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Atenolol / chlorthalidone Side Effects

In Summary

Commonly reported side effects of atenolol/chlorthalidone include: dizziness, fatigue, and cold extremities. Other side effects include: bradycardia, and lower leg pain. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to atenolol / chlorthalidone: oral tablet

In addition to its needed effects, some unwanted effects may be caused by atenolol / chlorthalidone. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking atenolol / chlorthalidone:

More common:
  • Cold arms or legs
  • difficult or labored breathing
  • shortness of breath
  • tightness in chest
  • wheezing
Less common:
  • Chest pain or discomfort
  • chills
  • cold sweats
  • confusion
  • dizziness, faintness, or lightheadedness when getting up from lying or sitting position
  • leg pain
  • lightheadedness, dizziness, or fainting
  • slow or irregular heartbeat
  • unusual tiredness or weakness
Incidence not determined
  • Black, tarry stools
  • bleeding gums
  • blood in urine or stools
  • feeling that others are watching you or controlling your behavior
  • feeling that others can hear your thoughts
  • fever
  • general feeling of discomfort, illness, or weakness
  • paleness or cold feeling in fingertips and toes
  • pinpoint red spots on skin
  • seeing, hearing, or feeling things that are not there
  • severe mood or mental changes
  • skin irritation or rash, including rash that looks like psoriasis
  • tingling or pain in fingers or toes when exposed to cold
  • unusual behavior
  • unusual bleeding or bruising

If any of the following symptoms of overdose occur while taking atenolol / chlorthalidone, get emergency help immediately:

Symptoms of overdose:
  • Blurred vision
  • decreased urination
  • dry mouth
  • increase in heart rate
  • muscle cramps or pain
  • numbness, tingling, pain, or weakness in hands or feet
  • rapid breathing
  • seizures
  • sunken eyes
  • sweating
  • thirst
  • trembling
  • weakness and heaviness of legs
  • wrinkled skin

Minor Side Effects

Some of the side effects that can occur with atenolol / chlorthalidone may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Discouragement
  • feeling sad or empty
  • irritability
  • lack of appetite
  • loss of interest or pleasure
  • tiredness
  • trouble concentrating
  • trouble sleeping
Less common:
  • Diarrhea
  • feeling of constant movement of self or surroundings
  • nausea
  • sensation of spinning
  • unusual drowsiness, dullness, or feeling of sluggishness
Incidence not determined
  • Decreased interest in sexual intercourse
  • disturbed color perception
  • double vision
  • hair loss, thinning of hair
  • halos around lights
  • headache
  • inability to have or keep an erection
  • loss in sexual ability, desire, drive, or performance
  • loss of vision
  • night blindness
  • overbright appearance of lights
  • pain of penis on erection
  • tunnel vision

For Healthcare Professionals

Applies to atenolol / chlorthalidone: oral tablet


The most common adverse reactions were bradycardia, cold extremities, gastrointestinal disturbances, fatigue, hyperuricemia, hyponatremia, hypokalemia, and impaired glucose tolerance.[Ref]


Common (1% to 10%): Hyperuricemia, hyponatremia, hypokalemia, impaired glucose tolerance

Chlorthalidone (chlortalidone):
Frequency not reported: Anorexia, hyperglycemia, hyperuricemia[Ref]


Common (1% to 10%): Bradycardia, cold extremities
Rare (less than 0.1%): Heart failure deterioration, heart block precipitation, postural hypotension, intermittent claudication increased, Raynaud's phenomenon

Very common (10% or more): Cold extremities (up to 12%)
Common (1% to 10%): Bradycardia, postural hypotension
Postmarketing reports: Sick sinus syndrome, Raynaud's phenomenon

Chlorthalidone (chlortalidone):
Frequency not reported: Orthostatic hypotension, necrotizing angiitis[Ref]


Common (1% to 10%): Gastrointestinal disturbances
Rare (less than 0.1%): Dry mouth
Frequency not reported: Constipation

Common (1% to 10%): Diarrhea, nausea
Postmarketing reports: Dry mouth

Chlorthalidone (chlortalidone):
Frequency not reported: Gastric irritation, vomiting, cramping, constipation, pancreatitis[Ref]


Common (1% to 10%): Fatigue

Very common (10% or more): Tiredness (up to 26%)
Common (1% to 10%): Fatigue, lethargy

Chlorthalidone (chlortalidone):
Frequency not reported: Weakness[Ref]


Uncommon (0.1% to 1%): Sleep disturbances
Rare (less than 0.1%): Mood changes, nightmares, confusion, psychoses, hallucinations

Very common (10% or more): Depression (up to 12%)
Common (1% to 10%): Dreaming
Postmarketing reports: Hallucinations, psychoses

Chlorthalidone (chlortalidone):
Frequency not reported: Restlessness[Ref]


Uncommon (0.1% to 1%): Transaminase levels increased
Rare (less than 0.1%): Hepatic toxicity

Postmarketing reports: Liver enzymes elevated, bilirubin elevated

Chlorthalidone (chlortalidone):
Frequency not reported: Intrahepatic cholestatic jaundice[Ref]


Rare (less than 0.1%): Purpura, alopecia, psoriasiform skin reaction, psoriasis exacerbation, skin rashes
Frequency not reported: Angioedema, urticaria

Postmarketing reports: Psoriasiform rash, psoriasis exacerbation, purpura, reversible alopecia

Chlorthalidone (chlortalidone):
Frequency not reported: Purpura, photosensitivity, rash, urticaria, cutaneous vasculitis, toxic epidermal necrolysis[Ref]

Nervous system

Rare (less than 0.1%): Dizziness, headache, paresthesia

Very common (10% or more): Dizziness (up to 13%)
Common (1% to 10%): Vertigo, lightheadedness, drowsiness
Postmarketing reports: Headache

Chlorthalidone (chlortalidone):
Frequency not reported: Vertigo, paresthesia[Ref]


Rare (less than 0.1%): Thrombocytopenia, leukopenia

Postmarketing reports: Thrombocytopenia

Chlorthalidone (chlortalidone):
Frequency not reported: Leukopenia, agranulocytosis, thrombocytopenia, aplastic anemia[Ref]


Rare (less than 0.1%): Dry eyes, visual disturbances

Postmarketing reports: Visual disturbance

Chlorthalidone (chlortalidone):
Frequency not reported: Xanthopsia[Ref]


Rare (less than 0.1%): Bronchospasm

Common (1% to 10%): Wheeziness, dyspnea[Ref]


Rare (less than 0.1%): Impotence

Postmarketing reports: Impotence, Peyronie's disease

Chlorthalidone (chlortalidone):
Frequency not reported: Glycosuria[Ref]


Very rare (less than 0.01%): Antinuclear antibodies increased
Frequency not reported: Hypersensitivity reactions

Postmarketing reports: Development of antinuclear antibodies[Ref]


Frequency not reported: Lupus-like syndrome

Common (1% to 10%): Leg pain
Postmarketing reports: Lupus syndrome

Chlorthalidone (chlortalidone):
Frequency not reported: Muscle spasm[Ref]


1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. "Product Information. Tenoretic (atenolol-chlorthalidone)." Zeneca Pharmaceuticals, Wilmington, DE.

Not all side effects for atenolol / chlorthalidone may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.