Dosing & Uses
Dosage Forms & Strengths
tablet
- 20mg
- 40mg
- 80mg
Hypertension
40-320 mg PO qDay
Angina Pectoris
Initial 40 mg/day PO, increase gradually q 3-7Days
Doses up to 160-240mg qDay may be needed
SVT, Maintenance (Off-label)
60-160 mg/day PO
Aggressive Behavior; Upper GI Rebleed (Off-label)
40-160 mg/day PO
Migraine, Prophylaxis (Off-label)
40-80 mg PO qDay (up to 240 mg/day)
Renal Impairment
CrCl >50 mL/min: Administer qDay
CrCl 31-50 mL/min: Administer q24-36hr
CrCl 10-30 mL/min: Administer q24-48hr
CrCl <10 mL/min: Administer q40-60hr
Hepatic Impairment
Dose adjustments not listed in manufacturer’s label
Additional Information
Less effective than thiazide diuretics in black and geriatric patients
Shown to decrease mortality in hypertension and post-myocardial infarction
Other Indications & Uses
Off-label: Arrhythmias, GI bleed, hyperthyroidism, reduce IOP, SVT
Not approved
Hypertension
20-320 mg PO qDay
Angina Pectoris
Initial 20 mg/day PO, increase gradually q 3-7Days
Doses up to 160-240mg qDay may be needed
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (32)
- acebutolol
acebutolol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- atenolol
atenolol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- betaxolol
betaxolol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- bisoprolol
bisoprolol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- carvedilol
carvedilol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- celiprolol
celiprolol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- clonidine
clonidine, nadolol. Either increases toxicity of the other by unspecified interaction mechanism. Avoid or Use Alternate Drug. Can increase risk of bradycardia.
- digoxin
digoxin, nadolol. Either increases toxicity of the other by unspecified interaction mechanism. Avoid or Use Alternate Drug. Can increase risk of bradycardia.
- diltiazem
diltiazem, nadolol. Either increases toxicity of the other by unspecified interaction mechanism. Avoid or Use Alternate Drug. Can increase risk of bradycardia.
- epinephrine
nadolol increases effects of epinephrine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of hypertension and bradycardia. Consider selective beta 1 blocker (e.g., metoprolol).
- epinephrine racemic
nadolol increases effects of epinephrine racemic by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of hypertension and bradycardia. Consider selective beta 1 blocker (e.g., metoprolol).
- erdafitinib
erdafitinib will increase the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration unavoidable, separate administration by at least 6 hr before or after administration of P-gp substrates with narrow therapeutic index.
- esmolol
esmolol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- fexinidazole
fexinidazole, nadolol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to induce bradycardia. .
- iobenguane I 131
nadolol will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.
- labetalol
labetalol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- lofexidine
lofexidine, nadolol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.
- mavacamten
nadolol, mavacamten. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Expect additive negative inotropic effects of mavacamten and other drugs that reduce cardiac contractility.
- metoprolol
metoprolol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- nebivolol
nadolol and nebivolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- penbutolol
nadolol and penbutolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- pindolol
nadolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- propranolol
nadolol and propranolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- rivastigmine
nadolol increases toxicity of rivastigmine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive bradycardia effect may result in syncope.
- sotalol
nadolol and sotalol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- sotorasib
sotorasib will decrease the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If use is unavoidable, refer to the prescribing information of the P-gp substrate for dosage modifications.
- tepotinib
tepotinib will increase the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If concomitant use unavoidable, reduce the P-gp substrate dosage if recommended in its approved product labeling.
- timolol
nadolol and timolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- trilaciclib
trilaciclib will decrease the level or effect of nadolol by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of trilaciclib (OCT2, MATE1, and MATE-2K inhibitor) with substrates where minimal increased concentration in kidney or blood may lead to serious or life-threatening toxicities.
- umeclidinium bromide/vilanterol inhaled
nadolol, umeclidinium bromide/vilanterol inhaled. pharmacodynamic antagonism. Avoid or Use Alternate Drug. If a beta-blocker must be used in patients with COPD taking a beta-agonist, consider using a beta-blocker that is beta-1 selective .
- verapamil
verapamil, nadolol. Either increases toxicity of the other by unspecified interaction mechanism. Avoid or Use Alternate Drug. Can increase risk of bradycardia.
- vilanterol/fluticasone furoate inhaled
nadolol, vilanterol/fluticasone furoate inhaled. pharmacodynamic antagonism. Avoid or Use Alternate Drug. If a beta-blocker must be used in patients with COPD taking a beta-agonist, consider using a beta-blocker that is beta-1 selective .
