Nadolol Side Effects

Please note - some side effects for Nadolol may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Nadolol - for the Consumer

Nadolol

All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Nadolol:

Dizziness; fatigue; lightheadedness; mild drowsiness; slow heartbeat; unusual tiredness or weakness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); unusually slow heartbeat.

Nadolol Side Effects - for the Professional

Nadolol

Most adverse effects have been mild and transient and have rarely required withdrawal of therapy.

Cardiovascular

Bradycardia with heart rates of less than 60 beats per minute occurs commonly, and heart rates below 40 beats per minute and/or symptomatic bradycardia were seen in about 2 of 100 patients. Symptoms of peripheral vascular insufficiency, usually of the Raynaud type, have occurred in approximately 2 of 100 patients. Cardiac failure, hypotension, and rhythm/conduction disturbances have each occurred in about 1 of 100 patients. Single instances of first degree and third degree heart block have been reported; intensification of AV block is a known effect of beta-blockers.

Central Nervous System

Dizziness or fatigue has been reported in approximately 2 of 100 patients; paresthesias, sedation, and change in behavior have each been reported in approximately 6 of 1000 patients.

Respiratory

Bronchospasm has been reported in approximately 1 of 1000 patients.

Gastrointestinal

Nausea, diarrhea, abdominal discomfort, constipation, vomiting, indigestion, anorexia, bloating, and flatulence have been reported in 1 to 5 of 1000 patients.

Miscellaneous

Each of the following has been reported in 1 to 5 of 1000 patients: rash; pruritus; headache; dry mouth, eyes, or skin; impotence or decreased libido: facial swelling; weight gain: slurred speech; cough; nasal stuffiness; sweating; tinnitus; blurred vision. Reversible alopecia has been reported infrequently.

The following adverse reactions have been reported in patients taking Nadolol and/or other beta-adrenergic blocking agents, but no causal relationship to Nadolol has been established.

Central Nervous System

Reversible mental depression progressing to catatonia: visual disturbances; hallucinations; an acute reversible syndrome characterized by disorientation for time and place, short-term memory loss, emotional lability with slightly clouded sensorium, and decreased performance on neuropsychometrics.

Gastrointestinal

Mesenteric arterial thrombosis: ischemic colitis; elevated liver enzymes.

Hematologic

Agranulocytosis; thrombocytopenic or nonthrombocytopenic purpura.

Allergic

Fever combined with aching and sore throat; laryngospasm; respiratory distress.

Miscellaneous

Pemphigoid rash; hypertensive reaction in patients with pheochromocytoma; sleep disturbances; Peyronie’s disease.

The oculomucocutaneous syndrome associated with the beta-blocker practolol has not been reported with Nadolol.

Side Effects by Body System

Cardiovascular

Rare cases of A-V heart block are reported.

Cardiovascular side effects are usually mild and transient and rarely require discontinuation of therapy. Bradycardia, hypotension, conduction disturbances, chest pain, and heart failure have each been reported in 1% to 3% of patients. Complaints of cold extremities have been reported in approximately 5% of patients. Edema has rarely been associated with the use of nadolol.

Nervous system

Nadolol is hydrophilic and is less likely to penetrate into the central nervous system compared to other beta-blockers. Depression and anxiety are reported in one patient while receiving nadolol. The symptoms started two days after an increase in his dosage and resolved within three days of discontinuing nadolol. Organic brain syndrome was diagnosed in two patients receiving nadolol should be considered as a possible cause of acute deterioration in mental or emotional status.

The most common nervous system side effect appears to be fatigue (up to 10% of patients). Headache or dizziness have been reported in 5% and 8% of patients, respectively.

Respiratory

At least one case of severe bronchospasm associated with nadolol therapy is reported. This patient had a history of childhood asthma and exercise-induced bronchospasm requiring albuterol inhalations. After one dosage of nadolol the patient had a respiratory arrest and required mechanical ventilation for several days. If nadolol is necessary in a patient with a history of bronchospasm, it is recommended that therapy be initiated in a controlled environment with bronchodilators available.

Respiratory system side effects have been rare (1 in 1,000), but may be important in patients with reactive airways disease. The use of nadolol has been associated with precipitation of bronchospasm in patients with a history of asthma.

Gastrointestinal

Gastrointestinal problems, such as nausea, diarrhea, constipation, and general abdominal upset have each been reported in less than 1% of patients.

Psychiatric

Psychiatric side effects have been limited to anxiety-depression in approximately 4% of patients.

Renal

Renal insufficiency has not associated with nadolol, but one study of 10 elderly hypertensive patients has shown that the antihypertensive effect of nadolol was associated with a decrease in effective renal blood flow. The glomerular filtration rate in affected patients remained stable, however.

Hematologic

Hematologic side effects have included at least one reported case of nadolol-associated thrombocytopenia.

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