Beta blockers
A family of medicines that slow the heart and blunt the effects of adrenaline. Used for heart conditions, blood pressure, migraine and tremor.
Brand names
- Metoprolol (Betaloc, Lopresor, Minax), atenolol (Noten, Tenormin)
- Bisoprolol (Bicor), carvedilol (Dilatrend), nebivolol (Nebilet)
- Propranolol (Deralin, Inderal), sotalol (Sotacor), timolol eye drops, many generics
How it works
Beta blockers block beta receptors, which adrenaline acts on. This slows the heart, reduces how hard it pumps and lowers blood pressure, so the heart needs less oxygen. Some, like propranolol, also act elsewhere in the body.
Used for
- Angina, and after a heart attack
- Heart failure (bisoprolol, carvedilol, metoprolol slow-release, nebivolol)
- Heart rate control in atrial fibrillation and other fast rhythms
- High blood pressure (now rarely first choice)
- Preventing migraine; tremor (propranolol)
- Performance anxiety (propranolol; off-label); glaucoma (eye drops)
Side effects
How often, from the official product information (e.g. metoprolol). Bold = serious.
Very common more than 1 in 10
- Tiredness
- Drop in blood pressure, incl. on standing, sometimes with fainting
Common 1 in 10 to 1 in 100
- Dizziness or headache
- Slow heart rate
- Palpitations
- Cold hands and feet
- Short of breath on exertion
- Nausea, tummy pain, diarrhoea or constipation
Uncommon 1 in 100 to 1 in 1,000
- Low mood, poor concentration, nightmares
- Sleepiness or poor sleep, weight gain, pins and needles
- Worsening heart failure, heart block
- Chest pain
- Wheeze or asthma attack (bronchospasm)
- Vomiting, rash, sweating, cramps or swelling
Rare 1 in 1,000 to 1 in 10,000
- Nervousness, anxiety
- Vision changes, dry or sore eyes
- Heart rhythm disturbances
- Runny nose, dry mouth, hair loss
- Abnormal liver tests
- Unmasking of diabetes, sexual problems
Very rare fewer than 1 in 10,000
- Low platelets or white cells
- Memory problems, confusion or hallucinations
- Ringing in the ears, hearing problems
- Worse leg pain on walking or Raynaud’s
- Taste change, hepatitis, psoriasis flare
- Sun sensitivity, joint pain, weakness
Get help urgently if
- Wheeze or trouble breathing
- Fainting, a very slow pulse or chest pain
- Worsening breathlessness, swollen ankles or rapid weight gain
Good to know
- Don’t stop suddenly. This can trigger angina or a heart attack. Doses are reduced over 1 to 2 weeks.
- Usually avoided in asthma; used with care in COPD.
- Can hide signs of low blood sugar in diabetes. Verapamil and diltiazem add to the slowing.
- Some are used in pregnancy (e.g. labetalol). Discuss with your doctor.
- Take care driving until you know if it makes you tired or dizzy.
Information only. Not a recommendation or endorsement of any product. Whether a medicine suits you depends on your health and other medicines, so talk to your doctor or pharmacist. In an emergency, call 000.
More information
- Metoprolol tartrate 50 mg tablets summary of product characteristics (UK)
- NPS MedicineWise: Medicine Finder
maladywise.com/drugs/beta-blockers/