!

Pregnancy and Atenolol?

Hi. I'm going to be getting married soon and I am on Atenolol for daily chest pain and an arythmia. I've had all kinds of tests done, but doctors still can't tell me why I'm having the pain. My dad has had atrial fibrillation, and he has had the same symptoms as me when he was my age (I'm 21). Anyway, I know that Atenolol can be harmful to a fetus, and obviously I don't want to hurt my baby if I get pregnant. Does anyone know a good alternative to Atenolol that won't hurt a baby? I know it's best not to be on any medication during pregnancy, but I get so weak when I'm not on medication and my heart beats too fast at night making me not able to sleep. Also, I would be afraid to go through childbirth if I couldn't be on something to lower my heart beat.
I'll be going to the doctor before I get married, but I just wanted to be more informed before I go in and ask them. Thanks!

There are other drugs that can be prescribed. You will need to coordinate your care with both your obstetrician and your cardiologist. They may have to prescribe two or more drugs to treat your angina and your a-fib without causing fetal harm.

You should discuss with your docs if becoming pregnant is safe for you and the fetus regarding your medical conditions. The risks may be great regardless of the medications you are taking.

Here's some more info on atenolol and its uses.

Atenolol is a drug belonging to the group of beta blockers, a class of drugs used primarily in cardiovascular diseases. Introduced in 1976, atenolol was developed as a replacement for propranolol in the treatment of hypertension.

As you stated atenolol should only be taken if clearly needed during pregnancy, as atenolol may retard fetal growth and possibly causes other abnormalities. Use of some beta-blockers during pregnancy has been associated with low blood sugar, breathing problems, a lower heart rate, and low blood pressure in the newborn infant. Other reports have not shown unwanted effects on the newborn infant. Animal studies have shown some beta-blockers to cause problems in pregnancy when used in doses many times the usual human dose. Before taking any of these medicines, make sure your doctor knows if you are pregnant or if you may become pregnant.

Beta blockers are particularly effective in patients with exertional angina, normally young to middle aged people, and is especially helpful to those with hypertension, hyperdynamic left ventricular systolic function, or an excessive heart rate or large blood pressure increases due to exercise.

Atenolol is also used to help combat cardiac arrhythmias primarily due to beta blockade, and is a class II anti-arrhythmic agent. It is also used to help control the ventricular response rate in chronic atrial fibrilation, supraventricular tachycardia and in symptomatic premature ventricular complexes.

Hope this helps.

Rick the pharmacist

Can High Blood pressure cause infertility for Women?

I have had high blood pressure for like awhile and well doctor said change your diet and so and so....
I did It did not work.
He put me on medication called ATENOLOL 25 mg. and its stable now. I'm also on water pills.
Me and my husband have been trying to conceive for 4 months now. and It has not happened.
Now that I'm on Blood pressure medication,


Can this medication be OK to try to conceive?
And While pregnant?

thanks~

Well ur question has multiple parts I will do my best to answer ur concern
Atenolol is a beta blocker used to decrease ur heart rate and thus dec. BP, water pills decrease ur blood volume and so also dec BP
They are both very old drugs and thus have been used by millions of people and they are very safe, however there is a tricky part, no pharmaceutical company dares to conduct a trial of its products on pregnant women so its written in the leaflet insert that it has not been tested in pregnancy
In other words its ur choice and the clinical judgement of ur doctor to use the drug in pregnancy but for these 2 drugs i would say its 90% safe
As for conception I assure u both these drugs and blood pressure itself has absolutely no effect of u not conceiving yet.
4 months is not a problem and conceiving problems are considered if conception fails for 1 year.
Take ur time and dont be stressed but once u conceive I would advise u to go for a gynaecologist consultation as u will be what they call medium risk case. u will need close follow up every 2 weeks

Can you have a baby?

I am taking medicine for high blood pressure and want to know if having a baby is a good choice. I take atenolol and triametrizine* 50 mf of each. Opinions please maybe someone has gotten pregnant that was on blood pressure meds.

You need to discuss this with your doctor.

Yes you can have a baby. However you are on what is called a potassium sparing diuretc. This drug class can actually cause problems with the pregnancy, as they make the body lose water, which then draws water out of your amniotic fluid...obviously this is bad for the baby. This drug class also depetes folic acid from the body, which is needed to prevent neural tube defects in the foetus.

There are safer alternatives though, such as Methyldopa (short term), or B-blockers (but not atenolol as this can affect the baby). There are also Calcium channel blockers, such as nifedipine and verapamil.

Women get pregnant on blood pressure meds all the time. A lot of women dont have hypertension, but then develop it when they fall pregnant! There are many treatments, but it has to be treated and controlled. Uncontrolled hypertension can lead to reduced blood flow through the placenta, which can decrease the amount of oxygen and nutrients that the child gets. So (depending on how severe it is) you may need to control your blood pressure with medications to avoid this risk. You will definately have to have more frequent checkups than normal as well

Definately talk to your doctor. There are many antihypertensive drugs that are perfectly safe for pregnancy, but there are many that can cause serious birth defects and even miscarraige. You should not make this decision over the internet. You have to get a medical opinion. But you can fall pregnant...you just have to make sure you get your medications right before hand, so that you and your baby are healthy

Goodluck!

PCOS and high BP?

I have PCOS and High BP, I am on HCTZ and Atenolol for it, its pretty well under control right now. I have a dr. app. tomorrow with the prenatal assessment center to change my meds to something that wont hurt a baby if/when I do get pregnant. Does anyone have any ideas what they might change it to, and if there are any specific questions that I should be asking at this visit??

Im not sure what they may put you on, but I did want to tell you to do some research on your own on the medications they give you for high blood pressure. Alot of they are not good for you if you are trying to conceive. They can cause fetal abnormalities. My dr. just wrote me a prescription for something for high bp and I did a search on the internet and found out you shouldnt take it when ttc.

Just my advice. Good luck to you.