Table of contents


21 min read

Tenormin vs. Zebeta: Which Should I Take?

Written by Klarity Editorial Team

Published: Nov 29, 2022

Medically Reviewed by Dr. Zoe Russell

Table of contents

With so many treatment options available for managing anxiety, finding the right medication for you can be overwhelming. Anxiety can present itself in many different forms, and there are a number of different medications that can target your symptoms. 

In this article, we give you a side-by-side comparison of two medications, Tenormin and Zebeta, so that you can be better informed before discussing treatment options with your healthcare provider. 

If you are experiencing symptoms of anxiety, Klarity may be able to help. We connect patients across the country with licensed healthcare providers for online anxiety treatment. This affordable, simple option can help you take control of your anxiety and determine which anxiety medication, if any, is right for you. 

In just 48 hours, we’ll match you with an experienced medical professional in your state for your first telehealth appointment. If you believe that you would benefit from medication like Tenormin, Zebeta, or another form of anxiety medication, find a provider through Klarity today. 

Drug ClassBeta blockerBeta blocker
Brand / Generic StatusBrand name for atenololBrand name for bisoprolol
Form(s) of the Drug• Immediate-release tablet• Immediate-release tablet
Standard DosageImmediate-release tablet:
• 25 mg
• 50 mg
• 100 mg
Immediate-release tablet:
• 5mg
• 10mg
Conditions TreatedFDA-approved uses:
• High blood pressure
• Chest pain (angina)
• Post-heart attack

Off-label uses:
• Anxiety disorder
• Atrial fibrillation or atrial flutter
• Ventricular arrhythmias
• Supraventricular tachycardia
• Thyrotoxicosis
• Marfan syndrome with aortic aneurysm
• Migraine headache prevention

FDA-approved uses:
• Hypertension
• Heart failure

Off-label uses:
• Anxiety disorder
CostBrand name:
• $392 to $432 for a 30-day supply

Generic (atenolol):
• $1 to $10 for a 30-day supply

Brand name:
• Not available for Rx

Generic (bisoprolol):
• $3.78 to $32.94 for a 30-day supply
Side-EffectsCommon side effects:
• Fatigue or increased drowsiness
• Vertigo
• Dizziness or lightheadedness upon standing
• GI upset
• Dry mouth
• Difficulty sleeping
• Dry mouth
• Weakness
• Runny nose
• Tinnitus
• Increased anxiety
• Muscle or joint pain
• Sexual dysfunction

Serious side effects:
• Chest pain
• Severe shortness of breath
• Irregular heartbeat
• Drops in blood pressure or heart rate
Common side effects:
• Headaches
• Tiredness
• Sleep problems
• Joint pain
• Swelling
• Cold symptoms like a runny or stuffy nose and a sore throat

Serious side effects:
• Lightheadedness
• Dizziness
• Shortness of breath
• Rapid weight gain
• Slow heart rate
• Eye pain or vision problems
• Trouble breathing
• Chest tightness
• Pounding heartbeats
• Numbness or tingling in your hands or feet
Warnings For UseContraindicated conditions:
• AV block
• Any heart condition
• Liver or kidney disease
• Diabetes
• Overactive thyroid
• Raynaud’s syndrome

Drug interactions:
• Other hypertensive medications
• Acetylcholinesterase inhibitors
• Stimulants
• Certain diabetic medications
• Antipsychotics
• Some antibiotics
• Duloxetine or Cymbalta

Drug interactions:
• Lasix
• Norvasc
• Trazodone
• Xanax

Zebeta and Tenormin are the Same Class of Drugs (Beta-Blockers)

Zebeta and Tenormin are two medications that belong to the same class of medications called beta-blockers. Beta-blockers are used for several conditions, including treating physical symptoms of certain anxiety disorders. 

What are Beta-Blockers?

Beta-blockers are a large class of medications that are commonly prescribed for a number of health conditions, most notably to treat high blood pressure or hypertension. 

