| name | Nadolol |
| Classification | Beta-blocker, non-selective |
| Pharmacokinetics | Nadolol is a non-selective beta-blocker with a long duration of action (approximately 24 hours). It is well absorbed after oral administration, with peak plasma concentrations typically achieved within 2-4 hours. Nadolol is extensively metabolized in the liver and is primarily eliminated in the urine as metabolites. The elimination half-life is relatively long, ranging from 20-24 hours. |
| suggested dosage | | male patient 25 70kg | | initial dosage | 40mg orally once daily; may be adjusted in 40mg increments at 1-2 week intervals | | maintenance dosage | 80-320mg/day in single or divided doses | | important note | Dosage should be individualized based on the patient's response and tolerance. Consult a physician for personalized dosage. |
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| indications | | 1 | Hypertension | | 2 | Angina pectoris | | 3 | Migraine prophylaxis | | 4 | Essential tremor | | 5 | Prevention of sustained arrhythmias, e.g., postoperative atrial fibrillation | | 6 | Hypertrophic obstructive cardiomyopathy (HOCM) |
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| Safety in pregnancy | Nadolol is contraindicated during pregnancy. It crosses the placenta and can potentially cause fetal harm. |
| Safety in breastfeeding | Nadolol is likely to be excreted in breast milk. The decision to use nadolol in breastfeeding women should be made cautiously. |
| side effects | | 1 | Bradycardia | | 2 | Hypotension | | 3 | Bronchospasm (rare but serious in patients with asthma or COPD) | | 4 | Fatigue | | 5 | Dizziness | | 6 | Depression | | 7 | Cold extremities | | 8 | Nausea | | 9 | Diarrhea | | 10 | Erectile dysfunction | | 11 | Sleep disturbances |
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| alternatives | |
| contraindications | | 1 | Severe bradycardia | | 2 | Sick sinus syndrome | | 3 | Second or third-degree heart block (unless a pacemaker is present) | | 4 | Bronchospasm or severe COPD | | 5 | Cardiogenic shock | | 6 | Hypersensitivity to nadolol or other beta-blockers | | 7 | Severe peripheral arterial disease |
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| interactions | | 1 | Other beta-blockers | | 2 | Calcium channel blockers | | 3 | Digoxin | | 4 | Verapamil | | 5 | Diltiazem | | 6 | Nonsteroidal anti-inflammatory drugs (NSAIDs) | | 7 | Insulin and oral hypoglycemics | | 8 | Alcohol | | 9 | MAO inhibitors |
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| warnings and precautions | | 1 | Patients with asthma or COPD may be more susceptible to bronchospasm | | 2 | Caution is advised in patients with diabetes mellitus as nadolol may mask symptoms of hypoglycemia | | 3 | Patients with peripheral arterial disease, Raynaud's syndrome or heart failure should be closely monitored. | | 4 | Sudden discontinuation of nadolol can lead to rebound hypertension or angina. | | 5 | Use caution in patients with renal impairment. | | 6 | Dosage adjustments may be necessary in patients with hepatic impairment. |
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| additional informations | Nadolol is generally well-tolerated, but individual responses vary. Close monitoring of blood pressure and pulse is essential during initiation of therapy and dose adjustments. If any serious side effects occur, discontinue use and consult a physician immediately. |
| disclaimer | This information is for educational purposes only and should not be considered medical advice. Always consult with a healthcare professional before starting any new medication. |
