nadolol: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
nadolol: clinical details
Prescribing considerations
- Avoid abrupt withdrawal, particularly with ischaemic heart disease or thyrotoxicosis.
- Review renal function because nadolol is principally eliminated unchanged by the kidneys.
- Assess heart failure history, bronchospastic disease, diabetes, fasting risk, severe allergy history and planned anaesthesia.
- Nadolol can affect the interpretation of cardiac stress tests.
- Safety and efficacy are not established for the licensed product in children.
Contraindications and cautions
- Hypersensitivity to nadolol or an excipient
- Bronchial asthma or a history of asthma
- Sinus bradycardia
- Atrioventricular block greater than first degree
- Cardiogenic shock
- Right ventricular failure secondary to pulmonary hypertension
- Overt cardiac failure
Monitoring
- Heart rate, blood pressure and symptoms of hypotension or syncope
- Renal function and clinical response
- Heart failure, conduction disturbance and bronchospasm
- Blood glucose and masked hypoglycaemia in susceptible patients
- Fetal growth and neonatal heart rate, glucose and respiratory status when clinically indicated after pregnancy exposure
Clinical pharmacology
Nadolol is a non-selective beta-adrenoceptor antagonist without intrinsic sympathomimetic or membrane-stabilising activity. It is incompletely absorbed, is not metabolised and is excreted mainly unchanged in urine, with prolonged pharmacological activity.
Formulation and product differences
- The selected licensed product is a white or slightly mottled capsule-shaped tablet with a break line.
- Its listed excipients are microcrystalline cellulose and magnesium stearate.
- The selected pack uses PVC/aluminium blisters.
nadolol preparations and strengths
Tablet
Route: Oral
Strengths: 80 mg
nadolol interactions
Ask a prescriber or pharmacist to check all prescribed, pharmacy and herbal products. Important examples include:
Verapamil, diltiazem and other calcium-channel blockers
Cardiac effects may be increased, with greater risk of slow heartbeat, low blood pressure or conduction problems.
Other antihypertensives and diuretics
Blood pressure may fall too far, causing dizziness, postural symptoms or fainting.
Clonidine
Withdrawal order matters because stopping clonidine at the wrong time can cause harmful cardiovascular effects.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.