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Beta-adrenergic Blocking Agents  (Systemic)

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Brand Names

Some commonly used brand names are:

In the U.S.—

  • Betapace13
  • Blocadren14
  • Cartrol5
  • Corgard8
  • Inderal12
  • Inderal LA12
  • Kerlone3
  • Levatol10
  • Lopressor7
  • Normodyne6
  • Sectral1
  • Tenormin2
  • Toprol-XL7
  • Trandate6
  • Visken11
  • Zebeta4

In Canada—

  • Apo-Atenolol2
  • Apo-Metoprolol7
  • Apo-Metoprolol (Type L)7
  • Apo-Propranolol12
  • Apo-Timol14
  • Betaloc7
  • Betaloc Durules7
  • Blocadren14
  • Corgard8
  • Detensol12
  • Inderal12
  • Inderal LA12
  • Lopresor7
  • Lopresor SR7
  • Monitan1
  • Novo-Atenol2
  • Novometoprol7
  • Novo-Pindol11
  • Novo-Timol14
  • Novopranol12
  • Nu-Metop7
  • pms Propranolol12
  • Sectral1
  • Slow-Trasicor9
  • Sotacor13
  • Syn-Nadolol8
  • Syn-Pindolol11
  • Tenormin2
  • Trandate6
  • Trasicor9
  • Visken11

Note:

For quick reference, the following beta-adrenergic blocking agents are numbered to match the corresponding brand names.
This information applies to the following medicines:
1.  Acebutolol (a-se-BYOO-toe-lole)
2.  Atenolol (a-TEN-oh-lole)
3.  Betaxolol (be-TAX-oh-lol)
4.  Bisoprolol (bis-OH-proe-lol)
5.  Carteolol (KAR-tee-oh-lole)
6.  Labetalol (la-BET-a-lole)
7.  Metoprolol (met-oh-PROE-lol)
8.  Nadolol (nay-DOE-lole)
9.  Oxprenolol (ox-PREN-oh-lole)*
10.  Penbutolol (pen-BYOO-toe-lole)
11.  Pindolol (PIN-doe-lole)
12.  Propranolol (proe-PRAN-oh-lole)
13.  Sotalol (SOE-ta-lole)
14.  Timolol (TYE-moe-lole)
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in Canada

Category


Description

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.

Beta-adrenergic blocking agents are available only with your doctor's prescription, in the following dosage forms:



Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For the beta-blockers, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to the beta-blocker medicine prescribed. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

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, 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.

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.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking or receiving a beta-blocker it is especially important that your health care professional know if you are taking any of the following:

Other medical problems—The presence of other medical problems may affect the use of the beta blockers. 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 of beta-blocker 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. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules or tablets or teaspoonfuls of solution 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 taking the beta-blocker.

Missed dose—

Do not miss any doses. This is especially important when you are taking only one dose per day. Some conditions may become worse if this medicine is not taken regularly.

If you do miss a dose of this medicine, take it as soon as possible. However, if it is within 4 hours of your next dose (8 hours when using atenolol, betaxolol, bisoprolol, carteolol, labetalol, nadolol, penbutolol, sotalol, or extended-release [long-acting] metoprolol, oxprenolol, or propranolol), skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:


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.

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.

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:

Other 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. However, check with your doctor if any of the following side effects continue or are bothersome:

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:


For patients taking labetalol:

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


Additional Information

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:

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.

Revised: 08/13/1998

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