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Visken Side Effects

Generic Name: pindolol

Note: This page contains side effects data for the generic drug pindolol. It is possible that some of the dosage forms included below may not apply to the brand name Visken.

For the Consumer

Applies to pindolol: oral tablet

As well as its needed effects, pindolol (the active ingredient contained in Visken) may cause unwanted side effects that require medical attention.

Major Side Effects

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

More common:
  • Swelling of the face, fingers, feet, or lower legs
Less common:
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest pain
  • difficult or labored breathing
  • shortness of breath
  • tightness in chest
  • wheezing
  • Decreased urine output
  • dilated neck veins
  • extreme fatigue
  • fast, irregular, pounding, or racing heartbeat or pulse
  • irregular breathing
  • seeing, hearing, or feeling things that are not there
  • troubled breathing
  • weight gain

If any of the following symptoms of overdose occur while taking pindolol, get emergency help immediately:

Symptoms of overdose:
  • Blurred vision
  • dizziness
  • headache
  • nervousness
  • pounding in the ears
  • slow heartbeat

Minor Side Effects

Some pindolol 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:

More common:
  • Joint pain
  • muscle pain
  • sleeplessness
  • trouble sleeping
  • unable to sleep
  • unusual tiredness or weakness
Less common:
  • Itching skin
  • muscle cramps
  • nausea
  • stomach soreness or discomfort
  • unusual dreams
  • weakness
  • Rash

For Healthcare Professionals

Applies to pindolol: compounding powder, oral tablet


A 47-year-old man with idiopathic dilated cardiomyopathy and premature ventricular depolarizations (PVDs) was stable on propranolol and digoxin (4 to 5 PVDs/min). Due to fear of negative inotropic activity, the patient was switched to pindolol (the active ingredient contained in Visken) during ECG monitoring. Fifteen minutes after the first dose of pindolol 10 mg orally, the PVD rate increased to 22 to 25/min, and six beats of nonsustained ventricular tachycardia (VT) were observed. Salvos of VT and ventricular couplets were observed. An idioventricular rhythm with a rate of 63 beats/min was also observed during episodes of sinus bradycardia. The serum digoxin level was 0.5 ng/mL; serum electrolytes were within normal limits. Pindolol therapy was not continued, and 10 hours later, the patient's ventricular ectopy returned to baseline.

Pindolol increases AV nodal conduction time, and may cause or exacerbate AV heart block due to digitalis or other reasons. The effect of pindolol on the AV node is less than propranolol.

Pindolol appears to cause orthostatic hypotension in a significant number of patients with autonomic dysfunction. In one study of seven patients with Shy Drager syndrome, two developed orthostatic changes and frank congestive heart failure at dosages of 15 mg three times a day.[Ref]

Like some other nonselective beta-blockers, pindolol may inhibit myocardial contractility. This may be important in some patients with left ventricular systolic dysfunction or congestive heart failure. Other cardiovascular side effects include bradycardia, edema with weight gain (reported in up to 15% of patients in some studies), Raynaud's phenomenon, cold extremities, and AV heart block. Palpitations are reported in less than 1% of patients.

Due to the intrinsic sympathomimetic activity of pindolol, induction or exacerbation of arrhythmias is possible, particularly when higher doses are used. At least one case of enhanced ventricular ectopic activity has been associated with pindolol.

Abrupt withdrawal of pindolol can result in significant hypertension, angina pectoris, and acute coronary insufficiency with myocardial infarction. This may be particularly important in some patients with a history of coronary artery disease.[Ref]


Respiratory compromise has been observed in approximately 1% of patients. This may be very important in patients with reactive airways disease. While pindolol (the active ingredient contained in Visken) does have intrinsic sympathomimetic activity, its use in patients with bronchial asthma is limited.[Ref]


Endocrinologic abnormalities include hypoglycemia. Nonselective beta-blockers, such as pindolol (the active ingredient contained in Visken) may inhibit catecholamine-mediated gluconeogenesis and mask the signs and symptoms of hypoglycemia, such as sweating and tachycardia. Data on the effect of pindolol on the lipid profile is controversial. Periodic monitoring of the lipid profile is suggested for patients with preexisting lipid disorders and in whom the consequences of hypercholesterolemia or hypertriglyceridemia are unacceptable.[Ref]

A 35-year-old man with hypertension and type II diabetes mellitus developed lightheadedness and fell unconscious while skiing. Pertinent findings included hypothermia, hypotension, sinus bradycardia, "tented" T-waves on the ECG, and an undetectable blood glucose per fingerstick. The patient regained consciousness after intravenous glucose was given. He was accustomed to regular exercise, had not changed his pindolol dose (15 mg/day), but had not eaten a complete breakfast. The authors of this case report believe that, while the patient's glucose stores may have been low, the combined effects of exercise and beta-blockade on glucose metabolism caused the profound hypoglycemia.

