Harvard Health Letter

By the way, doctor: Is there an alternative to atenolol for atrial fibrillation?

Q. I am 81 with no history of heart problems. I recently developed atrial fibrillation and now take half of a 25-mg tablet of atenolol. The doctor says it's working, but it makes me extremely tired. Could you suggest another medication that I might have better luck with?

A. In atrial fibrillation, the upper chambers of the heart (the atria) quiver instead of beating regularly. Often the heart also beats too fast to pump blood efficiently, so doctors prescribe medications that slow it down. Atenolol (pronounced a-TEN-oh-lawl) is one of several drugs called beta blockers that do this. The usual goal is a rate no higher than 80 beats per minute when you're resting or 110 beats per minute while you're walking briskly.

Any of the beta blockers can make a person feel tired. But for reasons that are poorly understood, some people feel tired when taking one type but not another. So you should talk to your doctor about switching to a different beta blocker. Alternatives include metoprolol (Lopressor, Toprol-XL), nadolol (Corgard), and propranolol (Inderal).

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