Co-tenidone

STRENGTH PROVENANCE: the entire adult posology in the fetched eMC §4.2 is 'Adults: One tablet daily' — no milligram figure appears anywhere in the fetched section text. The strength above comes from the SPC record's own product identity, providers.emc.source.productName = 'Co-tenidone 100/25mg Film-Coated Tablets' (eMC product 2653). The fetched sections confirm the two components are atenolol (a beta-1 selective beta-blocker) and chlortalidone (§4.4, §4.8) but do NOT state which component is 100 mg and which is 25 mg — do not assume the mapping; confirm the per-component content against §2 of the product SPC. ELDERLY: one tablet daily. Elderly patients with hypertension who do not respond to low dose therapy with a single agent should have a satisfactory response to a single tablet daily of co-tenidone; where control is not achieved, addition of a small dose of a third agent, e.g. a vasodilator, may be appropriate. PAEDIATRIC: the use of co-tenidone is not recommended in children — safety and efficacy in children have not yet been established. Verify any under-18 use against a children's formulary. RENAL: due to the properties of the chlortalidone component, co-tenidone has reduced efficacy in the presence of renal insufficiency, and this fixed dose combination should not be administered to patients with severe renal impairment (see §4.3). BETA-BLOCKER PRECAUTIONS (§4.4): should not be discontinued abruptly in patients suffering from ischaemic heart disease. Although contraindicated in uncontrolled heart failure, it may be used in patients whose signs of heart failure have been controlled — exercise caution where cardiac reserve is poor. May increase the number and duration of angina attacks in Prinzmetal's angina. Caution in first degree heart block (negative effect on conduction time). May modify the warning signs of hypoglycaemia such as tachycardia, palpitation and sweating, and beta-blockers could further increase the risk of severe hypoglycaemia with sulfonylureas — diabetic patients should monitor blood glucose carefully. May mask the cardiovascular signs of thyrotoxicosis. Reduces heart rate — if symptoms attributable to a slow heart rate develop, the dose may be reduced. May cause a more severe reaction to allergens in patients with a history of anaphylaxis, and such patients may be unresponsive to usual doses of adrenaline. Patients with bronchospastic disease should in general not receive beta-blockers; the label and patient information leaflet carry the warning 'Do not take this medicine if you have a history of wheezing or asthma' — if increased airways resistance occurs, discontinue and give bronchodilator therapy (e.g. salbutamol) if necessary. In phaeochromocytoma, co-tenidone must be administered only after alpha-receptor blockade, with close blood pressure monitoring. Caution with anaesthetic agents — the anaesthetist should be informed. PRIOR VERIFY HOLD — NOW PART-RESOLVED BY THE 2026-08-05 RE-FETCH: an adversarial verification pass held this entry because 'adultDose.dose quantifies zero of the two components' and 'providers.emc.source.productName is truncated to the single token Co, so the fetched record does not even establish which strength product was read', leaving a 2-fold ambiguity in both a beta-blocker and a thiazide-like diuretic. The re-fetched bundle captures the full product name, 'Co-tenidone 100/25mg Film-Coated Tablets', so the presentation is now established and the strength is carried inside the dose string itself. STILL OPEN: the SPC text states no mg figure and no component mapping; that prior pass also noted UK co-tenidone is marketed as 50 mg/12.5 mg as well as 100 mg/25 mg — that claim is NOT verifiable from this bundle, but it is the reason the dose must never be read without its strength. SOURCE CAVEATS: §4.4 and §4.8 are truncated at the source-fetch limit; §4.5 (interactions) was not retrieved.