Due to their cardiovascular effects, beta-blockers are primarily used to treat the following: 

  • High blood pressure 
  • Arrhythmias or abnormal heart rhythm
  • Chest pain 
  • Ventricular dysfunction after experiencing a heart attack 
  • Migraine headaches 
  • Essential tremor 

How Do Beta-Blockers Work?

Beta-blockers are named after their function and can also be referred to as beta-adrenergic blocking agents. Epinephrine, or adrenaline, is released when the body’s sympathetic nervous system is activated, primarily when you are stressed. This is often referred to as the “fight or flight” response. 

Beta-blockers bind to beta receptors throughout the body to block their typical effects, including blocking the release of adrenaline. By blocking these stress hormones, the smooth muscle within the walls of blood vessels relaxes, causing vasodilation throughout the body, and the heart to beat at a slower rate. 

Due to these cardiovascular effects throughout the body, beta-blockers are primarily used for the treatment of high blood pressure and to decrease the heart rate in patients with abnormal heart rhythms, called arrhythmias.  

Zebeta and Tenormin Can Treat The Physical Symptoms of Anxiety

When someone is experiencing a panic attack or anxiety associated with social situations, the body responds to the increased stress by activating the sympathetic nervous system, increasing the release of adrenaline or epinephrine throughout the body.  

Anxiety can be defined as uncontrollable or unwanted thoughts or fears that are out of proportion to the given situation. Individuals who suffer from anxiety are thought to have an overactive or imbalanced nervous system response to stressors. 

Some of the most common physical symptoms associated with anxiety include:

  • Increased or irregular heartbeat
  • Increased rate or work of breathing
  • Tremor 
  • Temperature imbalances, including sweating or hot flashes 
  • Headaches
  • GI upset or an uneasy feeling in your stomach
  • Feeling restless or unable to sit still

What is Tenormin?

Tenormin, or atenolol, is a beta-1 receptor selective medication that is most commonly used for its cardiovascular effects, such as hypertension and chest pain, and to protect the heart from further damage after having a heart attack. It also has several off-label uses, including treatment of the physical symptoms associated with certain anxiety conditions.  

Off-label Uses for Tenormin 

The term off-label is used to describe any use for a medication that has not been approved by the FDA. This does not mean the medication is not effective in off-label use, but it simply has not gone through the FDA-approval process. 

For a drug to be approved by the FDA for a specific condition, there is a lengthy and expensive process that requires a great deal of research and resources. This often presents itself as a major barrier for drug companies to get multiple conditions FDA-approved for a single medication. 

Some common off-label uses for Tenormin include: 

  • Physical symptoms associated with certain anxiety disorders 
  • Atrial fibrillation or atrial flutter
  • Ventricular arrhythmias 
  • Supraventricular tachycardia
  • Thyrotoxicosis 
  • Marfan syndrome with aortic aneurysm 
  • Migraine headache prevention

Doses, Dosage Form, and Side Effects of Tenormin 

Common Tenormin Doses and Forms

Tenormin is the name brand for the drug name atenolol and is available in tablet form only. Like most beta-blocker medications, the medication is started at a low dose and then increased weekly until the desired dose is reached. The typical maximum dose is around 200 mg by mouth daily. 

Tenormin tablets are available in the following forms: 

  • 25 mg 
  • 50 mg 
  • 100 mg

Common Tenormin Side Effects

As with any medication, it is important to weigh the risks and benefits before starting a new drug. Most of the side effects associated with Tenormin are mild and may improve after continuous use. 

Some of the most common side effects of Tenormin include: 

  • Fatigue or increased tiredness 
  • Dizziness 
  • GI upset, including nausea and vomiting
  • Increased nervousness, anxiety, or depression
  • Sexual dysfunction, including loss of interest, inability to maintain an erection or difficulty achieving orgasm 

There are a few serious side effects that may occur when taking Tenormin, and you should contact your healthcare provider immediately or seek emergency medical care if you experience any of the following side effects: 

  • Severe shortness of breath or bronchospasm 
  • Chest pain or pressure
  • Dangerous drops in blood pressure 
  • Irregular heartbeat 

Common Tenormin Drug Interactions

There are a few medications you should avoid while taking Tenormin due to the potential interactions between drugs. It is important to discuss all medications you are currently taking with your healthcare provider, including all over-the-counter medications and supplements. 