Most data indicate (beneficial) significant decreases in total serum cholesterol and triglycerides and a significant increase of HDL cholesterol during pindolol therapy. Other data indicate significant increases in serum triglycerides and decreases of HDL cholesterol during pindolol therapy.[Ref]

Nervous system

Nervous system side effects include fatigue or unusual dreams in 5%, insomnia or dizziness in 3%, depression or headache in 2%, and nervousness or tremor in 1% of patients.[Ref]

Rare cases of pindolol-induced tremor have been reported. While beta-blockers are known to suppress different types of tremors, the paradoxical appearance of tremors during pindolol therapy is attributed to its partial beta-agonist activity.[Ref]


Gastrointestinal disturbances are unusual. Nausea or abdominal discomfort are reported in 2% of patients. Dry mouth or diarrhea are each reported in approximately 1% of patients.[Ref]


Genitourinary complaints are limited to decrease libido or impotence in approximately 1% of male patients.[Ref]

In one placebo-controlled, double-blinded study of four beta-blockers in 30 healthy male volunteers, the nonselective beta-blockers, pindolol and propranolol, were associated with the greatest reduction in serum testosterone after one week of treatment. Pindolol was associated with the longest time to nocturnal penile tumescence. There were no statistically significant subjective complaints associated with these laboratory findings, however.[Ref]


Pindolol (the active ingredient contained in Visken) and carteolol, beta-adrenergic receptor antagonists with intrinsic sympathomimetic activity (ISA), have more commonly been associated with muscle cramps and elevated serum creatine phosphokinase (CK) levels than beta-blockers without ISA.[Ref]

Musculoskeletal pain, usually presenting as muscle cramps, is reported in up to 3% of patients.[Ref]


Renal side effects are not reported during pindolol (the active ingredient contained in Visken) therapy. Data show that the glomerular filtration rate and effective renal plasma flow are unaffected by pindolol.[Ref]


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2. Rangno R, Langlois S "Comparison of withdrawal phenomena after propranolol, metoprolol, and pindolol." Am Heart J 104 (1982): 473-8

3. Foerster E-C, Greminger P, Siegenthaler W, et al "Atenolol versus pindolol: side-effects in hypertension." Eur J Clin Pharmacol 28 (1985): 89-91

4. Binkley PF, Lewe R, Lima J, et al "Enhanced ventricular ectopy following pindolol: an adverse effect of a beta blocker with intrinsic sympathomimetic activity." Am Heart J 112 (1986): 424-6

5. Szecsi E, Kohlschutter S, Schiess W, Lang E "Abrupt withdrawal of pindolol or metoprolol after chronic therapy." Br J Clin Pharmacol 13 (1982): s353-7

6. Golightly LK "Pindolol: a review of its pharmacology, pharmacokinetics, clinical uses, and adverse effects." Pharmacotherapy 2 (1982): 134-47

7. Eliasson K, Lins L-E, Sundqvist K "Peripheral vasospasm during beta-receptor blockade: a comparison between metoprolol and pindolol." Acta Med Scand 665 (1982): 109-12

8. Andersen EB, Lindskov HO, Marving J, et al "Decrease in beta-receptor density explaining the development of pindolol- and prenalterol-tolerance in orthostatic hypotension." Dan Med Bull 32 (1985): 194-6

9. Rangno RE, Langlois S "Comparison of withdrawal phenomena after propranolol, metoprolol and pindolol." Br J Clin Pharmacol 13 (1982): s345-51

10. Frishman W "Pindolol: A new beta-adrenoceptor antagonist with partial agonist activity." N Engl J Med 398 (1983): 940-4

11. Walden RJ, Hernandez J, Yu Y, et al "Withdrawal of beta-blocking drugs." Am Heart J 104 (1982): 515-20

12. Tsukiyama H, Otsuka K, Yamamoto Y "Effect of pindolol and nifedipine alone and in combination on haemodynamic parameters/variables in essential hypertension." J Int Med Res 12 (1984): 154-62

13. Abrahamsen AM, Digranes O, Gisholt K "Comparison of the side-effects of pindolol and atenolol in the treatment of hypertension." J Intern Med 228 (1990): 219-22

