Atenolol vs. Olmesartan

See how Atenolol and Olmesartan compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Atenolol is a beta-blocker that slows the heart rate to lower blood pressure, while olmesartan is an ARB that relaxes blood vessels without affecting heart rate.

  • Both are taken once daily, but atenolol usually starts low and increases over time, while olmesartan can start at its typical dose right away.

  • Atenolol costs much less per month than olmesartan, though olmesartan carries a boxed pregnancy warning that atenolol does not.

Atenolol vs. Olmesartan Drug Summary

Atenolol

Atenolol is a beta-1 selective beta-blocker approved for hypertension, angina, and stable heart attack recovery. It works by slowing the heart rate and reducing the force of each heartbeat, taken as a once-daily oral tablet with a dose that may be increased over time.

Olmesartan

Olmesartan is an angiotensin II receptor blocker (ARB) approved to treat high blood pressure in adults and children age 6 and up. It relaxes blood vessels by blocking a hormone that narrows them, taken as a once-daily oral tablet without a titration schedule.

Atenolol vs. Olmesartan Side Effects

Atenolol

Most common
fatigue (up to 26%)
dizziness (up to 13%)
cold extremities (up to 12%)
depression (up to 12%)

Olmesartan

Most common
dizziness (up to 3%)
headache (>1%)
back pain (>1%)
diarrhea (>1%)

Atenolol vs. Olmesartan Dosage

Atenolol

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 50 mg once daily At the start
Maximum dose 200 mg once daily If needed
Dose changes 2 increases As tolerated

Olmesartan

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily At the start
Maximum dose 40 mg once daily Week 3 onward
Dose changes 2 increases As tolerated

Atenolol vs. Olmesartan Indications

Atenolol

Atenolol treats high blood pressure, chest pain from angina, and helps stabilize patients recovering from a heart attack. Doctors also prescribe it off-label for migraine prevention and tremor control, though these uses are not FDA approved.

  • Hypertension

  • Angina pectoris

  • Acute myocardial infarction (stable)

Olmesartan

Olmesartan is approved solely for treating high blood pressure, either alone or combined with other antihypertensive medications. It is approved for both adults and children as young as 6, but not as an initial treatment in patients 75 or older or those with liver problems.

  • Hypertension in adults

  • Hypertension in children age 6 and up

  • Combination therapy with other antihypertensives

Atenolol vs. Olmesartan Pros and Cons

Atenolol

Atenolol has decades of real-world use and treats several heart conditions beyond blood pressure, making it useful for patients with angina or a recent heart attack. It is one of the least expensive blood pressure medications available, though it requires caution in people with breathing problems or a slow heart rate.

Pros

  • Also treats angina and post-heart-attack recovery

  • Decades of clinical use and safety data

  • Roughly $6 to $37 per month, much cheaper than olmesartan

  • Available off-label for migraine and tremor

Cons

  • Cannot be stopped abruptly without tapering

  • Unsafe for people with slow heart rate or heart block

  • Can mask symptoms of low blood sugar or overactive thyroid

  • Requires caution in asthma or COPD

Olmesartan

Olmesartan targets blood pressure specifically and tends to cause fewer effects on heart rate or mood than a beta-blocker like atenolol. It carries a boxed warning against use in pregnancy and requires monitoring of kidney function and potassium, and its monthly cost is notably higher.

Pros

  • Does not slow heart rate or mask low blood sugar

  • Simple once-daily dosing with no titration needed

  • Approved for children as young as 6

  • Fewer effects on mood or energy levels

Cons

  • Boxed warning against use during pregnancy

  • Risk of high potassium and reduced kidney function

  • Rare risk of severe chronic diarrhea (sprue-like enteropathy)

  • Roughly $115 to $205 per month, pricier than atenolol

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.