Monitor Closely (207)
- acebutolol
acebutolol and nadolol both increase serum potassium. Use Caution/Monitor.
- aceclofenac
nadolol and aceclofenac both increase serum potassium. Use Caution/Monitor.
aceclofenac decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - acemetacin
nadolol and acemetacin both increase serum potassium. Use Caution/Monitor.
acemetacin decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - albuterol
nadolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - aldesleukin
aldesleukin increases effects of nadolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- alfuzosin
alfuzosin and nadolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- aluminum hydroxide
aluminum hydroxide decreases levels of nadolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- amifostine
amifostine, nadolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.
- amiloride
nadolol and amiloride both increase serum potassium. Modify Therapy/Monitor Closely.
- amiodarone
amiodarone, nadolol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of cardiotoxicity with bradycardia.
- amlodipine
nadolol and amlodipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- amobarbital
amobarbital decreases levels of nadolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of amobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- arformoterol
nadolol increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of arformoterol by pharmacodynamic antagonism. Use Caution/Monitor. - articaine
nadolol, articaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Increased effects of epinephrine in anesthetic; risk of hypertension and bradycardia. Do NOT D/C chronic beta blocker Tx prior to anesthetic administration. Consider selective beta 1 blocker (e.g., metoprolol).
- asenapine
asenapine and nadolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- aspirin
nadolol and aspirin both increase serum potassium. Use Caution/Monitor.
aspirin decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - aspirin rectal
nadolol and aspirin rectal both increase serum potassium. Use Caution/Monitor.
aspirin rectal decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
nadolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - atazanavir
atazanavir increases effects of nadolol by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypotension, bradycardia, AV block, and prolonged PR interval. Consider lowering beta blocker dose.
- atenolol
atenolol and nadolol both increase serum potassium. Use Caution/Monitor.
- avanafil
avanafil increases effects of nadolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- bendroflumethiazide
nadolol increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- berotralstat
berotralstat will increase the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor or titrate P-gp substrate dose if coadministered.
- betaxolol
betaxolol and nadolol both increase serum potassium. Use Caution/Monitor.
- bismuth subsalicylate
bismuth subsalicylate, nadolol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Blockage of renal prostaglandin synthesis; may cause severe hypertension.
- bisoprolol
bisoprolol and nadolol both increase serum potassium. Use Caution/Monitor.
- bosutinib
bosutinib increases levels of nadolol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- bretylium
nadolol, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.
- bumetanide
nadolol increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bupivacaine
nadolol, bupivacaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Use extreme caution during concomitant use of bupivacaine and antihypertensive agents.
- butabarbital
butabarbital decreases levels of nadolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butabarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- butalbital
butalbital decreases levels of nadolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butalbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- calcium acetate
calcium acetate decreases effects of nadolol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium carbonate
calcium carbonate decreases effects of nadolol by unspecified interaction mechanism. Use Caution/Monitor.
calcium carbonate decreases levels of nadolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours. - calcium chloride
calcium chloride decreases effects of nadolol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium citrate
calcium citrate decreases effects of nadolol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium gluconate
calcium gluconate decreases effects of nadolol by unspecified interaction mechanism. Use Caution/Monitor.
- candesartan
candesartan and nadolol both increase serum potassium. Use Caution/Monitor.
nadolol, candesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - carbenoxolone
nadolol increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbidopa
carbidopa increases effects of nadolol by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.
- carvedilol
carvedilol and nadolol both increase serum potassium. Use Caution/Monitor.
- celecoxib
nadolol and celecoxib both increase serum potassium. Use Caution/Monitor.
celecoxib decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - celiprolol
celiprolol and nadolol both increase serum potassium. Use Caution/Monitor.
- chloroprocaine
nadolol, chloroprocaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Increased effects of epinephrine in anesthetic; risk of hypertension and bradycardia. Do NOT D/C chronic beta blocker Tx prior to anesthetic administration. Consider selective beta 1 blocker (e.g., metoprolol).
- chlorothiazide
nadolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorpropamide
nadolol decreases effects of chlorpropamide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.
- chlorthalidone
nadolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- choline magnesium trisalicylate
nadolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
choline magnesium trisalicylate decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - clevidipine
nadolol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- clonidine
nadolol, clonidine. Mechanism: pharmacodynamic synergism. Modify Therapy/Monitor Closely. Non selective beta blocker administration during withdrawal from centrally acting alpha agonists may result in rebound hypertension.
