Nadolol

Class: beta-Adrenergic Blocking Agents
VA Class: CV100
CAS Number: 42200-33-9
Brands: Corgard, Corzide

Introduction

Nonselective β-adrenergic blocking agent.^{a b}

Uses for Nadolol

Hypertension

Management of hypertension, alone or in combination with other antihypertensive agents.^{a b}

One of several preferred initial therapies in hypertensive patients with heart failure, post-MI, high coronary disease risk, or diabetes mellitus.¹⁵³

Can be used as monotherapy for initial management of uncomplicated hypertension; however, thiazide diuretics are preferred by JNC VII.¹⁵³

Angina

Long-term prophylactic management of chronic stable angina.^{a b}

A component of standard therapeutic measures for management of unstable angina and non-ST-segment elevation myocardial infarction†.^a

Supraventricular Tachyarrhythmias

Has been used for management of frequent VPCs, paroxysmal atrial tachycardia, and sinus tachycardia and to decrease heart rate in patients with atrial flutter or fibrillation†.^a

Vascular Headache

Prophylaxis of migraine headache†.^{100 101 148}

US Headache Consortium states there is evidence of efficacy and clinical experience suggests clinically important improvement in most patients.¹⁴⁸

Nadolol Dosage and Administration

General

• 
  

  Individualize dosage according to patient response.^{a b}

  
  


• 
  

  If long-term therapy is discontinued, reduce dosage gradually over 1–2 weeks.^{a b} (See Abrupt Withdrawal of Therapy under Cautions.)

  
  

Hypertension

• 
  

  Careful monitoring of BP during initial titration or subsequent upward adjustment in dosage is recommended.^{119 153} Large or abrupt reductions in BP generally should be avoided.¹¹⁹

  
  


• 
  

  Adjust antihypertensive dosage at approximately monthly intervals (more aggressively in high-risk patients) if response is inadequate.^{119 153}

  
  


• 
  

  Nadolol/bendroflumethiazide fixed combination is not recommended for initial combination therapy; adjust initial and subsequent dosages by administering each drug separately.^{a 135}

  
  


• 
  

  Bendroflumethiazide in the fixed-combination preparation with nadolol is about 30% more bioavailable than the drug alone.^{a 135}

  
  

Angina

• 
  

  Wide variation in individual dosage requirements; carefully titrate dosage to achieve optimum results.^a

  
  


• 
  

  Periodically evaluate chronic therapy for angina to determine need for dosage alteration or continued therapy.^a

  
  

Administration

Oral Administration

Administer orally once daily without regard to meals.^{a b 135}

Dosage

Adults

Hypertension

Monotherapy

Oral

Initially, 20–40 mg daily.^a

May gradually increase by 40–80 mg daily at 2- to 14-day intervals until optimum BP response is achieved.^a

Manufacturers recommend usual maintenance dosage of 40–80 mg daily; dosages up to 240 or 320 mg daily may be needed.^{a b}

JNC 7 currently recommends 40–120 mg daily.¹⁵³ It usually is preferable to add another antihypertensive agent to the regimen than to continue increasing nadolol dosage; continued increases may not be tolerated.¹⁵⁷

Combination Therapy

Oral

Nadolol in fixed combination with bendroflumethiazide: Initially 40 mg of nadolol and 5 mg of bendroflumethiazide once daily.¹³⁵ If needed, increase to 80 mg of nadolol and 5 mg of bendroflumethiazide once daily.¹³⁵

If BP is not adequately controlled with the fixed combination alone, may gradually add another nondiuretic hypotensive agent, starting with 50% of the usual recommended starting dosage to avoid excessive reduction in BP.¹³⁵

Use of fixed-combination preparations initially and for subsequent dosage adjustment generally is not recommended.^{a 135} Adjust by administering each drug separately, then use the fixed combination if the optimum maintenance dosage corresponds to the ratio in the combination preparation.^a Administer separately for subsequent dosage adjustment.^a

