What is nadolol?

Nadolol is a prescription medication used to treat high blood pressure (hypertension) and angina.

High blood pressure is a condition where the force of blood against the artery walls is consistently too high. If left untreated, this force can damage blood vessels in the heart, brain, and kidneys. In turn, this could result in a heart attack, kidney failure, or a stroke.

Angina refers to chest pain, often described as squeezing, pressure, or heaviness, caused by reduced blood flow to the heart. Reduced blood flow is most often caused by coronary artery disease, where arteries narrow due to fatty deposits. A lack of blood flow to the heart deprives the body of oxygen, which could result in a heart attack.

Nadolol also has off-label uses as a treatment for migraines, tremors, and irregular heartbeat.

How nadolol works

Nadolol is a beta-blocker commonly used in combination with other blood pressure medications. Beta-blockers work by relaxing the blood vessels and reducing the workload on the heart. This allows for a slower heartbeat, and the amount of blood and oxygen to the heart to increase.

Nadolol and lifestyle changes  

Blood pressure medication like nadolol works best with a healthy change in lifestyle. Eating low-sodium and other healthy foods, exercising, and weight control all positively affect blood pressure. Refraining from alcohol and quitting smoking are also recommended.

How to take nadolol

The dosage of this medicine varies from patient to patient. Doctors generally start with a smaller dose and increase as needed with frequent blood pressure checks. Because many people with high blood pressure experience no symptoms, it’s essential to take nadolol as directed and check blood pressure regularly even if you feel healthy.

Nadolol comes in pill form and can be taken with or without food, usually once per day. Take a missed dose as soon as remembered unless it is close to the time for the next dose. Do not double up on doses. Do not stop taking this medicine without your doctor’s guidance. A sudden stop could worsen your medical condition and even cause chest pain or a heart attack.

Potential side effects of nadolol

As with all medications, nadolol may cause some unwanted side effects. Some are more common and may improve over time.

Let your doctor know if you experience any of the following common side effects:

  • Cold or numbness in hands or feet
  • Dizziness or headache
  • Dry and itchy skin
  • Change in mood or memory problems
  • Upset stomach, constipation
  • Tiredness

Seek medical care for less common but more concerning side effects such as:

  • Extreme fatigue
  • Lightheadedness, fainting
  • Pain in fingers and toes in the cold
  • Excessive sweating

Nadolol may increase blood sugar. Increased hunger and thirst or more frequent urination indicate high blood sugar levels. Dizziness and blurred vision are also a common result.

In some patients, nadolol increases the risk or causes heart failure. Dilated neck veins, intense chest pain, swelling in areas of the body, difficulty breathing, or irregular heartbeat should all be treated as a medical emergency.

Hives are a sign of a severe allergic reaction, as is swelling of the face, lips, tongue, or throat. Seek immediate care.

Effect on existing medical conditions

Nadolol can exacerbate or hide symptoms of other medical conditions. Tell your doctor ahead of time if you have any of the following:

  • Diabetes, hyperthyroidism, hypoglycemia: nadolol can hide symptoms of these diseases, such as a fast heartbeat.
  • Kidney disease: Slow removal of nadolol from the body by the kidneys may increase the medication’s effects
  • Lung disease, like emphysema or asthma: nadolol can make breathing even more difficult for patients with these conditions
  • Slow heartbeat, coronary artery disease, heart failure: nadalol slows the heartbeat even further, which can be dangerous

Drug and other interactions with nadolol

Inform your doctor of all current medicines, vitamins, and supplements you regularly take especially other blood pressure medications.

Because nadolol can increase blood sugar, reevaluate any insulin or diabetes medicine for appropriate dosage. Nadolol can also interfere with drugs used to treat allergic reactions, like injectable epinephrine. Dosage levels of epinephrine may need to be increased.

Speak with your doctor before using any over-the-counter cold, cough, or pain medication, as some can increase blood pressure. Green tea may lessen the effects of nadolol by keeping it from lowering your blood pressure as much as it should.

Pregnancy and nadolol

High blood pressure is closely monitored in pregnant women. While beta-blockers are safe, some have been associated with reduced growth of the baby. Whether this complication is due to the beta-blocker or the condition of high blood pressure is still unclear.

Women should let their doctors know about the use of beta-blockers at the time of delivery. There have been some reports of infants having a reduced heart rate and difficulty breathing during labor.

For women who breastfeed, another beta-blocker might be a better option than Nadolol. While some beta-blockers like Propranolol, Labetalol, and Metoprolol have been found in only small amounts in breastmilk, nadolol passes through in higher quantities and is not recommended.

What to avoid when taking nadolol

Because nadolol may impair your thinking or reactions, take caution before driving or engaging in an activity that requires mental clarity. Drinking alcohol lowers blood pressure and therefore increases the side effects of nadolol. Avoid sitting or standing too quickly to reduce the risk of fainting.

Key takeaways

Nadolol can effectively lower blood pressure when used as part of a treatment program that includes healthy lifestyle changes. This medication may cause side effects like increased blood sugar that should be monitored by a health care professional. If you have any additional questions about blood pressure or whether nadolol may be an option, contact your doctor for more information.