Nadolol

Brand names

• Alti-Nadol
• Apo-Nadol
• Corgard
• Corzide [CD]
• Novo-Nadolol
• Syn-Nadol

Usage

To treat mild to moderate high blood pressure and angina. It is also used to prevent or control heartbeat irregularities (cardiac arrhythmias).

How it works

Nadolol slows the rate and force of contraction of the heart by blocking certain nerve impulses, thus reducing blood pressure. By modifying nerve impulses to the heart, the medicament also helps to stabilize heart rhythm.

Side effects

Serious

Shortness of breath, wheezing; irregular or slow heartbeat (50 beats per minute or less); pain or feelings of tightness or pressure in the chest; swelling of the ankles, feet, and lower legs; mental depression. If you experience any such symptoms, stop taking nadolol and get medical help right away.

Common

Dizziness or lightheadedness, especially when rising suddenly to a standing position; rapid heartbeat or palpitations; decreased sexual ability; unusual fatigue, weakness, or drowsiness; insomnia.

Less common

Anxiety, irritability, nervousness; constipation; diarrhea; dry, sore eyes; itching; nausea or vomiting; nightmares or intensely vivid dreams; numbness, tingling, or other unusual sensations in the fingers, toes, or scalp.

Possible interactions

Other medicaments:

Nadolol may increase the effects of:

• other antihypertensive medicaments and cause excessive lowering of blood pressure; dose adjustments may be necessary.
• reserpine (Ser-Ap-Es, etc.) and cause sedation, depression, slowing of the heart rate and lowering of blood pressure.
• verapamil (Calan, Isoptin) or other calcium channel blockers and cause excessive depression of heart function; monitor this combination closely.

Nadolol may decrease the effects of:

• ritodrine(Yutopar), and may result in undesirable heart effects.
• theophyllines (Aminophyllin, Theo-Dur, etc.) and reduce their effectiveness in treating asthma.

Nadolol taken concurrently with:

• amiodarone (Cordarone) can cause severe slowing of the heart and potentially stop the heart (cardiac arrest).
• antacids containing aluminum can block absorption of this medicine and lessen therapeutic nadolol effects.
• clonidine (Catapres) requires close monitoring for rebound high blood pressure if clonidine is withdrawn while nadolol is still being taken.
• digoxin (Lanoxin) may result in undesirable heart effects.
• dihydropyridine calcium channel blockers may result in undesirable heart effects (bradycardia) or excessively low blood pressure.
• epinephrine can cause serious hypertension and slowing of the heart and, should anaphylaxis occur, epinephrine resistance.
• ergot derivatives can cause decreased blood flow to the extremities (peripheral ischemia).
• insulin requires close monitoring to avoid undetected hypoglycemia.
• lidocaine can lead to lidocaine toxicity (depressed heart function, cardiac arrest).
• oral antidiabetic medicaments can cause slowed recovery from any hypoglycemia that may occur.

The following medicament may decrease the effects of nadolol:

• indomethacin (lndocin), and possibly other "aspirin substitutes" or NSAIDs, and may impair nadolol's antihypertensive effect.

Foods:

Follow the diet your doctor prescribes. Avoid excessive salt intake.

Herbal medicines or minerals:

Ginseng may increase blood pressure, blunting the benefits of this medicine. Hawthorn, saw palmetto, ma huang, goldenseal, yohimbe and licorice may also increase blood pressure. Calcium and garlic may help lower blood pressure. Indian snakeroot has a German Commission E monograph indication for hypertension-talk to your doctor. Eleuthero root should be avoided by people living with hypertension.

Alcohol:

Alcohol may exaggerate this medicament's ability to lower blood pressure and may increase its mild sedative effect.

Tobacco smoking:

Nicotine may reduce this medicament's effectiveness.

Exposure to heat:

Hot environments can lower blood pressure and exaggerate the effects of this medicament.

Exposure to cold:

Cold environments can enhance the circulatory deficiency in the extremities that may occur with this medicament. The elderly should take precautions to prevent hypothermia.

Heavy exercise or exertion:

Prudent to avoid exertion that produces lightheadedness, excessive fatigue or muscle cramping.

Occurrence of unrelated illness:

Fever can lower blood pressure, requiring dose decreases. Nausea or vomiting may interrupt dosing. Ask your doctor for help.

Discontinuation:

Best not to stop this medicament suddenly. Gradual lowering of doses over 2 to 3 weeks is recommended.

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