Pindolol

Brand names

• Apo-Pindol
• Dom-Pindolol
• Gen-Pindolol
• Novo-Pindol
• Nu-Pindol
• PMS-Pindolol
• Syn-Pindolol
• Viskazide [CD]
• Visken

Usage

To treat mild to moderate high blood pressure. Also used to prevent angina pectoris.

How it works

Pindolol slows the rate and force of contraction of the heart by blocking certain nerve impulses, thus reducing blood pressure.

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 pindolol and seek medical help right away.

Common

Dizziness or lightheadedness, especially when rising suddenly to a standing position; 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:

Pindolol may increase the effects of:

• other antihypertensive medicaments and cause excessive lowering of blood pressure; dose adjustments may be necessary.
• digoxin (Lanoxin) on the heart conduction system, leading to AV block and possible digoxin toxicity as well.
• reserpine (Ser-Ap-Es, etc;) and cause sedation, depression, slowing of the heart rate and lowering of blood pressure.
• verapamil (Calan, Isoptin) and cause excessive depression of heart function; monitor this combination closely.

Pindolol taken concurrently with:

• amiodarone (Cordarone) may cause extremely slow heartbeats and risk of sinus arrest.
• clonidine (Catapres) requires close monitoring for rebound high blood pressure if clonidine is withdrawn while pindolol is still being taken.
• epinephrine (various) will result in a large increase in blood pressure and reflex increase in heart rate (tachycardia).
• fluoxetine (Prozac) may result in increased risk of pindolol toxicity.
• fluvoxamine (Luvox) may result in increased risk of pindolol toxicity.
• insulin requires close monitoring to avoid undetected hypoglycemia.
• oral antidiabetic medicaments can result in slowed recovery from low blood sugar.
• phenylpropanolamine (various) may result in severe increases in blood pressure-avoid this combination.
• venlafaxine (Effexor) may result in beta-blocker or venlafaxine toxicity-avoid this combination if possible or use decreased doses of both medicines.

The following medicaments may increase the effects of pindolol:

• cimetidine (Tagamet).
• methimazole (Tapazole).
• oral contraceptives.
• propylthiouracil (Propacil).
• ritonavir (Norvir) and perhaps other protease inhibitors.
• zileuton (Zyflo).

The following medicaments may decrease the effects of pindolol:

• barbiturates (phenobarbital, etc.).
• indomethacin (Indocin) and possibly other NSAIDs-may impair pindolol's antihypertensive effect.
• rifampin (Rifadin, Rimactane).
• theophylline (Theo-Dur, others).

Herbal medicines or minerals:

Ginseng may increase blood pressure, blunting the benefits of these medicines. 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 lowering of blood pressure or increase 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:

It is advisable to avoid exertion that produces lightheadedness, excessive fatigue or muscle cramping. The use of this medicament may intensify the hypertensive response to isometric exercise.

Occurrence of unrelated illness:

Fever can lower blood pressure and require adjustment of dose. Nausea or vomiting may interrupt regular doses. Ask your doctor for help.

Discontinuation:

It is advisable to avoid sudden discontinuation of this medicament in all situations. If possible, gradual reduction of dose over a period of 2 to 3 weeks is recommended. Ask your physician for specific guidance.

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