- cyclopenthiazide
nadolol increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dasiglucagon
nadolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- desflurane
desflurane, nadolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- diclofenac
nadolol and diclofenac both increase serum potassium. Use Caution/Monitor.
diclofenac decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - diflunisal
nadolol and diflunisal both increase serum potassium. Use Caution/Monitor.
diflunisal decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - digoxin
nadolol and digoxin both increase serum potassium. Use Caution/Monitor.
nadolol increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Enhanced bradycardia. - diltiazem
nadolol and diltiazem both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- dobutamine
nadolol increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of dobutamine by pharmacodynamic antagonism. Use Caution/Monitor. - dopexamine
nadolol increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of dopexamine by pharmacodynamic antagonism. Use Caution/Monitor. - doxazosin
doxazosin and nadolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- drospirenone
nadolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.
- elagolix
elagolix will increase the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- eliglustat
eliglustat increases levels of nadolol by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect.
- ephedrine
nadolol increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of ephedrine by pharmacodynamic antagonism. Use Caution/Monitor. - epinephrine
nadolol increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of epinephrine by pharmacodynamic antagonism. Use Caution/Monitor. - epinephrine inhaled
nadolol decreases effects of epinephrine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. Beta2-adrenergic blockers may may inhibit bronchodilatory effects of epinephrine.
- epinephrine racemic
nadolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. - eprosartan
eprosartan and nadolol both increase serum potassium. Use Caution/Monitor.
nadolol, eprosartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - esmolol
esmolol and nadolol both increase serum potassium. Use Caution/Monitor.
- ethacrynic acid
nadolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ether
nadolol, ether. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both beta blockers and ether depress the myocardium; consider lowering beta blocker dose if ether used for anesthesia.
- etodolac
nadolol and etodolac both increase serum potassium. Use Caution/Monitor.
etodolac decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - etomidate
etomidate, nadolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- felodipine
nadolol and felodipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- fenbufen
nadolol and fenbufen both increase serum potassium. Use Caution/Monitor.
- fenoprofen
nadolol and fenoprofen both increase serum potassium. Use Caution/Monitor.
fenoprofen decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - fingolimod
nadolol increases effects of fingolimod by pharmacodynamic synergism. Use Caution/Monitor. Both medications decrease heart rate. Monitor patients on concomitant therapy, particularly in the first 6 hours after fingolimod is initiated or after a treatment interruption of at least two weeks, for bradycardia and atrioventricular block. To identify underlying risk factors of bradycardia and AV block, obtain a new or recent ECG in patients using beta-blockers prior to starting fingolimod.
- flurbiprofen
nadolol and flurbiprofen both increase serum potassium. Use Caution/Monitor.
flurbiprofen decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - formoterol
nadolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - fostamatinib
fostamatinib will increase the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Concomitant use of fostamatinib may increase concentrations of P-gp substrates. Monitor for toxicities of the P-gp substrate drug that may require dosage reduction when given concurrently with fostamatinib.
- furosemide
nadolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- gentamicin
nadolol increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- glecaprevir/pibrentasvir
glecaprevir/pibrentasvir will increase the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- glimepiride
nadolol decreases effects of glimepiride by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.
- glipizide
nadolol decreases effects of glipizide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.
- glucagon
glucagon decreases toxicity of nadolol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.
- glucagon intranasal
glucagon intranasal decreases toxicity of nadolol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.
- glyburide
nadolol decreases effects of glyburide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.
- guanfacine
nadolol, guanfacine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Non selective beta blocker administration during withdrawal from centrally acting alpha agonists may result in rebound hypertension.
- hydralazine
hydralazine increases effects of nadolol by pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects.
- hydrochlorothiazide
nadolol increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ibuprofen
nadolol and ibuprofen both increase serum potassium. Use Caution/Monitor.
ibuprofen decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ibuprofen IV
ibuprofen IV decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
nadolol and ibuprofen IV both increase serum potassium. Use Caution/Monitor. - indacaterol, inhaled
indacaterol, inhaled, nadolol. Other (see comment). Use Caution/Monitor. Comment: Beta-blockers and indacaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.
- indapamide
nadolol increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- indomethacin
nadolol and indomethacin both increase serum potassium. Use Caution/Monitor.
indomethacin decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - insulin aspart
nadolol, insulin aspart. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.
- insulin degludec
nadolol, insulin degludec. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- insulin degludec/insulin aspart
nadolol, insulin degludec/insulin aspart. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- insulin detemir
nadolol, insulin detemir. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.
