Compare Atenolol vs. hydrochlorothiazide

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


(hydrochlorothiazide )

Lowers blood pressure and controls heart rate. Tenormin (atenolol) is good for controlling chest pain and treating a heart attack. It has fewer side effects than other beta blockers. You need to take it on an empty stomach and you can't skip doses.Removes water from the body, which lowers blood pressure. Microzide (hydrochlorothiazide (HCTZ)) is a well-tolerated water pill that's often the first-choice treatment for mild high blood pressure.
Reviews & ratings
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Filter group. All currently selected
Reviews for Atenolol
of people (All ages) say Atenolol is worth it
say it works well
say it's a big hassle
457 reviews
Have you used Tenormin (atenolol)?
Worth itNot sureNot worth it
Reviews for hydrochlorothiazide
+11% better vs. Atenolol
+17% better vs. Atenolol
Same vs. Atenolol
139 reviews
Have you used Microzide (hydrochlorothiazide (HCTZ))?
Worth itNot sureNot worth it
Side effects
  • Feeling off balance 2%
  • Drowsiness 2%
  • Slower heartbeat 3%
  • Leg Pain 2%
  • Light-headedness 3%
  • Decreased energy 3%
  • Vivid dreams 2%
  • Diarrhea 1%
  • Nausea 2%
More Atenolol side effects »

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

More about hydrochlorothiazide side effects »
How it works
Tenormin (atenolol) is a selective beta blocker that works specifically on the heart by slowing down the heart and making the heart pump better.Microzide (hydrochlorothiazide (HCTZ)) is a thiazide diuretic (water pill) that makes you urinate more. It works in the kidneys to remove extra water and certain electrolytes, while lowering blood pressure and reducing swelling.
Type of medication
Prescription onlyLower-cost generic availablePrescription onlyLower-cost generic available
Available as
  • Pill
  • Pill
Used for
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
  • Lower kidney function
  • Dehydration
  • History of sulfa allergies
  • History of gout
Detailed Microzide (hydrochlorothiazide (HCTZ)) risks & warnings »

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.

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

Kidneys and liver
No kidneys and liver related info.
  • Requires routine blood tests to check kidney function.
Upsides and benefits
  • A first-choice treatment to prevent chest pain (angina).
  • A first-choice treatment for heart attack recovery.
  • At lower doses, Tenormin (atenolol) has fewer side effects than other beta blockers because it targets the heart and not other parts of the body.
  • Does a good job getting rid of extra fluids in your body by making you urinate more.
  • A first-choice blood pressure treatment. Works especially well for people of African descent.
  • Lowers the risk of heart attack and stroke.
  • Good option if you have high blood pressure and heart failure.
  • Most people have very few side effects from Microzide (hydrochlorothiazide (HCTZ)).
  • Can be good for patients with osteoporosis since it raises the body's level of calcium.
Downsides and risks
  • You need to take Tenormin (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 it might not go away for others.
  • Not a first-choice treatment for high blood pressure unless you have heart disease. However, your doctor could add it to other medicines you're already if your blood pressure is still too high.
  • You can't miss or skip doses. If you stop Tenormin (atenolol) suddenly, it can cause your blood pressure to go up really quickly, raising your risk of heart attack and stroke.
  • Tenormin (atenolol) can hide symptoms of low blood sugar if you're diabetic.
  • Makes you urinate more often.
  • Microzide (hydrochlorothiazide (HCTZ)) doesn't work well in people with severe kidney problems.
  • It can increase the risk of gout attacks in people with poor kidney function or a history of gout.
  • People with a sulfa allergy may be allergic to Microzide (hydrochlorothiazide (HCTZ)).
Tips from our pharmacists for people taking the medication
  • Lowers bad cholesterol and triglycerides. Raises good cholesterol.
  • Avoid grapefruit and grapefruit juice while taking this medicine.
  • Tell your doctor if you develop sudden muscle pain, fever, or weakness.
  • Tell your doctor if you notice dark urine or yellowing in your eyes or skin.
  • Microzide (hydrochlorothiazide (HCTZ)) starts working in about 2 hours.
  • It makes you urinate more often, so don't take it at bedtime.
  • 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.
  • Tell your doctor about any tiredness or muscle weakness that doesn't go away.
  • Requires routine blood tests to check kidney function.
Learn more
More about AtenololSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Tenormin (atenolol)?
Worth itNot sureNot worth it
More about hydrochlorothiazideSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Microzide (hydrochlorothiazide (HCTZ))?
Worth itNot sureNot worth it