Angina

Chronic Stable Angina

Oral

Initially, 40 mg daily.^a Gradually increase by 40–80 mg daily at 3- to 7-day intervals until optimum control of angina is obtained or there is pronounced slowing of the heart rate (i.e., <55 bpm).^{a b}

Usual maintenance dosage is 40 or 80 mg daily.^{a b} Up to 160 or 240 mg daily may be needed.^{a b}

Supraventricular Tachyarrhythmias†

Various Cardiac Arrhythmias†

Oral

Maintenance dose: 60–160 mg daily in single or divided doses has been used.^a

Vascular Headache†

Prevention of Migraine†

Oral

Usual effective dosage: 80–240 mg daily.¹⁴⁸

Prescribing Limits

Adults

Angina

Oral

Safety and efficacy of dosages >240 mg daily not established.^{a b}

Special Populations

Renal Impairment

Adjust intervals for usual dosage of nadolol alone or in fixed combination with bendroflumethiazide:^b

Clcr (mL/minute per 1.73 m2)	Dosage Interval
>50	24 h
31–50	24–36 h
10–30	24–48 h
<10	40–60 h

Cautions for Nadolol

Contraindications

• 
  

  Bronchial asthma.^{a b}

  
  


• 
  

  Sinus bradycardia and heart block greater than first degree.^{a b}

  
  


• 
  

  Cardiogenic shock.^{a b}

  
  


• 
  

  Overt cardiac failure.^{a b}

  
  

Warnings/Precautions

Warnings

Cardiac Failure

Possible precipitation of CHF.^{a b} Avoid use in patients with overt CHF;^{a b} may use cautiously in patients with inadequate myocardial function and, if necessary, in patients with well-compensated heart failure (e.g., those controlled with cardiac glycosides and/or diuretics).^{a b} Adequate treatment (e.g., with a cardiac glycoside and/or diuretic) and close observation recommended if signs or symptoms of impending cardiac failure occur; if cardiac failure continues, discontinue therapy, gradually if possible.^{a b}

Abrupt Withdrawal of Therapy

Abrupt withdrawal of nadolol not recommended as it may exacerbate angina symptoms or precipitate MI in patients with angina pectoris and/or CAD.^{a b} Avoid abrupt discontinuance, even when used only for hypertension.^{a b} Abrupt withdrawal may cause transient symptoms (e.g., tremulousness, sweating, palpitation, headache, malaise) in patients without CAD.^a Discontinue long-term therapy gradually (particularly in patients with myocardial ischemia); decrease dosage over 1–2 weeks and monitor carefully.^{a b} If exacerbation of angina occurs or acute coronary insufficiency develops, reinstitute therapy promptly, at least temporarily, and initiate appropriate measures for the management of unstable angina.^{a b}

Bronchospastic Disease

Possible inhibition of bronchodilation produced by endogenous or exogenous catecholamines;^{a b} use not recommended in patients with bronchial asthma.^b (See Contraindications under Cautions.) Generally, β-adrenergic blocking agents should not be used in patients with bronchospastic disease.^{a b} Use with caution in patients with a history of nonallergic bronchospasm (e.g., chronic bronchitis, emphysema).^{a b}

Major Surgery

Possible increased risks associated with general anesthesia (e.g., severe hypotension, difficulty restarting or maintaining heart beat) due to decreased ability of the heart to respond to reflex β-adrenergic stimuli.^{a b} Use with caution in major surgery involving general anesthesia; if possible, withdraw drug before surgery.^{a b} If nadolol is continued during surgery, inform the anesthesiologist.^{a b}

Diabetes and Hypoglycemia

Possible masked signs and symptoms of acute hypoglycemia (e.g., tachycardia and BP changes but not sweating), impaired glucose tolerance, delayed rate of recovery of blood glucose concentration following drug-induced hypoglycemia, altered hemodynamic response to hypoglycemia (possibly resulting in an exaggerated hypertensive response), and impaired peripheral circulation.^{a b}