- insulin glargine
nadolol, insulin glargine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.
- insulin glulisine
nadolol, insulin glulisine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.
- insulin inhaled
nadolol, insulin inhaled. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- insulin lispro
nadolol, insulin lispro. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.
- insulin NPH
nadolol, insulin NPH. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.
- insulin regular human
nadolol, insulin regular human. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.
- irbesartan
irbesartan and nadolol both increase serum potassium. Use Caution/Monitor.
nadolol, irbesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - isoproterenol
nadolol increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of isoproterenol by pharmacodynamic antagonism. Use Caution/Monitor. - isradipine
nadolol and isradipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- istradefylline
istradefylline will increase the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of P-gp substrates in clinical trials. Consider dose reduction of sensitive P-gp substrates.
- ivabradine
ivabradine, nadolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Most patients receiving ivabradine will also be treated with a beta-blocker. The risk of bradycardia increases with coadministration of drugs that slow heart rate (eg, digoxin, amiodarone, beta-blockers). Monitor heart rate in patients taking ivabradine with other negative chronotropes.
- ketamine
ketamine, nadolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- ketoprofen
nadolol and ketoprofen both increase serum potassium. Use Caution/Monitor.
ketoprofen decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ketorolac
nadolol and ketorolac both increase serum potassium. Use Caution/Monitor.
ketorolac decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ketorolac intranasal
nadolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - labetalol
labetalol and nadolol both increase serum potassium. Use Caution/Monitor.
- lasmiditan
nadolol increases effects of lasmiditan by pharmacodynamic synergism. Use Caution/Monitor. Lasmiditan has been associated with a lowering of heart rate (HR). In a drug interaction study, addition of a single 200-mg dose of lasmiditan to propranolol decreased HR by an additional 5 bpm compared to propranolol alone, for a mean maximum of 19 bpm.
- levalbuterol
nadolol increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of levalbuterol by pharmacodynamic antagonism. Use Caution/Monitor. - levodopa
levodopa increases effects of nadolol by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.
- lidocaine
nadolol, lidocaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Increased effects of epinephrine in anesthetic; risk of hypertension and bradycardia. Do NOT D/C chronic beta blocker Tx prior to anesthetic administration. Consider selective beta 1 blocker (e.g., metoprolol).
nadolol increases levels of lidocaine by decreasing elimination. Use Caution/Monitor. Risk of hypertension and bradycardia. Consider selective beta 1 blocker (e.g., metoprolol). - lomitapide
lomitapide increases levels of nadolol by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing dose when used concomitantly with lomitapide.
- lonafarnib
lonafarnib will increase the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Lonafarnib is a weak P-gp inhibitor. Monitor for adverse reactions if coadministered with P-gp substrates where minimal concentration changes may lead to serious or life-threatening toxicities. Reduce P-gp substrate dose if needed.
- lornoxicam
nadolol and lornoxicam both increase serum potassium. Use Caution/Monitor.
lornoxicam decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - losartan
losartan and nadolol both increase serum potassium. Use Caution/Monitor.
nadolol, losartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - lurasidone
lurasidone increases effects of nadolol by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.
- maraviroc
maraviroc, nadolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.
- meclofenamate
meclofenamate decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
nadolol and meclofenamate both increase serum potassium. Use Caution/Monitor. - mefenamic acid
nadolol and mefenamic acid both increase serum potassium. Use Caution/Monitor.
mefenamic acid decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - mefloquine
mefloquine increases levels of nadolol by decreasing metabolism. Use Caution/Monitor. Risk of arrhythmia.
- meloxicam
nadolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - mepivacaine
nadolol, mepivacaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Use extreme caution during concomitant use of bupivacaine and antihypertensive agents.
- metaproterenol
nadolol increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of metaproterenol by pharmacodynamic antagonism. Use Caution/Monitor. - methyclothiazide
nadolol increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- methyldopa
nadolol, methyldopa. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Non selective beta blocker administration during withdrawal from methyldopa may result in rebound hypertension.
- methylphenidate
methylphenidate will decrease the level or effect of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.
- metolazone
nadolol increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metoprolol
metoprolol and nadolol both increase serum potassium. Use Caution/Monitor.
- moxisylyte
moxisylyte and nadolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nabumetone
nadolol and nabumetone both increase serum potassium. Use Caution/Monitor.
nabumetone decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - naproxen
nadolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - nebivolol
nadolol and nebivolol both increase serum potassium. Use Caution/Monitor.
