nadolol, Corgard

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DRUG CLASS AND MECHANISM: Nadolol is a member of a class of drugs called beta-adrenergic receptor blockers that is used for treating high blood pressure and heart pain (angina). Examples of other beta-adrenergic blockers include propanolol (Inderal, Inderal LA), atenolol (Tenormin), and timolol (Blocadren). Norepinephrine and epinephrine (adrenaline) are chemicals released within the body that attach to receptors on several types of cells, including nerves and some muscles, and changes the way the cells function, either stimulating the cells or suppressing them. Nadolol prevents norepinephrine and epinephrine from binding to beta receptors on nerves. By blocking the effect of norepinephrine and epinephrine, beta blockers reduce heart rate, reduce the force of the heart's contractions, and reduce blood pressure by relaxing the muscles surrounding the blood vessels.

Heart pain (angina) occurs when the workload of the heart requires more oxygen than the blood can supply. By slowing the heart rate and decreasing the force of contractions of the heart, nadolol reduces the demand of the heart's muscle for oxygen and thereby prevents angina. Beta blockers may cause difficulty breathing since they cause the muscles surrounding the air passages of the lung to contract, narrowing the air passages and making it more difficult for air to pass through them. The FDA approved nadolol in 1979.



PREPARATIONS: Tablets: 20, 40, 80, 120,160 mg.

STORAGE: Nadolol should be stored at room temperature, 15-30 C (59-86 F).

PRESCRIBED FOR: Nadolol is used for the treatment of high blood pressure (hypertension) and chest pain (angina). Nadolol also has been used to treat abnormal heart rhythms, tremor, and to prevent migraine headaches and anxiety.

DOSING: The recommended dose is 40-320 mg once daily. The maximum dose for treating angina is 240 mg daily and for hypertension is 320 mg daily. Nadolol may be administered with or without food.

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 for 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 can cause complete block of the heart's electrical system, a life-threatening condition.

Nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Anaprox, Aleve), can reduce the blood pressure lowering effects of beta- blockers.

Nadolol can mask the early warning symptoms of low blood sugar (hypoglycemia) and should be used with caution in patients receiving treatment for diabetes.

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