Beta-blocking drugs are a category of prescription medicines that work primarily by blocking the β-type receptors for the hormones adrenaline and norepinephrine (beta-adrenergic types 1, 2 and 3) and significantly reducing the strength of contraction and heart rate. Due to their specific action on the heart, these drugs are particularly used in the therapy of some cardiovascular diseases including:
- high pressure (arterial hypertension), also in combination with other drugs
- chest pain (angina pectoris) caused by the narrowing of the coronary arteries that supply the heart
- inability of the heart to pump sufficient blood in the arteries (heart failure)
- irregular heartbeat (arrhythmias, atrial fibrillation)
- secondary prevention of myocardial infarction
Less commonly, beta blockers are used to prevent migraines or to treat:
- hyperactivity of the thyroid gland (hyperthyroidism)
- states of anxiety
- glaucoma, in this case in the form of eye drops
There are different types of beta blocker drugs and each one possesses different characteristics which makes it more suitable for treating certain diseases rather than others. For cardiovascular diseases, those selective for β1 adrenergic receptors are particularly suitable, although non-specific beta-blockers are also available on the market that interact with both β1 and β2 receptors.
A subdivision of the most commonly used beta-blockers is made precisely on the basis of their specificity for the β1 and β2 adrenergic receptors:
- propranolol, nadolol and timolol, considered first generation drugs, non-selective for β1 receptors and capable of interacting also with β2 receptors
- atenolol, metoprolol and bisoprolol, second generation beta blockers, which act preferentially by blocking the β1 receptors in the heart but at high doses can also interact with the β2 receptors
- carvedilol, labetalol, celiprolol and nebivolol, considered third generation drugs, especially specific for β1 receptors
People receiving a prescription for beta blockers should tell their doctor of any other illnesses they suffer from as it is not recommended to take them in some conditions. They include:
- asthma or any other lung disease
- heart disease
- kidney disease
- diabetes, especially if hypoglycemic episodes often occur
- allergic reaction to any drug
If you are being treated with beta-blockers, it is important not to stop taking them without consulting your doctor in order not to aggravate the disease for which they were prescribed.
Your doctor can tell you which drug to use during pregnancy or breastfeeding.
Interactions with other drugs
Beta-blockers, including those in the form of eye drops, can interact with other drugs, altering their effects. Before taking them, therefore, it is advisable to carefully read the package leaflet contained in the package to check that the use of the beta-blocker is not contraindicated. If you are unsure, you should consult your doctor.
Side effects of beta blockers
Most people who take beta-blocker drugs usually have no side effects (side effects); in some cases, slight disturbances may occur which lessen with continued treatment. It is a good idea, however, to contact your doctor immediately if you experience any problems after taking the beta-blocker. In this way, your doctor will be able to check whether these problems are due to the use of the drug and will be able to advise you on what to do.
In case you experience tiredness or vision problems, you should avoid driving a vehicle.
The most commonly reported disorders (symptoms) in clinical studies on the effects of beta-blockers are:
- blurred vision
- cold hands and feet
- slow heartbeat
- diarrhea and nausea
Less common disorders (symptoms) include:
- sleep disorders (insomnia)
- decreased sexual desire (decreased libido)
- problems getting or maintaining an erection (impotence)
Detailed information on possible side effects can be found in the package leaflet of each medicine.
Missed administration or overdose (overdose)
If you accidentally take a higher dose of beta-blockers than prescribed, you should contact your doctor or the emergency room to find out what to do. Most beta-blockers are taken in a single daily dose, excluding some types used during pregnancy and the sotalol which is administered two or three times a day.
If you forget to take a dose you need to check the package leaflet that came with the medicine to see what to do in this situation. Do not double the dose to make up for a forgotten dose. Your doctor or pharmacist can provide further guidance.
For more information on the active ingredients named in the contribution or in any case belonging to this class of drugs, you can visit the website of the Italian Medicines Agency (AIFA). To search for a drug using the trade name and not the active ingredient, you can consult the AIFA Medicines Database. Inside the site you can find all the package leaflets of the drugs and also some additional information. If "revoked" is written next to the name of the drug, the drug is no longer on the market.In-depth link
NHS Choices. Beta-blockers (English)