Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about Noten.
It does not contain all of the available information. It does not take the place of talking to your doctor or pharmacist.
All medicines have benefits and risks. Your doctor has weighed the risks of you taking Noten against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, talk to your doctor or pharmacist.
Keep this leaflet with your medicine. You may need to read it again.
What Noten is used for
Noten is used to:
lower high blood pressure, also called hypertension
treat an irregular heart beat or rhythm, also called arrhythmia
reduce the risk of heart complications following a heart attack.
Noten belongs to a group of medicines called beta-blockers. It works by affecting the body's response to certain nerve impulses, especially in the heart. As a result, it decreases the heart's need for blood and oxygen and therefore reduces the amount of work the heart has to do. It widens the blood vessels in the body, causing blood pressure to fall. It also helps the heart to beat more regularly.
Everyone has blood pressure. This pressure helps to push blood all around your body. Your blood pressure changes during the day, depending on how busy you are or how you are feeling.
You have hypertension (high blood pressure) when your blood pressure stays higher than is needed, even when you are calm and relaxed.
There are usually no symptoms of hypertension. The only way of knowing that you have hypertension is to have your blood pressure checked on a regular basis. You may feel fine and have no symptoms, but if high blood pressure is not treated, it can lead to serious health problems.
Noten helps to lower your blood pressure.
Angina is a pain or uncomfortable feeling in the chest, often spreading to the arms or neck and sometimes to the shoulders and back. This may be caused by too little blood and oxygen getting to the heart. The pain of angina is usually brought on by exercise or stress, but can also occur at rest.
Noten helps prevent angina. It is not used to relieve a sudden attack of angina.
Irregular heart beat (arrhythmia):
Irregular heart beat, also known as arrhythmia, means that there is a disturbance of the heart's normal rhythm or beat. Arrhythmias may be caused by a number of factors, including some heart diseases, an overactive thyroid gland, or chemical imbalances.
Noten helps restore the heart's normal rhythm.
Reducing heart complications after heart attack:
After a heart attack there is a chance of developing arrhythmias or of further heart attacks occurring.
Noten helps prevent these conditions from occurring.
Ask your doctor if you have any questions about why Noten has been prescribed for you. Your doctor may have prescribed Noten for another reason.
Noten is not recommended for use in children, as there have been no studies of its effects in children.
Noten is available only with a doctor's prescription.
There is no evidence that Noten is addictive.
Before you take Noten
When you must not take it
Do not take Noten if you have an allergy to:
any medicine containing atenolol
any of the ingredients listed at the end of this leaflet
any other beta-blocker medicine.
Some of the symptoms of an allergic reaction may include shortness of breath; wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; rash, itching or hives on the skin.
Do not take Noten if you have:
asthma, wheezing, difficulty breathing, or other lung problems; or have had them in the past
a history of allergic problems, including hayfever
a very slow heart beat, less than 45-50 beats per minute
other problems with your heart
low blood pressure, also called hypotension
phaeochromocytoma (a rare tumour of the adrenal gland) that is not already being treated with other medicines
a severe blood vessel disorder causing poor circulation in the arms and legs.
Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering.
If it has expired or is damaged, return it to your pharmacist for disposal.
If you are not sure whether you should start taking this medicine, talk to your doctor.
Before you start to take it
Tell your doctor if you have allergies to:
any other medicines, including eye drops, or other beta-blocker medicines
any other substances, such as foods, dyes or preservatives.
Tell your doctor if you are pregnant or plan to become pregnant. Noten may affect your baby if you take it early in pregnancy or in the last weeks before your baby is due. Your doctor will discuss the risks and benefits of taking Noten during pregnancy.
Tell your doctor if you are breastfeeding or wish to breastfeed. Noten passes into breast milk and may affect your baby. Your doctor will discuss the risks and benefits of taking Noten when breastfeeding.
Tell your doctor if you have, or have had, any medical conditions, especially the following:
an overactive thyroid gland
certain types of angina, such as Prinzmetal angina or variant angina
any other heart problem
any blood vessel disorders causing poor circulation in the arms and legs
phaeochromocytoma (a rare tumour of the adrenal gland) that is being treated.
If you have not told your doctor about any of the above, tell them before you start taking Noten.
