Post by the Scribe on Jan 23, 2024 2:46:15 GMT
A List of the 8 Most Common Beta Blockers
www.goodrx.com/classes/beta-blockers/list-of-beta-blockers
ThienLy Neal, PharmD
Christina Aungst, PharmD
Written by ThienLy Neal, PharmD | Reviewed by Christina Aungst, PharmD
Published on December 19, 2022
Key takeaways:
Beta blockers are used to treat many health conditions. But they’re best known for treating high blood pressure and other heart-related problems.
Beta blockers are classified as either selective or non-selective. Your healthcare provider will choose the type of beta blocker that’s best for you.
There are many ways to save on beta blocker medications. Many are available as lower-cost generics. GoodRx can help make your prescription more affordable.
Find savings on related medications:
Atenolol
Tenormin
Metoprolol
Lopressor
Metoprolol Er
Beta blockers are a class of medication commonly used to treat high blood pressure. They can also treat other heart-related conditions, such as heart failure and arrhythmias (irregular heartbeat). Other uses include migraine prevention, glaucoma, and essential tremor.
Beta blockers come in various forms such as pills, injections, and eye drops. Most are available as generics.
They’re usually classified as either selective or non-selective. Selective beta blockers mainly target beta-1 receptors (chemical binding sites). These receptors affect your heart rate and how hard your heart works to pump blood. Non-selective beta blockers attach to beta-1, beta-2, and sometimes even alpha receptors. These types of beta blockers affect blood vessels throughout the body, not just on the heart.
With so many types of beta blockers available, it’s hard to tell them apart. Below, we’ll break down the most commonly used ones and the differences between them.
1. Metoprolol
Metoprolol is a selective beta blocker. It comes in two different forms: metoprolol tartrate (Lopressor) and metoprolol succinate (Toprol XL). It’s FDA-approved to treat and manage high blood pressure, chest pain, and heart attack. It’s also used off-label as a first-choice medication for migraine prevention. Metoprolol succinate is also a preferred beta blocker for heart failure.
Metoprolol can be taken by mouth or administered into the vein. Metoprolol tartrate is an immediate-release (IR) form available as a tablet or an intravenous (IV, into the vein) injection. Metoprolol succinate is an extended-release (ER) form that comes in oral tablets and capsules. It’s also available as Kapspargo Sprinkle capsules that can be opened and sprinkled over soft foods.
Metoprolol tartrate is usually taken twice a day. Metoprolol succinate is typically taken once a day. But you should take both forms with food.
Metoprolol begins to work quickly. Both the IR and ER formulations usually start to work within 1 hour of use.
2. Carvedilol
Carvedilol (Coreg) is a non-selective beta blocker. It’s FDA-approved for the treatment and management of high blood pressure, heart failure, and heart attack. It’s also used off-label for chest pain and irregular heartbeats. Carvedilol is one of the three beta blockers that lowers the risk of death in patients living with heart failure.
Carvedilol comes in IR tablets and ER capsules. The IR tablets are taken twice a day, but the ER capsules are only taken once a day.
Carvedilol (the IR form in particular) can cause a sudden drop in blood pressure when you sit up or stand quickly. This is also known as orthostatic hypotension, and it can make you feel dizzy. You can take carvedilol IR tablets with food to slow down its absorption and lower the risk for this problem.
3. Atenolol
Atenolol (Tenormin) is a selective beta blocker. It’s FDA-approved to treat high blood pressure and manage angina (chest pain). It can also lower your risk of death after having a heart attack.
In addition, it’s used off-label for irregular heartbeat, alcohol withdrawal symptoms, and essential tremor. Atenolol is sometimes used to prevent migraines, but it’s not considered a first-choice option for this.
Currently, atenolol only comes in tablet form and is usually taken once a day. Unlike some of the other beta blockers, atenolol is not broken down by the liver. The kidneys remove most of the medication from the body. For this reason, it’s not recommended for people who have kidney function problems.
4. Propranolol
Propranolol (Inderal LA) is a non-selective beta blocker that’s been around for over 50 years. It was originally created to treat chest pain. Over the years, its list of uses has expanded. They include heart-related problems such as high blood pressure and irregular heartbeat. Other FDA-approved uses include tremors and migraine prevention. In fact, it’s considered one of the best beta blockers to prevent migraines.