Use with caution in patients with diabetes mellitus (especially those with labile diabetes or those prone to hypoglycemia).^{a b} If used with hypoglycemic agents, may need to adjust hypoglycemic agent dosage.^a

Thyrotoxicosis

Signs of hyperthyroidism (e.g., tachycardia) may be masked.^{a b} Possible thyroid storm if therapy is abruptly withdrawn; carefully monitor patients having or suspected of developing thyrotoxicosis.^{a b}

General Precautions

History of Anaphylactic Reactions

Possible increased reactivity to a variety of allergens; patients may be unresponsive to usual doses of epinephrine used to treat anaphylactic reactions.^{a b}

Other Precautions

Shares the toxic potentials of β-adrenergic blocking agents; observe usual precautions of these agents.^a In addition, when used in fixed-combination with bendroflumethiazide, consider the cautions, precautions, and contraindications associated with thiazide diuretics.^a

Specific Populations

Pregnancy

Category C.^{135 b}

Lactation

Distributed into milk.^{a b} Discontinue nursing or the drug.^{a b}

Pediatric Use

Safety and efficacy not established.^{a b}

Hepatic Impairment

Use with caution.^a

Renal Impairment

Use with caution.^b

Clearance may be decreased; dosage adjustments necessary depending on degree of renal impairment.^{a b} (See Renal Impairment under Dosage and Administration)

Common Adverse Effects

Bradycardia (heart rate <60 bpm), peripheral vascular insufficiency (usually Raynaud’s type), dizziness, fatigue.^a

Interactions for Nadolol

Specific Drugs

Drug	Interaction	Comments
Antidiabetic agents	Potential for altered antidiabetic responseb	Adjust antidiabetic agent dosage if neededb
Cardiovascular drugs (e.g., cardiac glycosides, nondihydropyridine calcium-channel blocking agents)	Possible additive negative effects on SA or AV nodal conduction116 117
Catecholamine-depleting drugs (e.g., reserpine)	Potential for additive effects (increased hypotension and marked bradycardia) a b	Monitor closely for symptoms (e.g., vertigo, syncope, postural hypotension)b
Diuretics	Possible increased hypotensive effecta	Careful dosage adjustments recommendeda
Drugs with anticholinergic effects	Potential for antagonism of cardiac β-adrenergic blocking effects
Hypotensive agents	Possible increased hypotensive effect a	Careful dosage adjustments recommendeda
Mibefradil (no longer commercially available in the US)	Slowing or complete suppression of SA node activity with development of slow ventricular rates116 117	Reported principally in geriatric patients with concomitant β-adrenergic blocker therapy116 117
Myocardial depressant general anesthetics	Increased risk of hypotension, myocardial depression, and heart failureb	See Major Surgery under Cautions
Neuromuscular blocking agents (e.g., tubocurarine chloride)	High doses of nadolol may increase effects of neuromuscular blocking agentsa
Phenothiazines	Possible additive hypotensive effect, especially when large phenothiazine doses are useda
Sympathomimetic agents (e.g., isopoterenol, epinephrine)	Possible antagonism of β-adrenergic stimulating effectsa	Administer epinephrine with caution; decreased pulse rate with first- and second-degree heart block and hypertension may occura Very large doses of isoproterenol may be needed to overcome β-adrenergic blocking effectsa

Nadolol Pharmacokinetics

Absorption

Bioavailability

Following oral administration, absorption is variable; averages about 30–40%.^{135 a b}

Duration

Following doses of 40–320 mg daily, duration of antihypertensive and antianginal effects is ≥24 hours.^a

Food

Food does not affect the rate or extent of absorption.^{a b}

Distribution

Extent

Widely distributed; minimal amounts detected in the brain of dogs.^a Distributed into bile.^a

Nadolol crosses the placenta in rats^a and is distributed into human milk.^b

Plasma Protein Binding

About 30%.^{135 a b}

Elimination

Metabolism

Not metabolized.^{a b}

Elimination Route

Excreted principally unchanged in feces (about 76.9%) and urine (about 24.6%) in 4 days.^a

