Health Guide
Drug Guide

Beta-adrenergic blocker (Oral route, injection route, intravenous route)

Brand Names:

Dosage Forms:

Uses of This Medicine:

This group of medicines is known as beta-adrenergic blocking agents, beta-blocking agents, or, more commonly, beta-blockers. Beta-blockers are used in the treatment of high blood pressure (hypertension). Some beta-blockers are also used to relieve angina (chest pain) and in heart attack patients to help prevent additional heart attacks. Beta-blockers are also used to correct irregular heartbeat, prevent migraine headaches, and treat tremors. They may also be used for other conditions as determined by your doctor.

Beta-blockers work by affecting the response to some nerve impulses in certain parts of the body. As a result, they decrease the heart's need for blood and oxygen by reducing its workload. They also help the heart to beat more regularly.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, some beta-blockers are used in certain patients with the following medical conditions:

Before Using This Medicine:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Some of these medicines have been used in children and, in effective doses, have not been shown to cause different side effects or problems in children than they do in adults.

Older adults

Some side effects are more likely to occur in the elderly, who are usually more sensitive to the effects of beta-blockers. Also, beta-blockers may reduce tolerance to cold temperatures in elderly patients.

Pregnancy

Use of some beta-blockers during pregnancy has been associated with low blood sugar, breathing problems, a lower heart rate, and low blood pressure in the newborn infant. Other reports have not shown unwanted effects on the newborn infant. Animal studies have shown some beta-blockers to cause problems in pregnancy when used in doses many times the usual human dose. Before taking any of these medicines, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding

It is not known whether bisoprolol, carvedilol, carteolol, or penbutolol passes into breast milk. All other beta-blockers pass into breast milk. Problems such as slow heartbeat, low blood pressure, and trouble in breathing have been reported in nursing babies. Mothers who are taking beta-blockers and who wish to breast-feed should discuss this with their doctor.

Other medicines

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using medicines in this class with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use your medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

Proper Use of This Medicine:

For patients taking the extended-release capsule or tablet form of this medicine:

For patients taking the concentrated oral solution form of propranolol:

Ask your doctor about checking your pulse rate before and after taking beta-blocking agents. If your doctor tells you to check your pulse regularly while you are taking this medicine, and it is much slower than the rate your doctor has designated, check with your doctor. A pulse rate that is too slow may cause circulation problems.

To help you remember to take your medicine, try to get into the habit of taking it at the same time each day.

For patients taking this medicine for high blood pressure:

Dosing

The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine:

It is important that your doctor check your progress at regular visits. This is to make sure the medicine is working for you and to allow the dosage to be changed if needed.

Do not stop taking this medicine without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are taking before stopping completely. Some conditions may become worse when the medicine is stopped suddenly, and the danger of heart attack is increased in some patients.

Make sure that you have enough medicine on hand to last through weekends, holidays, or vacations. You may want to carry an extra written prescription in your billfold or purse in case of an emergency. You can then have it filled if you run out of medicine while you are away from home.

Tell your doctor right away if you have weight gain or increasing shortness of breath. These could be symptoms of worsening heart failure.

Your doctor may want you to carry medical identification stating that you are taking this medicine.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine.

For diabetic patients:

This medicine may cause some people to become dizzy, drowsy, or lightheaded. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert. If the problem continues or gets worse, check with your doctor.

Beta-blockers may make you more sensitive to cold temperatures, especially if you have blood circulation problems. Beta-blockers tend to decrease blood circulation in the skin, fingers, and toes. Dress warmly during cold weather and be careful during prolonged exposure to cold, such as in winter sports.

Beta-blockers may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine:

Chest pain resulting from exercise or physical exertion is usually reduced or prevented by this medicine. This may tempt a patient to be overly active. Make sure you discuss with your doctor a safe amount of exercise for your medical problem.

Before you have any medical tests, tell the doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Before you have any allergy shots, tell the doctor in charge that you are taking a beta-blocker. Beta-blockers may cause you to have a serious reaction to the allergy shot.

For patients with allergies to foods, medicines, or insect stings:

For patients taking this medicine for high blood pressure:

For patients taking labetalol by mouth:

For patients receiving labetalol by injection:

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Less common
Breathing difficulty and/or wheezing
cold hands and feet
mental depression
shortness of breath
slow heartbeat (especially less than 50 beats per minute)
swelling of ankles, feet, and/or lower legs
Rare
Back pain or joint pain
chest pain
confusion (especially in elderly patients)
dark urine for acebutolol, bisoprolol, or labetalol
dizziness or lightheadedness when getting up from a lying or sitting position
fever and sore throat
hallucinations (seeing, hearing, or feeling things that are not there)
irregular heartbeat
red, scaling, or crusted skin
skin rash
unusual bleeding and bruising
yellow eyes or skin for acebutolol, bisoprolol, or labetalol

Get emergency help immediately if any of the following symptoms of overdose occur:

Slow heartbeat
dizziness (severe) or fainting
fast or irregular heartbeat
difficulty in breathing
bluish-colored fingernails or palms of hands
convulsions (seizures)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Decreased sexual ability
dizziness or lightheadedness
drowsiness (slight)
trouble in sleeping
unusual tiredness or weakness
Less common or rare
Anxiety and/or nervousness
changes in taste for labetalol only
constipation
diarrhea
dry, sore eyes
frequent urination for acebutolol and carteolol only
itching of skin
nausea or vomiting
nightmares and vivid dreams
numbness and/or tingling of fingers and/or toes
numbness and/or tingling of skin, especially on scalp for labetalol only
stomach discomfort
stuffy nose

Although not all of the side effects listed above have been reported for all of these medicines, they have been reported for at least one of them. Since all of the beta-adrenergic blocking agents are very similar, any of the above side effects may occur with any of these medicines. However, they may be more or less common with some agents than with others.

After you have been taking a beta-blocker for a while, it may cause unpleasant or even harmful effects if you stop taking it too suddenly. After you stop taking this medicine or while you are gradually reducing the amount you are taking, check with your doctor right away if any of the following occur:

Chest pain
fast or irregular heartbeat
general feeling of discomfort or illness or weakness
headache
shortness of breath (sudden)
sweating
trembling

For patients taking labetalol: You may notice a tingling feeling on your scalp when you first begin to take labetalol. This is to be expected and usually goes away after you have been taking labetalol for a while.

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


Last Updated: 6/12/2013

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