Taking other medicines
Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from a pharmacy, supermarket or health food shop.
Some medicines and Noten may interfere with each other. These include:
other medicines used to treat high blood pressure, angina or an irregular heart beat
digoxin, a medicine used to treat heart failure
medicines used to treat other heart conditions
insulin and other medicines used to treat diabetes
certain medicines used to treat arthritis, pain or inflammation such as indomethacin or ibuprofen
medicines commonly used during surgery or in emergency situations such as dopamine, adrenaline, noradrenaline and certain anaesthetics.
These medicines may be affected by Noten or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines.
Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking Noten.
How to take Noten
Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained in this leaflet.
If you do not understand the instructions on the label, ask your doctor or pharmacist for help.
How much to take
The usual dose is from 50 mg (1 tablet) up to 200 mg (4 tablets) daily.
If your dose is 100 mg or less, take it once a day. If you need to take more than 100 mg (2 tablets), take half of your dose in the morning and the other half in the evening.
Angina or Arrhythmia (irregular heart beat):
The usual dose is from 50 mg (1 tablet) up to 100 mg (2 tablets) taken as a single dose or half the dose in the morning and half at night.
The usual dose is 50 mg (1 tablet) daily for 1 - 3 years following a heart attack.
The doses mentioned for arrhythmia and heart attack should be given after the condition is brought under control.
Certain people e.g. the elderly or those with kidney problems, may require a lower dose.
How to take it
Swallow the tablets with a glass of water.
When to take it
It does not matter if you take this medicine before or after food.
Take your tablet(s) at about the same time each day. This will help you remember when to take the tablet.
How long to take it
Continue taking your medicine for as long as your doctor tells you to. This medicine helps to treat high blood pressure, irregular heart beat, heart attacks and prevent angina but does not cure it. Therefore, Noten must be taken every day.
If you forget to take it
If it is less than six hours from when you missed your dose, take it as soon as you remember, and then go back to taking your tablets at the same time you would normally
If it is more than six hours since your last dose, skip the dose you missed and take your next dose when you would normally.
Do not take a double dose to make up for the dose you missed.
If you are not sure what to do, ask your doctor or pharmacist.
If you have trouble remembering to take your medicine, ask your pharmacist for some hints.
If you take too much (overdose)
Immediately telephone your doctor or Poisons Information Centre (telephone 13 11 26), or go to Accident and Emergency at the nearest hospital, if you think you or anyone else may have taken too much Noten. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
If you take too much Noten, you may faint, feel dizzy or lightheaded, wheeze or have difficulty breathing. You may also have a very slow heart beat.
While you are taking Noten
Things you must do
If you are about to be started on any new medicine, tell your doctor and pharmacist that you are taking Noten.
Tell any other doctors, dentists and pharmacists who treat you that you are taking this medicine.
If you become pregnant while taking this medicine, tell your doctor immediately.
If you have a severe allergic reaction to foods, medicines or insect stings, tell your doctor immediately.
If you have a history of allergies, there is a chance that Noten may cause allergic reactions to be worse and harder to treat.
If you are going to have surgery (even at the dentist), tell your doctor or dentist that you are taking Noten. This medicine may affect some of the medicines used during surgery.
If you are being treated for diabetes, make sure you check your blood sugar level regularly. Noten may affect how well your diabetes is controlled. It may also cover up some of the symptoms of low blood sugar levels, such as a fast heart beat. It may also make low blood sugar last longer. Your doctor may need to change your dose of diabetic medicines, including insulin.
If you have angina and continue to have attacks or have more of them while you are taking this medicine, tell your doctor. Noten is used to help prevent angina, so your angina attacks should become less severe and occur less often.
If you feel light-headed, dizzy or faint when getting out of bed or standing up, get up slowly. You may feel light-headed or dizzy after taking Noten. This is because your blood pressure is falling suddenly.
If this problem gets worse or continues, talk to your doctor.
To help your body get used to the change in blood pressure, you may find the following hints useful:
Stand up slowly when getting up from a chair or bed. This will allow your body get used to the change in position and blood pressure.
If you feel dizzy, sit or lie down until you feel better.
If you feel faint, sit down and put your head between your knees.