- nicardipine
nadolol and nicardipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nifedipine
nadolol and nifedipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nisoldipine
nadolol and nisoldipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nitroglycerin rectal
nitroglycerin rectal, nadolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Beta-blockers blunt the reflex tachycardia produced by nitroglycerin without preventing its hypotensive effects. If beta-blockers are used with nitroglycerin in patients with angina pectoris, additional hypotensive effects may occur.
- norepinephrine
nadolol increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of norepinephrine by pharmacodynamic antagonism. Use Caution/Monitor. - olmesartan
olmesartan and nadolol both increase serum potassium. Use Caution/Monitor.
nadolol, olmesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - olodaterol inhaled
nadolol, olodaterol inhaled. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor. Beta-blockers and olodaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.
- oxaprozin
nadolol and oxaprozin both increase serum potassium. Use Caution/Monitor.
oxaprozin decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - oxymetazoline intranasal
nadolol increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. When beta-2 receptors are antagonized by nonselective beta blockers, alpha1 vasoconstriction may be unopposed, thus increasing hypertensive effect. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use an alternant anesthetic in patients taking nonselective beta blockers.
- oxymetazoline topical
oxymetazoline topical increases and nadolol decreases sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- parecoxib
nadolol and parecoxib both increase serum potassium. Use Caution/Monitor.
parecoxib decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - penbutolol
nadolol and penbutolol both increase serum potassium. Use Caution/Monitor.
- pentobarbital
pentobarbital decreases levels of nadolol by increasing metabolism. Use Caution/Monitor. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- phenobarbital
phenobarbital decreases levels of nadolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of phenobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- phenoxybenzamine
phenoxybenzamine and nadolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- phentolamine
phentolamine and nadolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- phenylephrine
nadolol increases effects of phenylephrine by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode (rare).
- phenylephrine PO
nadolol increases effects of phenylephrine PO by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode (rare).
- pindolol
nadolol and pindolol both increase serum potassium. Use Caution/Monitor.
- pirbuterol
nadolol increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of pirbuterol by pharmacodynamic antagonism. Use Caution/Monitor. - piroxicam
nadolol and piroxicam both increase serum potassium. Use Caution/Monitor.
piroxicam decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ponesimod
ponesimod and nadolol both increase pharmacodynamic synergism. Use Caution/Monitor. Beta-blockers may have additive effects on lowering HR. Consider resting HR before initiating ponesimod in patients on stable dose of beta-blocker. Refer to the ponesimod prescribing information for more dosing information.
- potassium acid phosphate
nadolol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium chloride
nadolol and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium citrate
nadolol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- prazosin
prazosin and nadolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- prilocaine
nadolol, prilocaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Use extreme caution during concomitant use of bupivacaine and antihypertensive agents.
- primidone
primidone decreases levels of nadolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of primidone. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- propofol
propofol, nadolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- propranolol
nadolol and propranolol both increase serum potassium. Use Caution/Monitor.
- ropivacaine
nadolol, ropivacaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Use extreme caution during concomitant use of bupivacaine and antihypertensive agents.
- sacubitril/valsartan
sacubitril/valsartan and nadolol both increase serum potassium. Use Caution/Monitor.
nadolol, sacubitril/valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - salicylates (non-asa)
nadolol and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor.
salicylates (non-asa) decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - salmeterol
nadolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. - salsalate
nadolol and salsalate both increase serum potassium. Use Caution/Monitor.
salsalate decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - saquinavir
saquinavir, nadolol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Use alternatives if available. Increased risk of PR prolongation and cardiac arrhythmias.
- sarecycline
sarecycline will increase the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor for toxicities of P-gp substrates that may require dosage reduction when coadministered with P-gp inhibitors.
- secobarbital
secobarbital decreases levels of nadolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of secobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- sevoflurane
sevoflurane, nadolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- silodosin
silodosin and nadolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- siponimod
siponimod, nadolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Caution when siponimod is initiated in patients receiving beta-blocker treatment because of additive effects on lowering heart rate. Temporary interruption of beta-blocker may be needed before initiating siponimod. Beta-blocker treatment can be initiated in patients receiving stable doses of siponimod.
- sodium bicarbonate
sodium bicarbonate decreases levels of nadolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- sodium citrate/citric acid
sodium citrate/citric acid decreases levels of nadolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- sotalol
nadolol and sotalol both increase serum potassium. Use Caution/Monitor.
- spironolactone
nadolol and spironolactone both increase serum potassium. Modify Therapy/Monitor Closely.
- stiripentol
stiripentol will increase the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.