Half-life

10–24 hours.^{135 a b}

Special Populations

Increased half-life in patients with renal impairment.^{a b} Removed by hemodialysis.^a

Stability

Storage

Oral

Tablets

Tight, light-resistant containers at room temperature.^{a b}

ActionsActions

• 
  

  Inhibits response to adrenergic stimuli by competitively blocking β₁-adrenergic receptors within the myocardium and β₂-adrenergic receptors within bronchial and vascular smooth muscle.^{a b}

  
  


• 
  

  Decreases resting heart rate, inhibits exercise-induced increases in heart rate, and decreases cardiac output at rest and during exercise.^a

  
  


• 
  

  Decreases AV node conduction velocity and decreases myocardial automaticity.^a

  
  


• 
  

  No intrinsic sympathomimetic activity, little direct myocardial depressant activity, and no membrane-stabilizing effect on the heart.^a

  
  


• 
  

  Reduces BP by blocking peripheral (especially cardiac) adrenergic receptors (decreasing cardiac output), by decreasing sympathetic outflow from the CNS, and/or by suppressing renin release.^a

  
  


• 
  

  Decreases BP in both supine and standing positions.^a

  
  


• 
  

  In patients with angina, blocks catecholamine-induced increases in heart rate, velocity and extent of myocardial contraction, and BP resulting in a net decrease in myocardial oxygen consumption.^a

  
  


• 
  

  May increase oxygen requirements by increasing left ventricular fiber length and end diastolic pressure in patients with heart failure.^a

  
  


• 
  

  Increases airway resistance (especially in asthmatic patients) and inhibits the release of free fatty acids and insulin.^a

  
  

Advice to Patients

• 
  

  Importance of taking exactly as prescribed.^a

  
  


• 
  

  Importance of not interrupting or discontinuing therapy without consulting clinician.^a

  
  


• 
  

  Importance of immediately informing clinician at the first sign or symptom of impending cardiac failure or if any difficulty in breathing occurs.^a

  
  


• 
  

  Importance of patient informing anesthesiologist or dentist about nadolol therapy before undergoing major surgery.^a

  
  


• 
  

  Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.^a

  
  


• 
  

  Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.^a

  
  


• 
  

  Importance of informing patients of other important precautionary information. (See Cautions.)

  
  

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Nadolol

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets	20 mg*	Corgard (scored)	Monarch
			Nadolol Tablets	Mylan, Teva, UDL
		40 mg*	Corgard (scored)	Monarch
			Nadolol Tablets	Mylan, Sandoz, Teva, UDL
		80 mg*	Corgard (with povidone; scored)	Monarch
			Nadolol Tablets	Mylan, Sandoz, Teva, UDL
		120 mg*	Corgard (with povidone; scored)	Monarch
			Nadolol Tablets	Teva
		160 mg*	Corgard (with povidone; scored)	Monarch
			Nadolol Tablets	Sandoz, Teva, UDL

Nadolol Combinations

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets	40 mg with Bendroflumethiazide 5 mg	Corzide (with povidone; scored)	Monarch
		80 mg with Bendroflumethiazide 5 mg	Corzide (with povidone; scored)	Monarch

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Corgard 20MG Tablets (KING PHARMA): 30/$93.99 or 90/$259.96

Corgard 40MG Tablets (KING PHARMA): 30/$109.99 or 90/$309.96

Corgard 80MG Tablets (KING PHARMA): 30/$129.99 or 90/$375.98

Corzide 40-5MG Tablets (KING PHARMA): 30/$109.99 or 90/$309.98

Corzide 80-5MG Tablets (KING PHARMA): 30/$119.99 or 90/$339.95

Nadolol 20MG Tablets (MYLAN): 30/$14.99 or 60/$19.97

Nadolol 40MG Tablets (MYLAN): 30/$15.99 or 90/$29.97

Nadolol 80MG Tablets (MYLAN): 30/$19.99 or 90/$39.97

Nadolol-Bendroflumethiazide 40-5MG Tablets (GLOBAL PHARMACEUTICAL CORP): 100/$219.99 or 300/$599.99

