Drug Class: Cardioselective Beta-Blocker + Thiazide-Like Diuretic Combination | Form: Oral Tablet | Prescription Status: Prescription Only (Rx) — DRAP Registered
What is Blokium Diu 100mg Tablet? Blokium Diu 100mg contains Atenolol 100mg and Chlortalidone 25mg — a fixed-dose combination of a cardioselective beta-blocker and a long-acting thiazide-like diuretic that lowers blood pressure through two complementary and independent mechanisms. Atenolol reduces heart rate and cardiac output while Chlortalidone reduces fluid volume through enhanced kidney sodium and water excretion. Together they produce superior blood pressure control compared to either medicine alone — making this combination particularly effective for patients whose hypertension is not adequately controlled by a single agent. The combination also addresses both the cardiac and fluid-retention components of hypertension simultaneously in a convenient single daily tablet.
What is Blokium Diu 100mg Used For?
- Hypertension — high blood pressure inadequately controlled by single agent (ہائی بلڈ پریشر)
- Chronic stable angina — prevention of chest pain from reduced coronary blood flow (سینے کے درد کی روک تھام)
- Hypertension with fluid retention — oedematous hypertension requiring diuretic component (سوجن کے ساتھ ہائی بلڈ پریشر)
- Cardiovascular risk reduction — combined cardiac and diuretic protection in high-risk patients
- Hypertension with rapid heart rate — Atenolol addresses both elevated BP and tachycardia simultaneously
How Does it Work? Atenolol selectively blocks beta-1 adrenergic receptors in the heart — reducing heart rate, decreasing force of cardiac contraction, and lowering cardiac output to reduce blood pressure and myocardial oxygen demand. This cardioselectivity means it acts primarily on the heart with relatively less effect on bronchial airways than non-selective beta-blockers. Chlortalidone inhibits sodium and chloride reabsorption in the distal renal tubule — increasing urinary excretion of sodium and water, reducing circulating blood volume, and lowering vascular resistance. Its exceptionally long duration of action of 48 to 72 hours produces smooth sustained diuresis without the peaks and troughs of shorter-acting diuretics. The combination addresses both elevated cardiac output and excess fluid volume — two key drivers of hypertension.
Dosage and Administration
⚠️ Never stop suddenly — abrupt discontinuation causes dangerous rebound hypertension and can trigger heart attack or severe angina. Always reduce dose gradually under cardiologist supervision. Monitor blood potassium, blood glucose, and uric acid regularly during treatment. Take in the morning to avoid nighttime urination from diuretic component.
| Indication | Usual Adult Dose | Frequency | Notes |
|---|---|---|---|
| Hypertension | 1 tablet (100mg/25mg) | Once daily in morning | Same time each day |
| Chronic stable angina | 1 tablet (100mg/25mg) | Once daily in morning | Adjusted by cardiologist |
| Hypertension with fluid retention | 1 tablet (100mg/25mg) | Once daily in morning | Monitor electrolytes regularly |
Active Ingredients
| Ingredient | Strength |
|---|---|
| Atenolol | 100mg |
| Chlortalidone | 25mg |
Who Should NOT Take Blokium Diu 100mg?
- Allergy to Atenolol, Chlortalidone, sulphonamide-derived medicines, or any component
- Severe bradycardia — resting heart rate below 60 beats per minute
- Cardiogenic shock or decompensated heart failure
- Second or third degree heart block without a pacemaker
- Severe asthma or chronic obstructive pulmonary disease — beta-blocker contraindicated
- Severe peripheral artery disease
- Severe kidney impairment — Chlortalidone ineffective and Atenolol accumulates
- Severe liver impairment
- Significant hypokalaemia or hyponatraemia — electrolyte imbalance
- Refractory hypokalaemia or hypomagnesaemia
- Gout — Chlortalidone raises uric acid levels
- Pregnancy and breastfeeding — consult cardiologist before use
- Children under 18 years
Side Effects
Common: Fatigue and tiredness (تھکاوٹ), slow heart rate, mild dizziness especially on standing, cold hands and feet, increased urination from Chlortalidone component (پیشاب زیادہ آنا — صبح کی خوراک سے کم ہوتا ہے), mild muscle cramps, mild nausea.
Serious — Stop and seek emergency help immediately: Severely slow heart rate below 50 beats per minute with dizziness or fainting (دل کی دھڑکن بہت سست — فوری ہسپتال جائیں), sudden worsening of chest pain or breathlessness particularly if stopped abruptly, significant low blood potassium — severe muscle weakness and irregular heartbeat (پٹھوں کی کمزوری اور دل کی دھڑکن میں خلل — فوری مدد لیں), significant worsening of asthma or bronchospasm, severe allergic reaction with swelling of face or throat, severely low blood pressure with fainting (بے ہوشی — فوری مدد لیں), significant worsening of peripheral circulation — very cold or painful limbs, acute gout attack — severe joint pain and swelling (گنٹھیا کا شدید دورہ).
Drug Interactions
| Medicine | Interaction |
|---|---|
| Verapamil / Diltiazem | Dangerous combination with Atenolol — severely slows heart rate and conduction — avoid |
| Antiarrhythmics (Amiodarone, Digoxin) | Increased risk of heart block and dangerously slow heart rate |
| Other antihypertensives | Additive blood pressure lowering — increased hypotension risk |
| NSAIDs (Ibuprofen, Diclofenac) | Reduce antihypertensive effectiveness of both components |
| Antidiabetic medicines (Insulin, oral hypoglycaemics) | Atenolol masks hypoglycaemia warning signs — Chlortalidone raises blood sugar — monitor closely |
| Lithium | Chlortalidone reduces Lithium excretion — increased Lithium toxicity risk |
| Corticosteroids | Antagonise Chlortalidone diuretic effect and worsen hypokalaemia |
| Potassium-depleting medicines | Additive hypokalaemia risk with Chlortalidone — monitor potassium closely |
| Clonidine | Never stop Clonidine abruptly while on Atenolol — severe rebound hypertension |
| Alcohol (شراب) | Increases blood pressure lowering and dizziness risk — avoid excessive consumption |
Storage: Store below 25°C in a cool, dry place. Protect from moisture and direct sunlight. Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں). Do not use after expiry date.
FAQs
Q: Why must Blokium Diu be taken in the morning rather than at night? The Chlortalidone diuretic component increases urination — taking it in the morning ensures this diuretic effect occurs during waking hours, preventing disruptive nighttime urination that significantly affects sleep quality and patient compliance with long-term therapy.
Q: Can Blokium Diu be stopped suddenly if side effects like fatigue become bothersome? Never stop suddenly — abrupt Atenolol discontinuation causes dangerous rebound hypertension and can trigger a serious heart attack or severe angina attack. Always consult your cardiologist who will provide a gradual dose reduction plan over several weeks.
Q: Why does Blokium Diu require regular blood potassium monitoring? Chlortalidone increases urinary potassium excretion alongside sodium — prolonged use can cause low blood potassium which causes muscle weakness and dangerous cardiac arrhythmias. Regular blood tests to monitor potassium and other electrolytes are essential throughout long-term treatment.
Medical Disclaimer: This information is for general awareness only and does not replace medical advice. Always consult a qualified doctor or pharmacist before taking any prescription medicine.