US EPA

Atenolol is a cardioselective B-adrenoreceptor blocking agent, used for treatment of hypertension, including hypertension in pregnancy. Beta-adrenoreceptor antagonists have been impacted in the production of intrauterine growth retardation and considerable range of neonatal problems including hypoglycemia, bradycardia, respiratory depression and death [1,2]. The relationship between these complications and drug administration is often difficult to evaluate because of the anecdotal or retrospective nature of observations. In addition, since B-blockers are used in pregnancies having a major complication (e.g. severe hypertension), it can be very difficult to differentiate drug effects on the fetus from those caused by the underlying maternal disease. This paper reviews pharmacokinetic and pharmacodynamic issues relevant to atenolol prenatal toxicity in humans and in experimental animal species with the aim of better understanding the origin of adverse developmental outcomes that have been associated with atenolol exposures in pregnancy.

Tabacova, S. A. AND C. A. Kimmel. Atenolol: Pharmacokinetic/Dynamic Aspects Of Comparative Developmental Toxicity: A Review. REPRODUCTIVE TOXICOLOGY 16(1):1-7, (2002).