Some common drugs that interact with Tenormin include: 

  • Other hypertensive medications, including certain diuretics such as Lasix, Norvasc, & Hydrochlorothiazide
  •  Acetylcholinesterase inhibitors 
  • Stimulants, such as Adderall and diet supplements
  • Certain diabetic medications 
  • Antipsychotics
  • Some antibiotics, such as Ampicillin & Bacampicillin
  • Duloxetine or Cymbalta 
  • NSAIDs

How Much Does Tenormin Cost?

Tenormin or atenolol is a relatively affordable medication. The cost of Tenormin varies based on your dosage, which pharmacy you use, and your insurance coverage. Tenormin is typically covered by most health insurance plans that have medication coverage. 

Without insurance, the cost can be significantly reduced with the use of generic atenolol and coupon codes, which are available at most large pharmacies. The average cost of Tenormin with a coupon code ranges from $1-10 for a 30-day supply. 

What is Zebeta?

Zebeta, or bisoprolol, is also a beta-1 receptor selective beta-blocker medication that is primarily used for the treatment of high blood pressure. Similar to Tenormin, there are several off-label uses for Zebeta, which include treating the physical symptoms of specific anxiety conditions.  

Off-label Uses for Zebeta  

As previously described, off-label does not mean that it is unsafe to use Zebeta for the following symptoms, but rather that it has not gone through the lengthy and expensive process of FDA approval. 

Some common off-label uses for Zebeta include: 

  • Physical symptoms associated with anxiety 
  • Angina pectoris or chest pain 
  • Atrial fibrillation or atrial flutter 
  • Ventricular arrhythmias 
  • Heart failure with reduced ejection fraction
  • Prevention of heart attacks or stroke, especially used patients who have previously had a heart attack 
  • Migraine headache prophylaxis 

Doses, Dosage Form, and Side Effects of Zebeta   

Common Zebeta Doses and Forms

Zebeta is the name-brand form of the drug bisoprolol fumarate and is also only available in tablet form. The medication is typically started at a low dose and can then be increased weekly until the desired effective dose is achieved. Zebeta is typically taken once a day, and a daily dose should not exceed 20 mg per day. 

Zebeta tablets are available in the following dosages: 

  • 5 mg 
  • 10 mg 

Common Zebeta Side Effects

As with most medications, there are some potential side effects associated with Zebeta. Most of these adverse effects are mild, but it is important to keep in mind that you may notice some changes when starting the medication, and if you begin to experience severe adverse reactions, contact your prescribing provider immediately or seek out urgent medical care. 

Some common side effects of Zebeta include: 

  • Fatigue or increased drowsiness
  • Vertigo
  • Dizziness or lightheadedness upon standing 
  • GI upset, including nausea, vomiting, diarrhea, or constipation
  • Dry mouth 
  • Difficulty sleeping 
  • Dry mouth 
  • Weakness 
  • Runny nose 
  • Tinnitus or ringing in the ears
  • Increased anxiety or feelings of restlessness
  • Muscle or joint pain 
  • Sexual dysfunction, including loss of interest in sex and inability to achieve orgasm 

If you begin to experience any of the following serious side effects, seek out urgent medical attention: 

  • Chest pain 
  • Severe shortness of breath or increased work of breathing 
  • Irregular heartbeat 
  • Drops in blood pressure or heart rate, which can result in falls, loss of consciousness, or confusion

Common Zebeta Drug Interactions

There are some drug interactions associated with Zebeta to keep in mind and avoid. As always, it is important to disclose all current medications you are taking with your healthcare provider, including over-the-counter medications and supplements. 

Common drug interactions with Zebeta include: 

  • Other blood pressure and antiarrhythmic medications 
  • Insulin or other diabetic medication 
  • Asthma or other breathing medication 
  • Clonidine
  • Digitalis 
  • Rifampin 
  • Guanethidine 
  • Disopyramide 

How Much Does Zebeta Cost?

