Compare Atenolol vs. Hydrochlorothiazide

Head-to-head comparisons of medication uses, side effects, ratings, and more.

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(Hydrochlorothiazide )

Lowers blood pressure and controls heart rate. Tenormin (Atenolol) is good for controlling chest pain and treating heart failure and heart attack with fewer side effects than other beta blockers. You have to take it on an empty stomach, and you can't miss doses.Lowers blood pressure. Removes extra water from your body. Microzide (Hydrochlorothiazide (Hctz)) is a well-tolerated water pill that's often the first-choice treatment for mild high blood pressure.
How it works
Tenormin (Atenolol) is a selective beta blocker that works specifically on the heart. It lowers blood pressure by slowing down the heart and making it less work to pump.Microzide (Hydrochlorothiazide (Hctz)) is a thiazide diuretic (water pill). It works in the kidneys to make you urinate more, which removes extra water and certain electrolytes. This lowers blood pressure and swelling.
Type of medication
Beta blocker
Prescription only
Prescription only
Available as
  • Pill
  • Pill
Used for (click to learn more)
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Reviews & ratings
Button Group. All currently active
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Reviews for Tenormin (Atenolol)
of people say Tenormin (Atenolol) is worth it
say it works well
say it's a big hassle
Reviews for Microzide (Hydrochlorothiazide (Hctz))
10% vs. Tenormin (Atenolol)
17% vs. Tenormin (Atenolol)
+1% vs. Tenormin (Atenolol)
Side effects
  • Tiredness 13%
  • Dizziness 7%
  • Cold extremities 7%
  • Low mood disorder 3%
  • Vivid dreams 2%
  • Shortness of breath 2%
  • Leg pain 2%
  • Nausea 2%
  • Diarrhea 1%
  • Fatigue 1%
More Atenolol side effects »

The Hydrochlorothiazide FDA package insert doesn’t have numbers about how common side effects are.

More about Hydrochlorothiazide side effects »
Risk factors for serious side effects
  • Suddenly stopping Tenormin (Atenolol)
    • Taking calcium channel blockers
    • Major surgery requiring anesthesia
    • Diabetes
      • Taking clonidine
      Detailed Tenormin (Atenolol) risks & warnings »
      • Current electrolyte imbalance
      • History of sulfa allergies
      • History of gout
      • Current kidney problems
        Detailed Microzide (Hydrochlorothiazide (Hctz)) risks & warnings »
        Pregnancy category
        DFDA pregnancy category (Weigh risks vs. benefits)

        Research studies with real people found harmful effects on unborn babies, but the benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

        See the FDA package insert
        BFDA pregnancy category (Probably safe)

        Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

        See the FDA package insert
        No specific alcohol-related info.No specific alcohol-related info.
        No specific food-related info.No specific food-related info.
        Kidneys and liver
        No specific kidneys and liver-related info.
        • Doesn't work well in people with severe kidney problems.
        • Requires routine blood tests to check kidney function.
        No specific sex-related info.No specific sex-related info.
        No specific sleep-related info.No specific sleep-related info.
        No specific weight-related info.No specific weight-related info.
        Upsides and benefits
        • A first-choice treatment to prevent chest pain (angina).
        • A first-choice treatment for heart failure and heart attack.
        • At lower doses, Atenolol has fewer side effects than most beta blockers because it targets the heart and doesn't cross into the brain and central nervous system.
        • Works well to get rid of extra fluids in your body through urination.
        • A first-choice blood pressure treatment for many people. Works especially well for African Americans.
        • Lowers the risk of heart attack and stroke.
        • Good option if you have both high blood pressure and heart failure.
        • Raises calcium levels in the body, so it can be good for people with osteoporosis to slow down bone loss and even help with new bone formation.
        • Most people have very few side effects.
        Downsides and risks
        • You have to take Atenolol on an empty stomach.
        • Taking a beta blocker might make you feel more tired or out of breath during exercise or normal daily routines. This gets better for most people, but for some might not go away.
        • Not a first-choice treatment for high blood pressure according to the latest guidelines, except if you have heart failure or heart disease. As a second choice, your doctor might add it to medicines you're already taking if your blood pressure is still too high.
        • You can't miss doses. Stopping Atenolol suddenly can cause your blood pressure to go up suddenly, which raises the risk of heart attack and stroke.
        • Can hide symptoms of low blood sugar if you're diabetic.
        • Makes you urinate more often.
        • Doesn't work well in people with severe kidney problems.
        Tips from our pharmacists for people taking the medication
        • Take it on an empty stomach.
        • Can cause fatigue and insomnia.
        • Can hide symptoms of low blood sugar. Be careful if you're diabetic.
        • Don't stop taking this medicine suddenly.
        • Can cause dizziness in the first few days.
        • Check your blood pressure 1 week after starting this medicine, and tell your doctor if it hasn't improved.
        • Starts working in about 2 hours.
        • Makes you urinate more often, so avoid taking it at bedtime.
        • Tell your doctor about any dizziness, fatigue, or muscle weakness that doesn't go away.
        • Requires routine blood tests to check kidney function.
        • Can cause dizziness in the first few days.
        • Check your blood pressure 1 week after starting this medicine, and tell your doctor if it hasn't improved.
        Learn more
        More about AtenololSide effectsReviews & ratingsAlternativesFDA package insert
        More about HydrochlorothiazideSide effectsReviews & ratingsAlternativesFDA package insert