Nadolol
CORGARD
What it isLong-acting beta blocker; hypertension, angina, and variceal-bleeding prophylaxis.
Why this oneIts renal clearance and long action distinguish it from hepatically cleared beta blockers used in portal hypertension.
What limits itRenal impairment causes accumulation; bradycardia and abrupt withdrawal are the key prescribing hazards.
FDA-approved for
- hypertension/angina (1979)
Off-label
- portal hypertension
- essential tremor
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Angina pectoris | adult | 40 mg QD | 40–80 mg QD | 240 mg/day |
| Hypertension | adult | 40 mg QD | 40–80 mg QD | 320 mg/day |
Titration Angina: increase in 40–80 mg increments at 3–7 day intervals
Renal Dose interval by CrCl (mL/min/1.73m²): >50 → q24h; 31–50 → q24–36h; 10–30 → q24–48h; <10 → q40–60h
Hepatic Undefined
Instructions
- May be taken without regard to meals
- When discontinuing, reduce dose gradually over 1–2 weeks
Contraindications
- Bronchial asthma
- Sinus bradycardia and greater than first-degree conduction block
- Cardiogenic shock
- Overt cardiac failure
Cautions
- Abrupt withdrawal exacerbates ischemic heart disease
- Bradycardia and AV block
- Bronchospasm
- May mask hypoglycemia/hyperthyroidism
- Cardiac failure
Adverse reactions
- Bradycardia
- Fatigue/dizziness
- Peripheral vascular insufficiency (Raynaud-type)
- Cardiac failure
- Hypotension
- Bronchospasm
Pregnancy Use only if benefit justifies risk; neonatal bradycardia and hypoglycemia reported
Lactation Undefined
NO BOXED WARNINGS
Principal riskBradycardia; accumulates in CKD
Cost, est. cash$5–$150/month
Generic entry1993
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityBradycardia, hypotension and bronchospasm; overdose may cause conduction block or cardiogenic shock.
Mechanism of action: Nadolol ballicule
Open Nadolol in the interactive console ↗
Memory aids: mascots and interaction avatars
LOL hat → beta blocker