Zebeta is covered by the majority of health insurance coverage plans. If you do not have insurance, the use of generic formularies and coupon codes significantly reduces the cost of the medication. 

The cost of Zebeta widely varies based on your insurance coverage, the dosage, and which pharmacy you use. On average, the cost of a 30-day supply of Zebeta is around $6-10 with the use of coupon codes, which are available at most major pharmacies. 

Do I Need A Prescription for Zebeta or Tenormin?

Yes, both Zebeta and Tenormin are prescription medications and will need to be prescribed by your healthcare provider. If you need an experienced provider who specializes in mental health care, schedule an appointment on Klarity today. 

Beta Blocker Drug Warnings

Although beta-blockers are considered a relatively safe medication, they have a few warnings to be aware of. Beta-blocker medications may not be the right choice for everyone, and your healthcare provider will help decide if this medication would be beneficial for you. 

Pregnancy and Breastfeeding on Beta-Blockers

Overall, beta blocker medications are considered to be relatively safe medications to take while pregnant or breastfeeding. In fact, beta-blockers are considered the first-line treatment for hypertension in pregnant patients. Although, when comparing different beta-blockers, some may be safer for use than others. 

Comparing Tenormin and Zebeta, Zebeta is considered to be a safer alternative than Tenormin during pregnancy and breastfeeding. This is because higher levels of Tenormin are found in the transfer of cord blood from mom to baby and in breast milk. 

It is important to mention that these are still in negligible amounts and rarely cause negative health outcomes in the baby. Your healthcare provider will monitor you and your baby throughout pregnancy and up to 48 hours after birth, assessing for fetal growth, hypoglycemia, and depressed respiratory drive in the baby. 

Licensed providers on Klarity provide personalized treatment. Find a provider that matches your needs and preferences.

Find Effective Anxiety Treatment Online With Klarity

If you are struggling with anxiety symptoms and believe that medications like Tenormin or Zebeta could benefit you, Klarity can help. We connect patients with licensed healthcare providers for online anxiety treatment. 

Your provider can evaluate your symptoms, diagnose them, and develop a personalized treatment plan for you (if applicable), all through affordable and simple telehealth appointments. They can also help you determine which medication, if any, is right for you, and send a prescription directly to your local pharmacy. 

To finally find relief from your anxiety symptoms, schedule your first appointment on Klarity today. 

Tenormin and Zebeta Frequently Asked Questions

Comparing two medications from the same drug class can be confusing. We also went over a lot of information, and you may have additional questions. Below we have listed some of the most frequently asked questions about Tenormin vs. Zebeta, and if you would like more information, head over to Klarity to learn more about anxiety treatment.

Are Tenormin, Zebeta, and other Beta-Blockers the same drug?

No, although both medications belong to the same class of medications called beta-blockers, Tenormin and Zebeta are two different medications. The two medications share some similarities but also have key differences. 

What’s better for anxiety? Tenormin or Zebeta?

While neither medication is considered first-line treatment for anxiety, they can be effective at treating the physical symptoms associated with specific anxiety conditions, such as panic attacks, social anxiety, or presentation anxiety. 

When comparing the two medications, Zebeta tends to be more cardio-specific than Tenormin and, therefore, could be more beneficial for those who experience racing or irregular heartbeats while experiencing anxiety. But overall, the two medications are relatively equal with regard to treating anxiety. 

Can I drink alcohol on Tenormin or Zebeta?

It is recommended that you avoid alcohol while taking any beta blocker medications, including Tenormin and Zebeta. This is due to the fact that alcohol can cause an increase in adverse effects of the medications and may also cause dangerous changes in blood pressure. 

Does it matter what time of day I take Tenormin or Zebeta?

There are different dosing, frequency, and timing of when you should take your medication based on your symptoms. Some may take their medication at the same time every day, while others may use the medication as needed, such as before a stressful event or situation, to prevent physical symptoms from occurring. 

Your healthcare provider will give you detailed instructions on how and when to take your beta blocker medication. It is important to take your medication as prescribed and do not abruptly discontinue your beta blocker medication. 

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