What are the side effects of beta blockers?

• Beta blockers may cause:
  
  
  • diarrhea,
    
    
  • stomach cramps,
    
    
  • nausea, and
    
    
  • vomiting.
    
    
• Rash, blurred vision, muscle cramps, and fatigue may also occur.
  
  
• As an extension of their beneficial effect, they slow heart rate, reduce blood pressure, and may cause heart failure or heart block in patients with heart problems.
  
  
• Beta blockers should not be withdrawn suddenly because sudden withdrawal may worsen angina (chest pain) and cause heart attacks or sudden death.
  
  
• Central nervous system effects of beta blockers include:
  
  
  • headache,
    
    
  • depression,
    
    
  • confusion,
    
    
  • dizziness,
    
    
  • nightmares, and
    
    
  • hallucinations.
    
    
• Beta blockers that block β2 receptors may cause shortness of breath in asthmatics.
  
  
• As with other drugs used for treating high blood pressure, sexual dysfunction may occur.
  
  
• Beta blockers may cause low or high blood glucose and mask the symptoms of low blood glucose (hypoglycemia) in diabetic patients.

With which drugs do beta blockers interact?

• Combining propranolol (Inderal) or pindolol (Visken) with thioridazine (Mellaril) or chlorpromazine (Thorazine) may result in low blood pressure (hypotension) and abnormal heart rhythms because the drugs interfere with each others' elimination and result in increased levels of the drugs.
  
  
• Dangerous elevations in blood pressure may occur when clonidine (Catapres) is combined with a beta blocker, or when clonidine (Catapres) or beta blocker is discontinued after their concurrent use. Blood pressure should be closely monitored after initiation or discontinuation of clonidine (Catapres) or a beta blocker when they have been used together.
  
  
• Phenobarbital and similar agents may increase the breakdown and reduce blood levels of propanolol (Inderal) or metoprolol (Lopressor, Toprol XL). This may reduce effectiveness of the beta blocker.
  
  
• Aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs) (for example, ibuprofen) may counteract the blood pressure reducing effects of beta blockers because they reduce the effect of prostaglandins. Prostaglandins play a role in control of blood pressure.

What are some examples of beta blockers?

• acebutolol (Sectral)
• atenolol (Tenormin)
• betaxolol (Kerlone)
• betaxolol (Betoptic, Betoptic S)
• bisoprolol fumarate (Zebeta)
• carteolol (Cartrol)
• carvedilol (Coreg)
• esmolol (Brevibloc)
• labetalol (Trandate, Normodyne)
• metoprolol (Lopressor, Toprol XL)
• nadolol (Corgard)
• nebivolol (Bystolic)
• penbutolol (Levatol)
• pindolol (Visken)
• propranolol (Inderal, InnoPran)
• sotalol (Betapace)
• timolol (Blocadren)
• timolol ophthalmic solution (Timoptic) 

Reference: FDA Prescribing Information

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