Objective: To describe a case of atenolol-induced breast pain and swelling in a patient receiving atenolol.
Case summary: A 54-year-old woman was diagnosed with hypertension with no existing comorbidity. The patient was not taking any prescription medications, but was using an herbal supplement and several other over-the-counter supplements. After diet and exercise failed to control the woman's blood pressure, atenolol 25 mg daily was initiated. She reported symptoms of insomnia 9 days after starting the medication. During a follow-up visit 5 weeks later, the patient reported continued insomnia, as well as a 6 day history of breast pain, swelling, and tenderness. Atenolol was quickly titrated to discontinuation, and a thiazide diuretic was prescribed. Subsequently, the pain and swelling gradually resolved.
Discussion: Assessment using the Naranjo probability scale revealed that the adverse reaction was probably associated with atenolol. While rare cases of hyperprolactinemia and galactorrhea have been reported with beta-blocker use, no reports of breast pain caused by this drug class were identified in the literature.
Conclusions: Atenolol has many reported adverse reactions, both common and rare; however, until this report, breast pain and swelling had not been documented adverse reactions. Clinicians should be aware that atenolol may be a cause of nonorganic breast pain and swelling in women.