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Penbutolol Side Effects

Medically reviewed by Last updated on Jun 7, 2024.

Applies to penbutolol: oral tablet.


Do not stop taking penbutolol without first talking to your doctor. Stopping suddenly may make your condition worse.

If you need surgery, tell the surgeon ahead of time that you are using penbutolol. You may need to stop using the medicine for a short time.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drinking alcohol can increase certain side effects of penbutolol.

Penbutolol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Get emergency medical help if you have any of these signs of an allergic reaction while taking penbutolol: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

Less serious side effects of penbutolol may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For Healthcare Professionals

Applies to penbutolol: oral tablet.


Penbutolol is generally well tolerated in selected patients. In one study of 111 hypertensive patients who took penbutolol for eight weeks, 12% reported side effects. The incidence of side effects appeared to decrease with continued therapy. Less than 1% of patients discontinue therapy due to side effects.[Ref]

Nervous system

Nervous system are the most common. General tiredness is reported in 7%, headache in 3%, and dizziness in 5% of patients. Dizziness may be related to orthostatic hypotension. Peripheral paresthesias are rarely described, and may be due to the peripheral cardiovascular side effects of the drug. Penbutolol may rarely be associated with sleeping problems.[Ref]


Cardiovascular effects of penbutolol (decreased blood pressure or heart rate) can be problematic. Bradycardia and postural hypotension occur in approximately 2% and 4% of patients, respectively. Dizziness is reported in 5% of patients and may be related to hypotension or bradycardia in some cases. Because penbutolol decreases myocardial contractility, new or worsened heart failure is seen in rare, isolated cases, usually in patients with preexisting left ventricular systolic dysfunction. Dyspnea on exertion or AV block have been associated with penbutolol in rare cases.

Penbutolol can have a deleterious effect on the serum lipid profile, which may be important in some patients with or at risk for coronary artery disease.

Peripheral cardiovascular effects usually present as cold extremities or paresthesias.[Ref]

One double-blinded, placebo-controlled study in 10 hypertensive patients who suffered recurrent bouts of Raynaud's phenomenon showed that penbutolol 20 mg twice a day did not produce any additional vasoconstrictor effect on digital circulation as measured by skin thermometry, time to induce symptoms, or superficial skin blood flow.[Ref]


Respiratory side effects including respiratory insufficiency can develop due to beta-2-adrenergic receptor blockade (inhibition of bronchial dilation). This can result in asthmatic symptoms in 1% of patients and can be more likely or more severe in patients with preexisting reactive airways disease.[Ref]


Gastrointestinal side effects include nausea or vomiting in 5%, abdominal pain in 2%, flatulence in 1%, and dry mouth in 1% of patients.[Ref]


Endocrine side effects have been reported. Some patients with diabetes or thyrotoxicosis are at risk for masking the signs or symptoms of their diseases (sweating, tachycardia, hypoglycemia) during penbutolol therapy. Like some other beta-blockers with intrinsic sympathomimetic activity, penbutolol may cause significant increases in serum triglycerides and decreases in HDL cholesterol.[Ref]


Renal side effects of penbutolol appear to be of no significance. Data show that glomerular filtration rate and renal plasma blood flow are not significantly affected when blood pressure is lowered using therapeutic doses in patients with chronic renal insufficiency.[Ref]


Musculoskeletal side effects including muscular fatigue or cramping is rare. No other musculoskeletal complaints have been reported.[Ref]


Hypersensitivity reactions have not been reported during penbutolol therapy, but have been associated with other beta-blockers. These reactions have presented as erythema, fever with sore throat, laryngospasm, and respiratory distress.[Ref]


Hematologic side effects (including laboratory abnormalities) have not been associated with penbutolol. The manufacturer, however, states that agranulocytosis and both thrombocytopenic and nonthrombocytopenic purpura have been associated with other beta-blockers.[Ref]


1. Hayes G (1983) "Single-blind comparison of penbutolol and long-acting propranolol in general practice." Pharmatherapeutica, 3, p. 456-63