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions July 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

100. Ryan RE Sr, Ryan RE Jr, Sudilovsky A. Nadolol: its use in the prophylactic treatment of migraine. Headache. 1983; 23:26-31. [PubMed 6131052]

101. Ryan RE Sr. Comparative study of nadolol and propranolol in prophylactic treatment of migraine. Am Heart J. 1984; 108:1156-9. [IDIS 192098] [PubMed 6148878]

102. The Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The 1984 report of the joint national committee on detection, evaluation, and treatment of high blood pressure. Arch Intern Med. 1984; 144:1045-57. [IDIS 184763] [PubMed 6143542]

103. 1988 Joint National Committee. The 1988 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med. 1988; 148:1023-38. [IDIS 242588] [PubMed 3365073]

104. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Arch Intern Med. 1993; 153:154-83. [IDIS 309043] [PubMed 8422206]

105. Weber MA, Laragh JH. Hypertension: steps forward and steps backward: the Joint National Committee fifth report. Arch Intern Med. 1993; 153:149-52. [PubMed 8422205]

106. Collins R, Peto R, MacMahon S et al. Blood pressure, stroke, and coronary heart disease. Part 2, short-term reductions in blood pressure: an overview of randomized drug trials in their epidemiological context. Lancet. 1990; 335:827-38. [IDIS 264836] [PubMed 1969567]

107. Alderman MH. Which antihypertensive drugs first—and why! JAMA. 1992; 267:2786-7. Editorial.

108. MacMahon S, Peto R, Cutler J et al. Blood pressure, stroke, and coronary heart disease. Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990; 335:765-74. [PubMed 1969518]

109. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA. 1991; 265:3255-64. [IDIS 282107] [PubMed 2046107]

110. Dahlof B, Lindholm LH, Hansson L et al. Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-hypertension). Lancet. 1991; 338:1281-5. [IDIS 289158] [PubMed 1682683]

111. MRC Working Party. Medical Research Council trial of treatment of hypertension in older adults: principal results. BMJ. 1992; 304:405-12. [IDIS 292411] [PubMed 1445513]

112. National Heart, Lung, and Blood Institute. NHLBI panel reviews safety of calcium channel blockers. Rockville, MD; 1995 Aug 31. Press release.

113. National Heart, Lung, and Blood Institute. New analysis regarding the safety of calcium-channel blockers: a statement for health professionals from the National Heart, Lung, and Blood Institute. Rockville, MD; 1995 Sep 1.

114. Psaty BM, Heckbert SR, Koepsell TD et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. 1995; 274:620-5. [IDIS 352203] [PubMed 7637142]

115. Yusuf S. Calcium antagonists in coronary artery disease and hypertension: time for reevaluation? Circulation. 1995; 92:1079-82. Editorial.

116. Roche. Posicor (mibefradil hydrochloride) tablets prescribing information. Nutley, NJ; 1997 Dec.

117. Ellison RH. Dear doctor letter regarding appropriate use of Posicor. Nutley, NJ: Roche Laboratories; 1997 Dec.

118. Mylan Pharmaceuticals. Nadolol tablets prescribing information. Morgantown, WV; 1993 Nov.

119. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). Bethesda, MD: National Institutes of Health; 1997 Nov. (NIH publication No. 98-4080.)

