What is nadolol, and how does it work (mechanism of action)?

Nadolol is a member of a class of drugs called beta-adrenergic receptor blockers that is used for treating high blood pressure and heart pain (angina). Examples of other beta-adrenergic blockers include propanolol (Inderal, Inderal LA), atenolol (Tenormin), and timolol (Blocadren). Norepinephrine and epinephrine (adrenaline) are chemicals released within the body that attach to receptors on several types of cells, including nerves and some muscles, and changes the way the cells function, either stimulating the cells or suppressing them. Nadolol prevents norepinephrine and epinephrine from binding to beta receptors on nerves. By blocking the effect of norepinephrine and epinephrine, beta blockers reduce heart rate, reduce the force of the heart’s contractions, and reduce blood pressure by relaxing the muscles surrounding the blood vessels.

Heart pain (angina) occurs when the workload of the heart requires more oxygen than the blood can supply. By slowing the heart rate and decreasing the force of contractions of the heart, nadolol reduces the demand of the heart’s muscle for oxygen and thereby prevents angina. Beta blockers may cause difficulty breathing since they cause the muscles surrounding the air passages of the lung to contract, thus narrowing the air passages and making it more difficult for air to pass through . The FDA approved nadolol in 1979.

What brand names are available for nadolol?

Corgard

Is nadolol available as a generic drug?

Yes

Do I need a prescription for nadolol?

Yes

What are the side effects of nadolol?

Nadolol is generally well tolerated. Side effects include abdominal cramps, diarrhea, constipation, fatigue, insomnia, nausea, depression, impotence, lightheadedness, slow heart rate, low blood pressure, cold extremities, sore throat, and shortness of breath or wheezing. Nadolol can increase breathing difficulties in patients with asthma, chronic bronchitis, or emphysema.

In patients with existing slow heart rates (bradycardias) and heart blocks (defects in the electrical conduction of the heart), nadolol can cause dangerously slow heart rates, and even shock. Nadolol reduces the force of heart muscle contraction and can increase symptoms of heart failure. In patients with coronary artery disease, abruptly stopping nadolol can suddenly worsen angina and occasionally precipitate heart attacks. If it is necessary to discontinue nadolol, its dose should be reduced gradually over several weeks.

What is the dosage for nadolol?

The recommended dose is 40-320 mg once daily. The maximum dose for treating angina is 240 mg daily and for hypertension is 320 mg daily. Nadolol may be administered with or without food. The dose for preventing migraines is 40 to 240 mg daily.

Which drugs or supplements interact with nadolol?

The blood pressure-lowering effects of nadolol are additive with other medications that lower blood pressure, and combinations of these other medications with nadolol often is used for treating persons with high blood pressure. When used in combination with diltiazem (Cardizem; Tiazac; Dilacor), verapamil (Calan, Isoptin, Verelan, Covera), amiodarone (Cordarone), or digoxin (Lanoxin), however, nadolol can cause complete block of the heart’s electrical system, a life-threatening condition.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Anaprox, Aleve), can reduce the blood pressure lowering effects of  beta-blockers.

Nadolol can mask the early warning symptoms of low blood sugar (hypoglycemia) and should be used with caution in patients receiving treatment for diabetes.

Is nadolol safe to take if I’m pregnant or breastfeeding?

Safe use of nadolol during pregnancy has not been established.

Nadolol is excreted into breast milk. Nadolol should not be used while breastfeeding because of the potential risk of adverse effects in the nursing infant.

What else should I know about nadolol?

What preparations of nadolol are available?

Tablets: 20, 40, 80 mg.

How should I keep nadolol stored?

Nadolol should be stored at room temperature, 15 C -30 C (59 F – 86 F).

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Medically Reviewed on 3/11/2019

References

Medically reviewed by John P. Cunha, DO, FACOEP; Board Certified Emergency Medicine

REFERENCE:

FDA Prescribing Information