2. Frishman WH, Covey S (1990) "Penbutolol and carteolol: two new beta-adrenergic blockers with partial agonism." J Clin Pharmacol, 30, p. 412-21

3. (1989) "Carteolol and penbutolol for hypertension." Med Lett Drugs Ther, 31, p. 70-1

4. Vander Elst E, Lawrence J, Rossner M, Mertens H (1983) "Penbutolol in hypertension, alone and in combination with furosemide. A long-term multicentre study." S Afr Med J, 63, p. 143-7

5. Vierhapper H, Dudczak R, Waldhausl W (1980) "Penbutolol: comparison of its antihypertensive effect with that of alpha-methyldopa in patients with primary hypertension." Arzneimittelforschung, 30, p. 1008-11

6. Giudicelli JF, Richer C, Chauvin M, Idrissi N, Berdeaux A (1977) "Comparative beta-adrenoceptor blocking effects and pharmacokinetics of penbutolol and propranolol in man." Br J Clin Pharmacol, 4, p. 135-40

7. Schlanz KD, Thomas RL (1990) "Penbutolol: a new beta-adrenergic blocking agent." DICP, 24, p. 403-8

8. Heel RC, Brogden RN, Speight TM, Avery GS (1981) "Penbutolol: a preliminary review of its pharmacological properties and therapeutic efficacy in hypertension and angina pectoris." Drugs, 22, p. 1-25

9. Ohman KP, Asplund J, Landahl S, Liander B (1982) "Penbutolol (Hoe 893d) in primary hypertension. Blood pressure effects, tolerance and plasma concentrations." Eur J Clin Pharmacol, 22, p. 95-9

10. Lameijer LD, Voermans LA, Houtzagers JJ, Chadha DR (1981) "Use of fixed doses of beta blocking drugs in the treatment of hypertension. Randomised study of atenolol and penbutolol." Eur J Clin Pharmacol, 21, p. 93-6

11. Lund-Johansen P (1979) "Long-term hemodynamic effects of penbutolol at rest and during exercise in essential hypertension." Eur J Clin Pharmacol, 16, p. 149-53

12. Houtzagers JJ, Chadha DR (1982) "Once-daily penbutolol or atenolol can replace combination therapy in essential hypertension." J Int Med Res, 10, p. 1-5

13. Graml E, Verho M, Rangoonwala B, Englert R, Haringer E, Pahnke K (1985) "Efficacy of penbutolol and a combination of a low dose of penbutolol with piretanide in the treatment of mild to moderate hypertension." Pharmatherapeutica, 4, p. 236-43

14. van der Meulen J, Reijn E, Heidendal GA, Oe PL, Donker AJ (1986) "Comparison of the effects of penbutolol and propranolol on glomerular filtration rate in hypertensive patients with impaired renal function." Br J Clin Pharmacol, 22, p. 469-74

15. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick

16. Holti G (1979) "A double-blind study of the peripheral vasoconstrictor effects of the beta-blocking drug penbutolol in patients with Raynaud's phenomenon." Curr Med Res Opin, 6, p. 267-70

17. Clucas A, Miller N (1988) "Effects of acebutolol on the serum lipid profile." Drugs, 36 Suppl 2, p. 41-50

18. Haeringer E, Graml W, Rangoonwala B, Roessner M (1982) "Efficacy of penbutolol and a fixed combination of penbutolol with furosemide in the treatment of hypertension." Pharmatherapeutica, 3, p. 233-42

19. Valimaki M, Maass L, Harno K, Nikkila EA (1986) "Lipoprotein lipids and apoproteins during beta-blocker administration: comparison of penbutolol and atenolol." Eur J Clin Pharmacol, 30, p. 17-20

20. Bailey RR, Carlson RV, Walker RJ, Swainson CP (1985) "Effect of oral penbutolol on renal haemodynamics of hypertensive patients with renal insufficiency." N Z Med J, 98, p. 683-5

21. De Plaen JF, Vander Elst E, Van Ypersele de Strihou C (1981) "Penbutolol or hydrochlorothiazide once a day in hypertension. A controlled study with home measurements." Br J Clin Pharmacol, 12, p. 215-21

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.