Using Beta Blocker Drugs

Beta-blockers are among the most commonly prescribed drugs in medical practice. They work by blocking the effect of epinephrine (adrenaline) on the tissues, specifically, by blocking the “beta receptors” that bind epinephrine. Among other things, blocking the beta receptors slows the heart rate, reduces the force of contraction of the heart muscle, reduces the amount of oxygen the heart muscle needs to do its work, reduces stress on the vascular system, and tends to lower the blood pressure.

When Are Beta-Blockers Used?

Given these effects, it is not surprising that beta-blockers have proven useful in treating a host of medical conditions, especially cardiovascular problems. These include:

• Angina
• Myocardial infarction (heart attacks)
• Congestive heart failure
• Cardiac arrhythmias, especially atrial fibrillation
• Aortic dissection
• Hypertrophic cardiomyopathy
• Migraine headaches
• Social anxiety disorders
• Hypertension
• Glaucoma 
• Benign essential tremor

Beta-blockers are the first line of therapy for people who have stable angina. In these people, beta-blockers slow the heart rate and reduce the force of contraction of the heart muscle. Both of these effects prevent or delay the onset of ischemia of the heart muscle, and thereby reduce the risk of having an attack of angina. 

For similar reasons, in the vast majority of cases, beta-blockers are an important part of treating a heart attack. These drugs reduce cardiac ischemia during the acute heart attack and help prevent future heart attacks.

They are also an important part of therapy for heart failure. These drugs greatly reduce the excess stress on the failing heart muscle and allow the heart to do more work with less energy expenditure. 

In people with atrial fibrillation, beta-blockers are a key component of achieving adequate control of the heart rate. 

Beta-blockers were among the early drugs of the modern era shown to be effective for treating for hypertension, and for many years were first-line drugs for this condition. However, in the past several years, studies have shown that many of the newer drugs for hypertension — in particular, thiazide diuretics, calcium channel blockers, ACE inhibitors, and ARB drugs — are more effective in controlling blood pressure and improving the outcomes of people with hypertension.

Commonly Used Beta-Blockers

Given the many uses of beta-blockers, it is perhaps not surprising that drug companies have developed quite a few of them. Here is a list of commonly used beta-blockers (generic name - trade name):

• Acebutolol - Sectral
• Atenolol - Tenormin
• Betaxolol - Kerlone
• Bisoprolol - Zebeta, also sold as Ziac
• Carteolol - Cartrol
• Carvedilol - Coreg
• Labetalol - Normodyne, also sold as Trandate
• Metoprolol - Lopressor, also sold as Toprol
• Nadolol - Corgard
• Penbutolol - Levatol
• Propranolol - Inderal, Inderal LA
• Timolol - Blocadren

How Beta Blockers Are Taken

There are obviously a lot of different beta-blockers available, and the specific instructions on how often and what time of day to take them will vary from drug to drug. However, as a general rule, the side effects of beta-blockers can usually be minimized by taking them with a meal, which causes these drugs to be absorbed more gradually.

Side Effects of Beta Blockers

The side effects of beta-blockers are related mainly to their underlying mechanism of action, that is, to their adrenaline-blocking effects.

In pregnant women, beta-blockers are avoided when possible, since they can affect the baby by causing a slow heart rate, reduced blood pressure, and lower blood sugar levels.

In general, the side effects of beta-blockers can often be managed by a careful choice of which beta-blocker is selected, and by attempting to use smaller doses.

A Word From Verywell

The beta-blockers have proven to be very useful in treating a variety of medical conditions, and as a consequence are commonly prescribed. While they can cause several side effects that can limit their usefulness, most of the time an appropriate drug and dosage can be found to allow people who would benefit from beta-blockers to take them.