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Common and rare side effects of beta-blocker medications

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Side effects of beta-blockers may include short-term fatigue and dizziness, weight changes, and mood dysregulation. Rest, hydration, and medical guidance are a few ways to manage them.
Medically reviewed by Monica Kean, PharmD
Written by Rashida Ruwa, RN
Updated on November 1, 2023

Beta-blockers are a class of medications that inhibit the effects of the hormones noradrenaline and adrenaline, which help slow down heart rate and decrease blood pressure.

Healthcare professionals prescribe beta-blockers to manage several conditions, including:

  • high blood pressure
  • angina (chest pain)
  • arrhythmias
  • heart failure
  • migraine (for prevention) 

Common beta-blockers include:

Short-term side effects of beta-blockers

Adult man taking his blood pressure while experiencing side effects of beta blockers
FilippoBacci/Getty Images

Beta-blockers may temporarily lead to the following side effects:

  • Fatigue: Beta-blockers slow the heart rate by reducing its workload, which may cause temporary fatigue.
    • To manage this beta-blocker side effect, try to prioritize rest and regular physical activity. Engaging in stress management techniques, including meditation and grounding exercises, may also help you feel more energetic.
  • Dizziness: Beta-blockers lower blood pressure. A sudden drop in blood pressure may lead some people to experience dizziness or lightheadedness, especially when getting up from a sitting or lying position.
    • To minimize dizziness, try to move and rise slowly whenever possible. Holding onto something for support can help prevent potential falls.
  • Nausea: Some people may experience mild nausea when starting beta-blockers.
    • Taking these medications with food or a light snack may help reduce this side effect. If the problem persists, consider talking with your healthcare professional about potential adjustments to your dosage or alternative treatments for nausea.
  • Cold hands and feet: Reduced blood flow to the extremities may lead to cold hands and feet.
    • If you’re feeling uncomfortable, try to dress warmly and perform simple exercises like wiggling fingers and toes to improve circulation. Movement may help raise your temperature in these places.

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Long-term side effects of beta-blockers

Long-term use of beta-blockers may lead to more severe or persistent side effects, including:

  • Weight changes: Beta-blockers may lead to unintended weight gain over time.
    • To manage changes in your weight, it’s helpful to eat a balanced diet that includes fruits, vegetables, and lean proteins. Incorporating regular physical activity, such as exercising, into your daily routine can help maintain a moderate weight.
  • Psychological distress: Some people taking beta-blockers may experience mood changes, insomnia, or unusual dreams.
    • If you notice these side effects, it may be a good idea to discuss treatment and support options with your healthcare professional. They may consider adjusting the type or dosage of beta-blockers. For example, you may be less sensitive to another brand.
  • Worsening of breathing in asthma or COPD: Beta-blockers may worsen breathing difficulties in people with preexisting lung conditions like asthma or chronic obstructive pulmonary disease (COPD).
    • It’s important to let your healthcare professional know if you have any history of respiratory conditions. They may consider alternative medications to manage your cardiovascular health or prescribe the minimum effective dose.

Rare side effects of beta-blockers

Rare but severe side effects of beta-blockers may include:

  • bronchospasm (airway constriction that leads to difficulty breathing)
  • hyperglycemia (high blood sugar) in people with diabetes 
  • jaundice (yellowing of the eyes and skin)
  • edema (swollen limbs)

If you experience any of these side effects, it’s important to let your healthcare professional know immediately. Do not discontinue your medication without having this conversation first. 

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How long can you stay on beta-blockers?

The duration of beta-blocker treatment may vary depending on your medical condition and tolerance of the medication.

Sometimes a healthcare professional may prescribe beta-blockers for a few months or years. Some people take them long term for chronic conditions like high blood pressure or heart disease.

It is also possible that you take beta-blockers only for a few months or that your healthcare professional switches you to a different type of medication if you cannot tolerate beta-blockers or they are not working for you. 

Do all beta-blockers have the same side effects?

Although beta-blockers share the same mechanism of action, the side effects they can cause vary from person to person.

Inactive ingredients in each beta-blocker and dosage may affect how the medication affects you. Your experience with a specific beta-blocker may not be the same for someone else.

Different beta-blockers may have different associations with beta receptors, which can determine the specific side effects of each drug.

Do you need to taper off beta-blockers?

When supervising discontinuing beta-blockers, your healthcare professional may recommend tapering the drug off gradually because stopping beta-blockers suddenly may worsen your symptoms.

A healthcare professional can help you develop a tapering plan, slowly reducing the dose to minimize side effects and ensure a smooth transition to a new medication.

Alternative to beta-blockers

Common alternatives to beta-blockers may include:

  • Calcium channel blockers: These work by relaxing the blood vessels and reducing the workload on the heart. Doctors may prescribe them to manage high blood pressure, angina, and certain heart rhythm disorders.
  • Angiotensin-converting enzyme (ACE) inhibitors: These work by blocking the production of a hormone that causes blood vessels to narrow, thus lowering blood pressure. Doctors often prescribe them to manage high blood pressure and certain heart conditions.
  • Angiotensin II receptor blockers (ARBs): ARBs work by blocking the effects of a hormone that causes blood vessels to constrict, resulting in lowered blood pressure. Doctors use them to treat high blood pressure and heart failure.
  • Diuretics: These work by increasing urination and reducing fluid volume in the blood vessels to help reduce fluid buildup in the body and manage high blood pressure and heart failure. 
  • Alpha-blockers: These block specific receptors in blood vessels, leading to relaxation and improved blood flow. Doctors may prescribe them for high blood pressure and prostate enlargement. 

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Summary

Fatigue, dizziness, nausea, and cold limbs are common side effects of beta-blockers. Although not everyone experiences these side effects, it’s essential to communicate any concerns or symptoms to a healthcare professional and report significant changes immediately. 

Staying hydrated and resting adequately is important in managing side effects. 

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