Warning/Precautions Safety and efficacy in children have not been established. Administer cautiously in compensated heart failure and monitor for a worsening of the condition (efficacy of atenolol in heart failure has not been established). Beta-blocker therapy should not be withdraw abruptly (particularly in patients with CAD), but gradually tapered to avoid acute tachycardia, hypertension, and/or ischemia. Use caution with concurrent use of beta-blockers and either verapamil or diltiazem; bradycardia or heart block can occur. Avoid concurrent I.V. (Asthma) and peripheral vascular disease (may aggravate arterial insufficiency). Atenolol, with B 1 selectivity, has been used cautiously in bronchospastic disease with close monitoring. Use cautiously in diabetics -maymask hypoglycemic symptoms. May mask signs of thyrotoxicosis. May cause fetal harm when administered in pregnancy. Use cautiously in the renally impaired (dosage adjustment required). Use care with anesthetic agents which decrease myocardial function. Caution in myasthenia gravis