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GENERIC NAME: nadolol

BRAND NAME: Corgard

DRUG CLASS AND MECHANISM: Nadolol is a beta-adrenergic receptor blocking agent that primarily blocks the action of the sympathetic nervous system on the heart. Nadolol reduces the heart rate and the force of contractions of the heart's muscle, thereby lowering blood pressure. Angina (heart pain) occurs when the heart's need for oxygen exceeds the supply of oxygen. By slowing the heart rate and decreasing the force of muscle contractions, nadolol reduces the demand of the heart's muscle for oxygen and thereby prevents angina.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: Round tablets: 20mg, 40mg, 80mg, 120mg, 160mg.

STORAGE: Tablets should be stored between 2° (36°F) and 30°C (86°F) and protected from light.

PRESCRIBED FOR: Nadolol is prescribed for patients with high blood pressure (hypertension). It is used to treat chest pain (angina) related to coronary artery disease. Nadolol also has been used to treat patients with tremor , to prevent migraine headaches, and to prevent anxiety in anxiety-provoking situations.

DOSING: Nadolol usually is taken once each day and may be taken with or without meals. When used to prevent anxiety, it can be taken two hours prior to the anxiety-provoking situation. In persons with even a moderate degree of reduced kidney function (as detected by laboratory tests), the dose of nadolol may be reduced or the interval between doses (usually about 24 hours) may need to be extended (e.g. to 36 or 48 hours).

DRUG INTERACTIONS: The blood pressure-lowering effects of nadolol are additive with other medications that lower blood pressure, and combinations of these other medications with nadolol often is used purposefully in treating persons with high blood pressure . When used in combination with diltiazem (Cardizem; Tiazac; Dilacor), verapamil (Calan; Isoptin; Verelan; Covera), amiodarone (Cordarone), or digoxin (Lanoxin), however, nadolol or other beta-blockers can cause complete block of the heart's electrical system. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin; Advil) and naproxen (Naprosyn; Anaprox; Aleve), can prevent the blood pressure-reducing effects of beta- blockers such as nadolol.

PREGNANCY: There is very little information about nadolol given to pregnant women. Physicians may elect to use it if its benefits are deemed to outweigh potential risks.

NURSING MOTHERS: Nadolol is excreted into breast milk. The manufacturers do not recommend the use of nadolol while breast- feeding because of the potential risk of toxicity in the nursing infant.

SIDE EFFECTS: Nadolol is generally well tolerated, and side effects are mild and transient. Rare side effects include abdominal cramps, diarrhea , constipation , fatigue, insomnia, nausea, depression , dreaming, memory loss, fever, impotence , lightheadedness, slow heart rate, low blood pressure , numbness, tingling, cold extremities, sore throat, and shortness of breath or wheezing.

If it is necessary to discontinue nadolol, the dose usually is reduced gradually over several weeks. Nadolol can mask the early warning symptoms of low blood sugar ( hypoglycemia ), especially in diabetics who are prone to hypoglycemia, and can increase or decrease blood sugar. Therefore, it should be used with caution in diabetic patients.


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