- succinylcholine
nadolol and succinylcholine both increase serum potassium. Use Caution/Monitor.
- sulfasalazine
nadolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.
sulfasalazine decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - sulindac
nadolol and sulindac both increase serum potassium. Use Caution/Monitor.
sulindac decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tadalafil
tadalafil increases effects of nadolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- telmisartan
telmisartan and nadolol both increase serum potassium. Use Caution/Monitor.
nadolol, telmisartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - terazosin
terazosin and nadolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- terbutaline
nadolol increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of terbutaline by pharmacodynamic antagonism. Use Caution/Monitor. - theophylline
nadolol, theophylline. Other (see comment). Use Caution/Monitor. Comment: Beta blockers (esp. non selective) antagonize theophylline effects, while at the same time increasing theophylline levels and toxicity (mechanism: decreased theophylline metabolism). Smoking increases risk of interaction.
- timolol
nadolol and timolol both increase serum potassium. Use Caution/Monitor.
- tolazamide
nadolol decreases effects of tolazamide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.
- tolbutamide
nadolol decreases effects of tolbutamide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.
- tolfenamic acid
nadolol and tolfenamic acid both increase serum potassium. Use Caution/Monitor.
tolfenamic acid decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tolmetin
nadolol and tolmetin both increase serum potassium. Use Caution/Monitor.
tolmetin decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tolvaptan
nadolol and tolvaptan both increase serum potassium. Use Caution/Monitor.
- torsemide
nadolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- triamterene
nadolol and triamterene both increase serum potassium. Modify Therapy/Monitor Closely.
- tucatinib
tucatinib will increase the level or effect of nadolol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities.
- valsartan
valsartan and nadolol both increase serum potassium. Use Caution/Monitor.
nadolol, valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - verapamil
nadolol and verapamil both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- xipamide
xipamide increases effects of nadolol by pharmacodynamic synergism. Use Caution/Monitor.
Minor (28)
- adenosine
nadolol, adenosine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Bradycardia.
- agrimony
agrimony increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- brimonidine
brimonidine increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- cevimeline
cevimeline increases effects of nadolol by unspecified interaction mechanism. Minor/Significance Unknown.
- ciprofloxacin
ciprofloxacin increases levels of nadolol by decreasing metabolism. Minor/Significance Unknown.
- cocaine
nadolol increases effects of cocaine by pharmacodynamic synergism. Minor/Significance Unknown. Risk of angina.
- cornsilk
cornsilk increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- dihydroergotamine
dihydroergotamine, nadolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.
- dihydroergotamine intranasal
dihydroergotamine intranasal, nadolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.
- dipyridamole
dipyridamole, nadolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of bradycardia.
- escitalopram
escitalopram increases levels of nadolol by decreasing metabolism. Minor/Significance Unknown.
- fenoldopam
fenoldopam increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
- forskolin
forskolin increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- imaging agents (gadolinium)
nadolol, imaging agents (gadolinium). Mechanism: unknown. Minor/Significance Unknown. Increased risk of anaphylaxis from contrast media.
- levobetaxolol
levobetaxolol increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- maitake
maitake increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- melatonin
melatonin decreases toxicity of nadolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.
- metipranolol ophthalmic
metipranolol ophthalmic increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- neostigmine
nadolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- noni juice
nadolol and noni juice both increase serum potassium. Minor/Significance Unknown.
- octacosanol
octacosanol increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- physostigmine
nadolol, physostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- pilocarpine
pilocarpine increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- reishi
reishi increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- shepherd's purse
shepherd's purse, nadolol. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.
- tizanidine
tizanidine increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.
- treprostinil
treprostinil increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- yohimbe
nadolol decreases toxicity of yohimbe by pharmacodynamic antagonism. Minor/Significance Unknown.