120. Kaplan NM. Choice of initial therapy for hypertension. JAMA. 1996; 275:1577-80. [IDIS 365188] [PubMed 8622249]

121. Psaty BM, Smith NL, Siscovich DS et al. Health outcomes associated with antihypertensive therapies used as first-line agents: a systematic review and meta-analysis. JAMA. 1997; 277:739-45. [IDIS 380501] [PubMed 9042847]

122. American College of Cardiology and American Heart Association. ACC/AHA guidelines for the management of patients with acute myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). J Am Coll Cardiol. 1996; 28:1328-428. [IDIS 376249] [PubMed 8890834]

123. Whelton PK, Appel LJ, Espeland MA et al. for the TONE COllaborative Research Group. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA. 1998; 279:839-46. [PubMed 9515998]

124. American Diabetes Association. Clinical Practice Recommendations 2001. Position Statement. Diabetic nephropathy. Diabetes Care. 2001; 24(Suppl 1):S69-72.

125. Genuth S. United Kingdom prospective diabetes study results are in. J Fam Pract. 1998; 47:(Suppl 5):S27.

126. American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care. 2001; 24(Suppl 1):S33-43.

127. Watkins PJ. UKPDS: a message of hope and a need for change. Diabet Med. 1998; 15:895-6. [PubMed 9827842]

128. Bretzel RG, Voit K, Schatz H et al. The United Kingdom Prospective Diabetes Study (UKPDS): implications for the pharmacotherapy of type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes. 1998; 106:369-72. [PubMed 9831300]

129. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998; 317:703-13. [IDIS 412064] [PubMed 9732337]

130. American Diabetes Association. The United Kingdom Prospective Diabetes Study (UKPDS) for type 2 diabetes: what you need to know about the results of a long-term study. Washington, DC; 1998 Sep 15 from American Diabetes Association web site.

131. UK Prospective Diabetes Study Group. Efficacy of atenolol and captopril in reducing risk of macrovascular complications in type 2 diabetes: UKPDS 39. BMJ. 1998; 317:713-20. [IDIS 412065] [PubMed 9732338]

132. Davis TME. United Kingdom Prospective Diabetes Study: the end of the beginning? Med J Aust. 1998; 169:511-2.

133. American Diabetes Association. Clinical Practice Recommendations 1999. Position statement. Implications of the United Kingdom propective Diabetes Study. Diabetes Care. 1999; 22(Suppl 1):S27-31.

134. Anon. Consensus recommendations for the management of chronic heart failure. On behalf of the membership of the advisory council to improve outcomes nationwide in heart failure. Part II. Management of heart failure: apporaches to the prevention of heart failure. Am J Cardiol. 1999; 83:9A-38A.

135. Monarch. Corzide (40/5) and Corzide (80/5) (nadolol and bendroflumethazide) tablets prescribing information. Bristol, TN; 2001 Oct.

136. Lim PO, MacDonald TM. Antianginal and β-adrenergic blocking drugs. In: Dukes MNG, ed. Meyler’s side effects of drugs. 13th ed. New York: Elsevier/North Holland Inc; 1996:488-535.

137. Gress TW, Nieto FJ, Shahar E et al. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. N Engl J Med. 2000; 342:905-12. [IDIS 442916] [PubMed 10738048]

138. Sowers JR, Bakris GL. Antihypertensive therapy and the risk of type 2 diabetes mellitus. N Engl J Med. 2000; 342:969-70. [IDIS 442921] [PubMed 10738057]

139. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. 2000; 35:1021-4. [PubMed 10818056]

140. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. 2000; 35:1019-20. [PubMed 10818055]

141. Bakris GL, Williams M, Dworkin L et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000; 36:646-61. [IDIS 452007] [PubMed 10977801]

142. Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial Lancet. 1998; 351:1755-62.

143. American Diabetes Association. Treatment of hypertension in adults with diabetes. Diabetes Care. 2002; 25(Suppl. 1):S71-S73.

144. American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care. 2002; 25(Suppl 1):S33-43.

145. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Chronic Stable Angina). J Am Coll Cardiol. 1999; 33:2092-7.

146. Braunwald E, Antman EM, Beasley JW et al. ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina). 2002. Available from ACC website. Accessed Sep. 10, 2002.

