A non-selective beta-blocker for blood pressure, angina and migraine
Nadolol
A non-selective beta-blocker used for high blood pressure, angina and the prevention of migraine.
What is Nadolol?
Nadolol is a non-selective beta-blocker, a medicine that slows the heart and eases its workload. It is used for high blood pressure, for angina (chest pain from the heart) and to help prevent migraine. It is taken by mouth, usually once a day. Common effects include a slow heart rate, tiredness and cold hands and feet. Because it is non-selective, it is generally avoided in people with asthma, as it can tighten the airways. It should not be stopped suddenly, as this can be dangerous for the heart. It is taken under medical supervision.
Education and reference only. This is a plain-language guide to Nadolol — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Nadolol is a beta-blocker, a medicine that blocks the action of stress hormones such as adrenaline on the heart and blood vessels. It is described as non-selective because it acts on beta receptors throughout the body, not just in the heart. It is used to lower high blood pressure, to ease and prevent the chest pain of angina, and to help prevent migraine attacks. It is taken by mouth, often once a day because it is long-acting. It is a long-established medicine used under medical supervision.
How it works
Nadolol blocks beta receptors, which are the docking points that adrenaline and similar hormones use to speed up and strengthen the heartbeat. With these receptors blocked, the heart beats more slowly and with less force, which lowers blood pressure and reduces the heart's need for oxygen, easing angina. Its effect in migraine is less fully understood but is thought to involve calming the responses in blood vessels and nerves that lead to attacks. Because it is non-selective, it also affects beta receptors in the airways, which is why it can be a problem in asthma.
Company & origin
Originated / developed by: Generic (long-established).
A non-selective beta-blocker used in the UK for high blood pressure, angina and the prevention of migraine.
What it treats
Conditions Nadolol is used for
Practical use
How to take Nadolol
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth as prescribed, usually once a day at about the same time.
- Do not stop it suddenly, as this can be dangerous for the heart; any change should be gradual and on advice.
- Tell your prescriber if you have asthma or wheezing, as this medicine can tighten the airways.
- Report a very slow heartbeat, dizziness or fainting to your prescriber.
- If you have diabetes, be aware it can mask some warning signs of low blood sugar.
Weighing it up
Advantages & disadvantages of Nadolol
Advantages
- Effective for high blood pressure, angina and the prevention of migraine.
- Long-acting, so it is usually taken just once a day.
- A long-established medicine with decades of experience behind it.
Disadvantages
- Can cause a slow heart rate, tiredness and cold hands and feet.
- Being non-selective, it is generally avoided in people with asthma, as it can tighten the airways.
- Must not be stopped suddenly, as this can be dangerous for the heart.
Practical use
Good to know
A key safety point with nadolol is that it should never be stopped suddenly, because abruptly stopping a beta-blocker can cause the heart to race, worsen angina or, in some cases, trigger a heart attack; the dose is reduced gradually if it needs to be stopped. Because it is non-selective, it is generally avoided in people with asthma, as it can tighten the airways and cause wheezing. Common effects are a slow heart rate, tiredness, and cold hands and feet, and some people notice vivid dreams or low mood. It can also mask some of the warning signs of low blood sugar, which matters for people with diabetes. It is usually taken once a day, and your prescriber will check your heart rate and blood pressure to get the dose right.
Who should not take it / use with caution
- People with asthma or certain other breathing conditions should generally not take it, as it can tighten the airways.
- People with a very slow heart rate, certain heart-rhythm or heart-conduction problems, or uncontrolled heart failure should not take it.
- People who have had a serious allergic reaction to nadolol should not take it.
Monitoring
- Checking heart rate and blood pressure to get the dose right.
- Reviewing how well it controls blood pressure, angina or migraine.
- Watching for a very slow heart rate, breathing problems and tiredness.
Side effects
- A slow heart rate, tiredness and cold hands and feet.
- Dizziness, especially when standing up, and sometimes low mood or vivid dreams.
- Wheezing or breathlessness, particularly in people prone to asthma.
- It can mask some of the warning signs of low blood sugar in people with diabetes.
Key interactions
- It can add to the heart-slowing effects of other medicines, such as some that control heart rhythm or rate.
- Combining it with certain calcium-channel blockers can slow the heart too much, so this is done with care.
- Tell your prescriber about all your medicines, including those for diabetes and blood pressure.
Available as: Tablets taken by mouth.
Answers
Nadolol: frequently asked questions
What is nadolol used for?
It is a non-selective beta-blocker used for high blood pressure, for angina (chest pain from the heart), and to help prevent migraine attacks.
Can I stop taking it suddenly?
No, stopping a beta-blocker suddenly can be dangerous for the heart; the dose should be reduced gradually and only on your prescriber's advice.
Can I take it if I have asthma?
It is generally avoided in people with asthma because, being non-selective, it can tighten the airways and cause wheezing; tell your prescriber.
Why do I feel tired or have cold hands?
Tiredness and cold hands and feet are common with beta-blockers because they slow the heart and affect blood flow; tell your prescriber if troublesome.
Does it affect diabetes?
It can mask some of the warning signs of low blood sugar, so people with diabetes should be aware of this and monitor as advised.
The wider class
About Beta-blocker (non-selective)
Nadolol belongs to the beta-blocker (non-selective) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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