Adverse Effects
>10%
Drowsiness
Insomnia
Decreased sexual ability
1-10%
Bradycardia (2%)
Dizziness (2%)
Fatigue (2%)
Hypotension (1%)
<1%
Abdominal discomfort
Constipation
Diarrhea
Nausea
Cough
Nasal congestion
Frequency Not Defined
Bronchospasm, depression, decreased exercise tolerance, Raynaud's phenomenon
May increase triglyceride levels and insulin resistance, and decrease HDL levels
Warnings
Black Box Warnings
May exacerbate ischemic heart disease following abrupt withdrawal
Hypersensitivity to catecholamines has been observed during withdrawal
Exacerbation of angina and, in some cases, myocardial infarction occurrence after abrupt discontinuation
When discontinuing chronically administered beta-blockers (particularly with ischemic heart disease) gradually reduce dose over 1-2 wk and carefully monitor
If angina markedly worsens or acute coronary insufficiency develops, reinstate beta-blocker administration promptly, at least temporarily (in addition to other measures appropriate for unstable angina)
Warn patients against interruption or discontinuation of beta-blocker without physician advice
Because coronary artery disease is common and may be unrecognized, slowly discontinue beta-blocker therapy, even in patients treated only for hypertension
Contraindications
Hypersensitivity
2°/3° heart block
Bronchial asthma
Sinus bradycardia
Cardiogenic shock
Overt cardiac failure
Cautions
Anesthesia/surgery (myocardial depression); chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery, however the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures
Use caution in cerebrovascular insufficiency, well-compensated CHF, liver disease, renal impairment, peripheral vascular disease
Use caution in nonallergic bronchospasm; may block bronchodilation produced by endogenous or exogenous catecholamine stimulation of beta receptors
Beta-adrenergic blockade may prevent appearance of premonitory signs and symptoms (eg, tachycardia and blood pressure changes) of acute hypoglycemia; this is especially important with labile diabetics; beta-blockade also reduces release of insulin in response to hyperglycemia; dose adjustment of antidiabetic drugs may be necessary
Beta-adrenergic blockade may mask certain clinical signs (eg, tachycardia) of hyperthyroidism; patients suspected of developing thyrotoxicosis should be managed carefully to avoid abrupt withdrawal of beta-adrenergic blockade which might precipitate thyroid storm
Adequate alpha-blockade required prior to administering beta-blockade in untreated pheochromocytoma
Cardiac Failure
- Sympathetic stimulation may be a vital component supporting circulatory function in patients with congestive heart failure
- Inhibition by beta-blockade may precipitate more severe failure; although beta-blockers should be avoided in overt congestive heart failure, if necessary, may use with caution in patients with history of failure who are well-compensated, usually with digitalis and diuretics
- Beta-adrenergic blocking agents do not abolish inotropic action of digitalis on heart muscle
- In patients without a history of heart failure, continued use of beta-blockers can, in some cases, lead to cardiac failure
- At the first sign or symptom of heart failure, such patient should be digitalized and/or treated with diuretics, and response observed closely, or nadolol should be discontinued (gradually, if possible)
Exacerbation of Ischemic Heart Disease Following Abrupt Withdrawal
- Hypersensitivity to catecholamines has been observed in patients withdrawn from beta-blocker therapy
- Exacerbation of angina and, in some cases, myocardial infarction have occurred after abrupt discontinuation of therapy
- Gradually reduce dose when discontinuing chronically administered nadolol, particularly in patients with ischemic heart disease, over a period of one to two weeks; patient should be carefully monitored
- If angina markedly worsens or acute coronary insufficiency develops, nadolol administration should be reinstituted promptly, at least temporarily, and other measures appropriate for management of unstable angina should be taken
- Patients should be warned against interruption or discontinuation of therapy without physician's advice
- Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue nadolol therapy abruptly even in patients treated only for hypertension
Pregnancy & Lactation
Pregnancy Category: C
Lactation: concentrated in breast milk, use caution (AAP Committee states compatible w/ nursing)
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Blocks response to beta-adrenergic stimulation to beta1 and beta2 receptors; may reduce portal pressure through beta2 receptor, which reduces portal blood flow
Pharmacokinetics
Half-Life: 10-24 hr
Onset: 3-4 hr
Duration: 17-24 hr
Vd: 1.9 L/kg (1.88-2.02 L/kg)
Peak Plasma Time: 2-4 hr
Bioavailability: 20-40%
Protein Bound: 28-30%
Metabolism: None
Excretion: Urine
Dialyzable: Yes (HD)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| nadolol oral - | 20 mg tablet |  | |
| nadolol oral - | 40 mg tablet |  | |
| nadolol oral - | 40 mg tablet |  | |
| nadolol oral - | 20 mg tablet |  | |
| nadolol oral - | 80 mg tablet |  | |
| nadolol oral - | 80 mg tablet |  | |
| nadolol oral - | 40 mg tablet |  | |
| nadolol oral - | 40 mg tablet |  | |
| nadolol oral - | 80 mg tablet |  | |
| nadolol oral - | 40 mg tablet |  | |
| nadolol oral - | 20 mg tablet |  | |
| nadolol oral - | 80 mg tablet |  | |
| nadolol oral - | 20 mg tablet |  | |
| nadolol oral - | 40 mg tablet |  | |
| nadolol oral - | 40 mg tablet |  | |
| nadolol oral - | 80 mg tablet |  | |
| nadolol oral - | 20 mg tablet |  | |
| nadolol oral - | 20 mg tablet |  | |
