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Nadolol Side Effects

For the Consumer

Applies to nadolol: oral tablet

As well as its needed effects, nadolol may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking nadolol, check with your doctor immediately:

Less common
  • Blurred vision
  • chest pain or discomfort
  • confusion
  • dilated neck veins
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • extreme fatigue
  • irregular breathing
  • lightheadedness, dizziness, or fainting
  • paleness or cold feeling in fingertips and toes
  • shortness of breath
  • slow or irregular heartbeat
  • sweating
  • swelling of face, fingers, feet, or lower legs
  • tingling or pain in fingers or toes when exposed to cold
  • unusual tiredness or weakness
  • weight gain
  • wheezing
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • changes in behavior
  • cough
  • difficulty breathing
  • noisy breathing
  • slurred speech
  • tightness in chest

Some nadolol side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

  • Bloated
  • continuing ringing or buzzing or other unexplained noise in ears
  • decreased interest in sexual intercourse
  • diarrhea
  • difficulty having a bowel movement (stool)
  • drowsiness
  • dry mouth, eyes, or skin
  • excess air or gas in stomach or intestines
  • full feeling
  • gas in stomach
  • hair loss, thinning of hair
  • headache
  • hearing loss
  • heartburn
  • inability to have or keep an erection
  • itching skin
  • loss in sexual ability, desire, drive, or performance
  • loss of appetite
  • nausea
  • passing gas
  • rash
  • relaxed and calm
  • sleepiness
  • stomach pain
  • stomach soreness or discomfort
  • stuffy nose
  • vomiting
  • weight loss

For Healthcare Professionals

Applies to nadolol: compounding powder, oral tablet


Rare cases of A-V heart block are reported.[Ref]

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.[Ref]

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.[Ref]

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.[Ref]


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.[Ref]

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.[Ref]


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


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


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.[Ref]


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


1. Jackson DA "Nadolol, a once daily treatment for hypertension multi-centre clinical evaluation." Br J Clin Pract 34 (1980): 211-21

2. Frishman WH "Nadolol: a new beta-adrenoceptor antagonist." N Engl J Med 305 (1981): 678-82

3. Heel RC, Brogden RN, Pakes GE, et al "Nadolol: a review of its pharmacological properties and therapeutic efficacy in hypertension and angina pectoris." Drugs 20 (1980): 1-23

4. Herrera J, Vukovich RA, Griffith DL "Elimination of nadolol by patients with renal impairment." Br J Clin Pharmacol 7 (1979): s227-31

5. Sung RJ, Olukotun AY, Baird CL, et al "Efficacy and safety of oral nadolol for exercise-induced ventricular arrhythmias." Am J Cardiol 60 (1987): d15-20

6. Wilbur R, Kulik FA "Acute organic brain syndrome fron nadolol therapy." Arch Intern Med 141 (1981): 1723-4

7. Russell JW, Schuckit MA "Anxiety and depression in patient on nadolol." Lancet 12/04/82 (1982): 1286-7

8. Kanefsky, TM "Organic brain syndrome with nadolol." Arch Intern Med 141 (1981): 1846-7

9. Raine JM, Palazzo MG, Kerr JH, Sleight P "Near-fatal bronchospasm after oral nadolol in a young asthmatic and response to ventilation with halothane." Br Med J 282 (1981): 548-9

10. Levy MB, Fink JN, Guzzetta PA "Nadolol and hypersensitivity pneumonitis." Ann Intern Med 105 (1986): 806-7

11. Merkel C, Gatta A, Sacerdoti D, et al "Long-term effect of nadolol on quantitative liver function tests in patients with cirrhosis." Eur J Clin Pharmacol 34 (1988): 501-4

12. "Renal blood flow during nadolol administration." N Engl J Med 308 (1983): 49-50

13. Stamm PL, Jenkins JK, Vigrass HG "Suspected {beta}-antagonist-induced thrombocytopenia." Ann Pharmacother 39 (2005): 555-8

It is possible that some side effects of nadolol may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

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