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Beta-blockers

Published by Bupa's health information team, September 2009.

This factsheet is for people who are taking beta-blockers, or who would like information about them.

Beta-adrenoreceptor blocking drugs, or beta-blockers for short, mainly work on the heart and blood vessels where they act to reduce blood pressure and the amount of work the heart does. They are also used to reduce anxiety symptoms and help prevent migraines.

Why would I take beta-blockers?

Your doctor may prescribe beta-blockers for you if you have:

  • angina
  • high blood pressure
  • disturbance of the normal heart rhythm (arrhythmia)
  • heart failure

If you have had a heart attack, taking a beta-blocker reduces your risk of having another one. Beta-blockers are also used to relieve the symptoms of anxiety, such as palpitations, fast heart rate and trembling. However, they will not stop the feeling of anxiety itself.

Your doctor may suggest beta-blockers to help prevent migraines. If you have an overactive thyroid gland, you may be given beta-blockers before an operation to remove it.

There are also eye drops containing certain beta-blockers that are used to treat glaucoma, an eye condition caused by a build-up of pressure in the eye.

What are the main types of beta-blocker?

There are many different types of beta-blocker, which block the action of different types of beta-adrenoreceptors (see How do beta-blockers work?). Some work on all parts of the body that have beta-adrenoreceptors. Others are more specific and work only on specific parts of the body, such as the heart. Beta-blockers that affect mainly the heart are called cardioselective beta-blockers.

How do beta-blockers work?

Beta-blockers work by blocking the action of a natural substance called noradrenaline at special sites called adrenoreceptors in arteries, on the heart muscle and on some other muscles and organs.

A chemical messenger called noradrenaline causes arteries to narrow and the heart to beat faster. By blocking its action, beta-blockers can cause arteries to widen, slow down the heart and decrease its force of contraction. This results in a drop in blood pressure and less work for the heart.

Beta-blockers don't have much of an effect on the heart when you are at rest. But they partially block the effects of exercise or excitement (when noradrenaline levels rise) on the heart so that it doesn't work too hard at these times.

How to take beta-blockers

Beta-blockers are available only on prescription. They come as:

  • tablets or capsules
  • syrup or solution
  • injections
  • eye drops (for glaucoma)

The way you take beta-blockers depends on why you need them. For example, you may be given an injection of a beta-blocker in hospital if you have a heart attack.

The effects of some beta-blockers do not last very long, so if you need beta-blocker tablets to help control a long-term condition such as angina, you may need to take them once or twice a day.

Beta-blockers may be prescribed in combination with other drugs such as water tablets (diuretics) or calcium-channel blockers.

Don't stop taking a beta-blocker suddenly because this may make your symptoms worse. If you need to stop taking them, your doctor will tell you how to reduce your beta-blockers gradually.

Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

Special care

Beta-blockers also affect other organs in the body, such as your lungs and muscles. Your doctor may not prescribe beta-blockers for you, or will need to monitor you closely, if you have:

  • asthma or other breathing problems
  • severe heart failure
  • severe narrowing of the arteries that carry blood to your arms and legs (peripheral arterial disease)
  • low blood pressure
  • slow heart rate
  • diabetes - because beta-blockers can hide the symptoms of low blood sugar levels, especially if you are already taking a diuretic

Side-effects of beta-blockers

The side-effects you might have with your beta-blocker depend on which one you are taking. This section does not include every possible side-effect of beta blockers. Read the patient information leaflet that comes with your medicine for more information. Some common side-effects are:

  • cold hands and feet
  • tiredness
  • headache
  • dizziness
  • sleep disturbance (nightmares)
  • sexual problems (impotence)

Other side-effects can include:

  • wheezing
  • indigestion
  • visual disturbances
  • skin rashes
  • dry eyes

Interactions of beta-blockers with other medicines

Check with your doctor or pharmacist before you take any other medicines or herbal remedies at the same time as a beta-blocker.

Names of common beta-blockers

The main types of beta-blocker are shown in the table.

All medicines have a generic name. Many also have one or more brand name. Generic names are written in lower case, whereas brand names start with a capital letter.

Generic names Examples of common brand names

acebutolol

Sectral

atenolol

Tenormin

atenolol in combination with calcium-channel blocker

Beta-Adalat, Tenif

bisoprolol

Cardicor, Emcor

carvedilol

Eucardic

celiprolol

Celectol

esmolol

Brevibloc

labetalol

Trandate

metoprolol

Betaloc, Lopresor, Betaloc-SA, Lopressor SR

nadolol

Corgard

nebivolol

Nebilet

oxyprenaolol

Trasicor, Slow-Trasicor

pindolol

Visken

propranolol

Inderal, Half-Inderal LA, Inderal-LA

sotalol

Beta-Cardone, Sotacor

timolol

Betim

Related topics

Further information

Sources

  • Joint Formulary Committee, British National Formulary. 57th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2009: 85-91
  • Hypertension: management of hypertension in adults in primary care. National Institute for Health and Clinical Excellence (NICE), www.nice.org.uk June 2006
  • Rang HP, Dale MM, Ritter JM, et al. Pharmacology. 6th ed. London: Churchill Livingstone, 2007:180-1
  • MI - secondary prevention. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 21 May 2009

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: September 2009

 

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