14. Davies B, Bannister R, Mathias C, Sever P "Pindolol in postural hypotension: the case for caution." Lancet 10/31/81 (1981): 982-3

15. McGourty JC, Silas JH, Solomon SA "Tolerability of combined treatment with verapamil and beta-blockers in angina resistant to monotherapy." Postgrad Med J 61 (1985): 229-32

16. Chalmers JP, Wing LM, Grygiel JJ, et al "Effects of once daily indapamide and pindolol on blood pressure, plasma aldosterone concentration and plasma renin activity in a general practice setting." Eur J Clin Pharmacol 22 (1982): 191-6

17. Lepantalo M "Beta blockade and intermittent claudication." Acta Med Scand 700 (1985): 1-48

18. Cohen MB, Snow JS, Grasso V, Lehnert L, Goldner BG, Jadonath RL, Cohen TJ "Efficacy of pindolol for treatment of vasovagal syncope." Am Heart J 130 (1995): 786-90

19. Greenberg MA, Birx DL "Chronic cough in a 61-year-old female." Ann Allergy 61 (1988): 137-8

20. Sasaki J, Saku K, Ideishi M, et al "Effects of pindolol on serum lipids, apolipoproteins, and lipoproteins in patients with mild to moderate essential hypertension." Clin Ther 11 (1989): 219-24

21. Samuel P, Chin B, Schoenfeld BH, et al "Comparison of the effect of pindolol versus propranolol on the lipid profile in patients treated for hypertension." Br J Clin Pharmacol 24 (1987): s63-4

22. Uusitupa M, Aro A, Pietikainen M "Severe hypoglycaemia caused by physical strain and pindolol therapy." Ann Clin Res 12 (1980): 25-7

23. Harvengt C, Heller FR, Martiat P, Nieuwenhuyze YV "Short-term effects of beta blockers atenolol, nadolol, pindolol, and propranolol on lipoprotein metabolism in normolipemic subjects." J Clin Pharmacol 27 (1987): 475-80

24. Terent A, Ribacke M, Carlson LA "Long-term effect of pindolol on lipids and lipoproteins in men with newly diagnosed hypertension." Eur J Clin Pharmacol 36 (1989): 347-50

25. Pasotti C, Capra A, Fiorella G, et al "Effects of pindolol and metoprolol on plasma lipids and lipoproteins." Br J Clin Pharmacol 13 (1982): s435-9

26. Szollar LG, Meszaros I, Tornoci L, et al "Effect of metoprolol and pindolol monotherapy on plasma lipid- and lipoprotein-cholesterol levels (including the HDL subclasses) in mild hypertensive males and females." J Cardiovasc Pharmacol 15 (1990): 911-7

27. Grimaldi A, Bennett P, Delas B, et al "Beta-blockers and hypoglycaemia: assessment of cardioselective and intrinsic sympathomimetic properties in relation to severity of hypoglycaemia." Curr Ther Res Clin Exp 36 (1984): 361-73

28. Carlson LA, Ribacke M, Terent A "A long-term study on the effect of pindolol on serum lipoproteins: a preliminary report." Br J Clin Pharmacol 24 (1987): s61-2

29. Koller W, Orebaugh C, Lawson L, Potempa K "Pindolol-induced tremor." Clin Neuropharmacol 10 (1987): 449-52

30. Harston WE, Friesinger GC "Variability of response to beta receptor blockade for angina pectoris in clinical trials: a study of pindolol." Am J Cardiol 50 (1982): 722-7

31. Hod H, Kaplinsky N, Har-Zahav J, Frankl O "Pindolol-induced tremor." Postgrad Med J 56 (1980): 346-7

32. Rosen RC, Kostis JB, Jekelis AW "Beta-blocker effects on sexual function in normal males." Arch Sex Behav 17 (1988): 241-55

33. Imai Y, Watanabe N, Hashimoto J, Nishiyama A, Sakuma H, Sekino H, Omata K, Abe K "Muscle cramps and elevated serum creatine phosphokinase levels induced by beta-adrenoceptor blockers." Eur J Clin Pharmacol 48 (1995): 29-34

34. Pasternack A, Porsti P, Poyhonen L "Effect of pindolol and propranolol on renal function of patients with hypertension." Br J Clin Pharmacol 13 (1982): s241-4

35. Koch G, Fransson L, Karlegard L, Kothari P "Responses of glomerular filtration, renal blood flow and salt-water handling to acute cardioselective and non-selective beta-adrenoceptor blockade in essential hypertension." Eur J Clin Pharmacol 36 (1989): 343-5

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

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.