| nadolol oral - | 40 mg tablet |  | |
| nadolol oral - | 20 mg tablet |  | |
| nadolol oral - | 80 mg tablet |  | |
| nadolol oral - | 20 mg tablet |  | |
| nadolol oral - | 80 mg tablet |  | |
| nadolol oral - | 20 mg tablet |  | |
| nadolol oral - | 80 mg tablet |  | |
| nadolol oral - | 40 mg tablet |  | |
| nadolol oral - | 80 mg tablet |  | |
| Corgard oral - | 40 mg tablet |  | |
| Corgard oral - | 20 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
nadolol oral
NADOLOL - ORAL
(NAY-doe-lol)
COMMON BRAND NAME(S): Corgard
WARNING: If you have chest pain (angina) or heart disease (such as coronary artery disease, ischemic heart disease, high blood pressure), do not stop using this drug without first consulting your doctor. Your condition may become worse when the drug is suddenly stopped. If your doctor decides you should no longer use this drug, you must gradually decrease your dose according to your doctor's instructions.When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease work for the heart. Seek immediate medical attention if you develop worsening chest pain, tightness/pressure in the chest, chest pain spreading to the jaw/neck/arm, sweating, trouble breathing, or fast/irregular heartbeat.
USES: Nadolol is used alone or with other medications to treat high blood pressure (hypertension) and to prevent chest pain (angina). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. In the management of chest pain, nadolol may also help to reduce the frequency of chest pain episodes and improve your ability to exercise.Nadolol belongs to a class of medications called beta blockers. It works by blocking the action of certain natural substances such as adrenaline (epinephrine) on the heart and blood vessels. This results in a lowering of heart rate, blood pressure, and strain on the heart.
HOW TO USE: See also the Warning section.Take this medication by mouth with or without food, usually once daily or as directed by your doctor. Your dosage is based on your medical condition and response to therapy.Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day. This medication treats, but does not cure, high blood pressure. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.Do not stop taking this medication without consulting your doctor. Your condition may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.Inform your doctor if your condition lasts or gets worse (for example, if your routine blood pressure readings increase).
SIDE EFFECTS: Dizziness, drowsiness, weakness, and cough may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: bluish color of the fingers/toes/nails, hair loss (reversible), mental/mood changes (such as depression, confusion, memory problems), numbness/tingling, decreased sexual ability, vision changes, wheezing, new or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).Get medical help right away if you have any very serious side effects, including: slow/irregular/fast heartbeat, severe dizziness/fainting.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking nadolol, tell your doctor or pharmacist if you are allergic to it; or to other beta blockers (such as atenolol, propranolol); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain types of heart rhythm problems (such as a slow heartbeat, second- or third-degree atrioventricular block), blood circulation problems (such as Raynaud's disease, peripheral vascular disease), breathing problems (such as asthma, chronic bronchitis, emphysema), heart failure, kidney disease, mental/mood disorders (such as depression), a certain muscle disease (myasthenia gravis), skin conditions (such as atopy, psoriasis), overactive thyroid disease (hyperthyroidism), a certain type of tumor (pheochromocytoma).This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).If you have diabetes, this product may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of low blood sugar level, such as dizziness and sweating, are not affected by this drug. This product may also make it harder to control your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Children may be at greater risk for low blood sugar (hypoglycemia), especially if they are vomiting or not eating regularly. To help prevent low blood sugar, feed children on a regular schedule. If your child cannot eat regularly, is vomiting, or has symptoms of low blood sugar (such as sweating, seizures), stop this medication and tell the doctor right away.Older adults may be at a greater risk for side effects such as dizziness while using this drug.During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor.This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: alpha blockers (such as prazosin), arbutamine, other beta blockers (such as atenolol), clonidine, epinephrine, fenoldopam, fingolimod, methyldopa, neuromuscular blocking agents (such as tubocurarine), "water pills" (including diuretics such as furosemide).Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: very slow heartbeat, severe dizziness/fainting, loss of consciousness, severe weakness, shortness of breath.
NOTES: Do not share this medication with others.Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Laboratory and/or medical tests (such as blood pressure, kidney function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.Have your blood pressure and pulse checked regularly while taking this medication. It may be best to learn how to monitor your own blood pressure and pulse.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised February 2022. Copyright(c) 2022 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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