Make sure you drink enough water in hot weather and during exercise while you are taking Noten, especially if you sweat a lot. If you do not drink enough water while taking Noten, you may feel faint, lightheaded or sick. This is because your blood pressure is dropping suddenly. The recommended healthy minimum water intake is 6 - 8 glasses daily.
If you have to have any medical tests while you are taking Noten, tell your doctor. Noten may affect the results of some tests.
Things you must not do
Do not stop taking Noten without checking with your doctor. Stopping Noten suddenly may worsen your angina or cause other heart complications to occur. Your doctor may want you to gradually reduce the amount of Noten you are taking before stopping completely.
Do not take your medicine to treat any other complaints unless your doctor tells you to.
Do not give your medicine to anyone else, even if they have the same condition as you.
Things to be careful of
Be careful driving or operating machinery until you know how Noten affects you. Noten may cause dizziness or tiredness in some people. If you have any of these symptoms, do not drive, operate machinery or do anything else that could be dangerous.
Dress warmly during cold weather, especially if you will be outside for a long time (for example, when playing or watching sports in winter). Noten, like other beta-blocker medicines, may make you more sensitive to cold temperatures, especially if you have blood circulation problems. Beta-blockers tend to decrease blood circulation in the skin, fingers and toes.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Noten. Like all other medicines, Noten may have unwanted side effects in some people. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
Ask your doctor or pharmacist to answer any questions you may have.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
Tell your doctor if you notice any of the following and they worry you:
feeling generally unwell
stomach upsets such as diarrhoea, constipation, abdominal pain or indigestion
runny or blocked nose
sleep problems, nightmares, vivid dreams
problems with sexual function.
The above list includes the more common side effects of Noten. For the most part these have been mild.
Tell your doctor as soon as possible if you notice any of the following:
dizziness or lightheadedness, especially when getting up quickly
worsening of psoriasis
unsteadiness when walking
abnormal thinking, hallucinations (seeing or hearing things that are not there)
depression or mood changes or a worsening of these
dry, red or sore eyes, blurred vision
pins and needles in the hands or feet
numbness, tingling and colour change in the fingers and toes when exposed to the cold
ringing in the ears.
The above list includes serious side effects that may require medical attention. Serious side effects are rare.
Tell your doctor immediately or go to Accident and Emergency at the nearest hospital if you notice any of the following:
fast, slow or irregular heart beat
unusual bruising or bleeding
chest tightness, wheezing, difficulty breathing
shortness of breath (sometimes with tiredness, weakness and reduced ability to exercise), which may occur together with swelling of the feet or legs due to fluid build up
yellowing of the eyes or skin (jaundice) - this has been reported rarely
signs of an allergic reaction such as skin rash, itching or hives; swelling of the face, lips, tongue or other parts of the body; shortness of breath, wheezing or troubled breathing.
The above list includes very serious side effects. You may need urgent medical attention or hospitalisation. These side effects are rare.
Tell your doctor or pharmacist if you notice anything that is making you feel unwell. Other side effects not listed above may also occur in some patients.
After using Noten
Keep Noten where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Keep your tablets in the pack until it is time to take them. If you take the tablets out of the pack they may not keep well.
Keep your tablets in a cool dry place where the temperature stays below 30°C.
Do not store Noten or any other medicine in the bathroom or near a sink.
Do not leave Noten in the car or on window sills. Heat and dampness can destroy some medicines.
If your doctor tells you to stop taking Noten, or your tablets have passed their expiry date, ask your pharmacist what to do with any that are left over.
What it looks like
Noten is a white, oblong tablet marked AT/50 and a Greek alpha symbol.
Each pack contains 30 tablets.
The active ingredient in Noten is atenolol. Each Noten tablet contains 50 mg of atenolol.
The tablets also contain:
starch - maize
cellulose - microcrystalline
silica - colloidal anhydrous
hydrogenated vegetable oil
sodium starch glycollate
The tablets are gluten free.
Noten is made in Australia by:
Alphapharm Pty Limited
(ABN 93 002 359 739)
Chase Building 2
Wentworth Park Road
Glebe NSW 2037
Phone: (02) 9298 3999
Phone: 1800 028 365
Australian registration numbers:
Aust R 46250, 46251
This leaflet was prepared on 24 January 2007.