People also use propranolol to lessen performance anxiety, but this is an off-label use.
This medication is available as an oral IR tablet, ER capsule, and solution. It also comes in an injectable form that’s administered into a vein.
5. Labetalol
Labetalol (Trandate) is used to treat high blood pressure. It’s non-selective for beta receptors, but it’s selective for alpha-1 receptors. Blocking alpha-1 receptors makes labetalol more effective at lowering blood pressure than some other beta blockers. Labetalol is also a preferred treatment for severe high blood pressure in pregnancy. But this is an off-label use.
Dosage forms include an oral tablet and an IV injection. It’s best to take the tablets with food to help your body absorb it.
Labetalol is mainly used in hypertensive crises. This is when there’s a rapid and severe rise in your blood pressure. For these situations, IV is usually the preferred form.
6. Bisoprolol
Bisoprolol is a selective beta blocker that’s used to treat high blood pressure. It’s also a preferred beta blocker for heart failure, although this is an off-label use.
Bisoprolol only comes in a tablet form. Compared to other beta blockers, bisoprolol stays in the body for a much longer period of time.
7. Timolol
Timolol (Betimol, Timoptic) is a non-selective beta blocker that’s often used as an eye drop. But it’s also available as an oral tablet that’s taken twice a day.
Timolol eye drops are commonly used to treat glaucoma. Drops are available with timolol alone or in combination with other medications.
The tablet form can be used to lower the risk of complications after a heart attack. It’s also a first-choice beta blocker to prevent migraines. It can be used to treat high blood pressure, although it’s not considered a first-choice treatment option.
8. Nadolol
Nadolol (Corgard) is a non-selective beta blocker that’s used to treat and manage high blood pressure and chest pain. It’s usually reserved as a second-choice treatment option for high blood pressure. It’s also used off-label to treat essential tremors.
This medication is only available in tablet form and taken once a day. Nadolol stays in the body longer than most other beta blockers. Like atenolol, it’s removed from the body by the kidneys. So unlike most other beta blockers, it’s OK for people with liver problems to take it. But those with kidney problems should probably avoid it.
What are the common side effects of beta blockers?
Beta blockers are generally well-tolerated by most people. If you do experience side effects, it’s likely that they’ll go away as your body adjusts to the medication.
Some common side effects include:
Slow heart rate
Low blood pressure
Dizziness
Fatigue
Constipation
Nausea
Insomnia
Beta blockers can mask some of the symptoms of hypoglycemia (low blood sugar) such as shaking, irritability, and confusion. Untreated hypoglycemia can lead to serious complications such as coma, seizures, and even death. But sweating is a low blood sugar symptom that’s not masked by beta blockers. So if you have diabetes, it’s a good idea to check your blood sugar if you feel sweaty or clammy.
Non-selective beta blockers may cause tightening of the muscles lining your airways. This may make it harder for you to breathe — especially if you have asthma. Selective beta blockers are often a better choice if you have asthma. But beta blockers may not be a good option at all for people with certain lung conditions.
How do I find out which beta blocker is right for me?
There are many beta blockers, so choosing one can seem overwhelming.
The two main factors to consider when selecting a beta blocker are the medical condition that’s being treated and your personal medical history. Your healthcare provider will help decide if a specific beta blocker is better for you.
Each beta blocker works a bit differently, so you may have to try a few before you find one that’s right for you.
How to save
There are many ways to save on your beta blocker medication. GoodRx can help you navigate your options, which may include GoodRx discounts, copay savings cards, and patient assistance programs. You can find beta blocker prices as low as $6 with a free GoodRx discount. www.goodrx.com/classes/beta-blockers
The bottom line
Beta blockers are versatile medications, and there are quite a few to choose from. They’re mainly used to treat heart-related problems, but they can treat other conditions, like migraines and tremors. Most people tolerate beta blockers fairly well, with common side effects fading after a short time.
Not all beta blockers work the same way. Some, like atenolol and metoprolol, mainly target the heart. Others, like carvedilol and propranolol, can affect other places in the body as well. Your healthcare provider can help you choose the beta blocker that’s best for you.
References
American Family Physician. (2000). Taking a beta blocker for your heart problem.
Amneal Pharmaceuticals NY LLC. (2022). Nadolol tablets [package insert].
View All References (20)
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