147. Williams CL, Hayman LL, Daniels SR et al. Cardiovascular health in childhood: a statement for health professional from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2002; 106:143-60. [PubMed 12093785]

148. Ramadan NM, Silberstein SD, Freitag FG et al. Evidence-based guidelines for migraine headache in the primary care setting: pharmacological management for prevention of mirgaine. St. Paul, MN; 2001. From the American Academy of Neurology web site.

149. Ryan TJ, Antman EM, Brooks NH et al. ACC/AHA guidelines for the management of patients with acute myocardial infarction: 1999 update: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). From ACC website.

150. Antman EM, Fox KM et al. Guidelines for the diagnosis and management of unstable angina and non-Q-wave myocardial infarction: proposed revisions. Am Heart J. 2000; 139:461-75. [IDIS 444999] [PubMed 10689261]

151. Appel LJ. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002; 288:3039-42. [IDIS 490723] [PubMed 12479770]

152. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-riskhypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:2981-97. [IDIS 490721] [PubMed 12479763]

153. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) Express. Bethesda, MD: May 14 2003. From NIH website. (Also published in JAMA. 2003; 289.

154. Douglas JG, Bakris GL, Epstein M et al. Management of high blood pressure in African Americans: Consensus statement of the Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks. Arch Intern Med. 2003; 163:525-41.

155. American Diabetes Association. Treatment of hypertension in adults with diabetes. Diabetes Care. 2003; 26(Suppl 1):S80-2.

156. Guidelines Committee. 2003 European Society of Hypertension–European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertension. 2003; 21:1011-53.

157. Carter B for the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC). Personal communication.

160. Thadani U. Beta blockers in hypertension. Am J Cardiol. 1983; 52:10-5D.

161. Conolly ME, Kersting F, Dollery CT. The clinical pharmacology of beta-adrenoceptor-blocking drugs. Prog Cardiovasc Dis. 1976; 19:203-34. [PubMed 10600]

162. Shand DG. State-of-the-art: comparative pharmacology of the β-adrenoceptor blocking drugs. Drugs. 1983; 25(Suppl 2):92-9.

163. Breckenridge A. Which beta blocker? Br Med J. 1983; 286:1085-8. (IDIS 169422)

164. Anon. Choice of a beta-blocker. Med Lett Drugs Ther. 1986; 28:20-2. [PubMed 2869400]

165. Wallin JD, Shah SV. β-Adrenergic blocking agents in the treatment of hypertension: choices based on pharmacological properties and patient characteristics. Arch Intern Med. 1987; 147:654-9. [IDIS 227948] [PubMed 2881524]

166. McDevitt DG. β-Adrenoceptor blocking drugs and partial agonist activity: is it clinically relevant? Drugs. 1983; 25:331-8.

167. McDevitt DG. Clinical significance of cardioselectivity: state-of-the-art. Drugs. 1983; 25(Suppl 2):219-26.

168. Frishman WH. β-Adrenoceptor antagonists: new drugs and new indications. N Engl J Med. 1981; 305:500-6. [IDIS 136600] [PubMed 6114433]

169. Thadani U, Davidson C, Chir B et al. Comparison of the immediate effects of five β-adrenoceptor-blocking drugs with different ancillary properties in angina pectoris. N Engl J Med. 1979; 300:750-5. [PubMed 581782]

170. Lewis RV, McDevitt DG. Adverse reactions and interactions with β-adrenoceptor blocking drugs. Med Toxicol. 1986; 1:343-61. [IDIS 239050] [PubMed 2878346]

171. Frishman WH. Clinical differences between beta-adrenergic blocking agents: implications for therapeutic substitution. Am Heart J. 1987; 113:1190-8. [IDIS 229873] [PubMed 2883867]

a. AHFS Drug Information 2004. McEvoy GK, ed. Nadolol. Bethesda, MD: American Society of Health-System Pharmacists; 2004:1770-3 .

b. Monarch Pharmaceuticals. Corgard (nadolol) tablets prescribing information. Bristol, TN; 2001 Oct.

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