NADOLOL

Indications & Dose:

Hypertension

 Initially 80mg once daily, increased y increament of up to 80mg at weekely intervals if required ; max; dose 240mg daily ( higher doises may rarely necessary)

Angina

Initially 40mg once daily incrreased at weekely intervals if required; usual max; 160mg daily ( rarely up to 240mg may be required)

Arrythemia

Initially 40mg once daily incrreased at weekely intervals if required; usual max; 160mg daily, reduce to 40mg if bradycardia occurs.

Migraine.

Prophylaxix, initially 40mg once daily, increased by 40mg increaments at weekly intervals; usual maintainance dose 80-1160mg one daily

Thyrotoxicosis,

80-160mg one daily

Contraindications:

Asthma; bronchospasm; cardiogenic shock; heart failure; hypersensitivity to nadolol, other beta blockers, or their components; second- or third-degree AV block; severe COPD; sinus bradycardia

Side Effects:

Cautions:

Precautions:

Interaction:

DRUGS

allergen immunotherapy, allergenic extracts for skin testing: Increased risk of serious systemic reactions or anaphylaxis amiodarone: Increased risk of conduction abnormalities and negative inotropic effects beta blockers, digoxin: Increased risk of bradycardia calcium channel blockers: Increased risk of bradycardia

cimetidine: Possibly increased effects of nadolol

clonidine, guanabenz: Impaired blood pressure control

diazoxide, nitroglycerin: Increased risk of hypotension

estrogens, NSAIDs: Possibly reduced antihypertensive effect of nadolol general anesthetics: Increased risk of hypotension and myocardial depression insulin, oral antidiabetic drugs: Possibly increased risk of hyperglycemia and impaired recovery from hypoglycemia, masking of signs of hypoglycemia lidocaine: Increased risk of lidocaine toxicity neuromuscular blockers: Possibly prolonged action of these drugs phenothiazines:

Possibly increased blood levels of both drugs

reserpine: Increased risk of bradycardia and hypotension

sympathomimetics with alpha- and beta-adrenergic effects, such as pseudoephedrine: Possibly hypertension, excessive bradycardia, and heart block

xanthines, such as theophyllines: Possibly decreased therapeutic effects of both drugs

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Anxiety, depression, dizziness, drowsiness fatigue, headache, paresthesia, syncope, vertigo, weakness, yawning

CV: Bradycardia, chest pain, edema, heart block, heart failure, hypotension, orthostatic hypotension, ventricular arrhythmias

EENT: Nasal congestion, taste perversion

GI: Dyspepsia, elevated liver function test results, hepatic necrosis, hepatitis, nausea, vomiting

GU: Ejaculation failure, impotence

RESP: Cough, dyspnea, wheezing

SKIN: Jaundice, pruritus, scalp tingling

Patient And Carer Advice: