Nadolol, sold under the brand name Corgard among others, is a medication used to treat hypertension, angina pectoris, atrial fibrillation, and some Channelopathy.[ It has also been used to prevent Migraine and complications of cirrhosis.]
Common side effects include dizziness, feeling tired, a slow heart rate, and Raynaud syndrome.[ Serious side effects may include heart failure and bronchospasm.][ Its use in pregnancy and breastfeeding is of unclear safety.]
Nadolol was patented in 1970 and came into medical use in 1978.[ In 2020, it was the 340th most commonly prescribed medication in the United States, with more than 700thousand prescriptions.]
Medical uses
Nadolol is used to treat hypertension and for long-term treatment of angina pectoris and is approved by the FDA for these purposes.[Nadolol entry in AccessMedicine. McGraw-Hill Global Education Holdings, LLC. Accessed 8 November 2014]
It is regularly used off-label[ for control of heart rate in people with atrial fibrillation,][ and to treat people with high levels of thyroid hormone.]
Nadolol is the preferred beta-blockers in the management of patients with LQTS for prevention of ventricular arrhythmia. It is more efficacious than selective beta blockers or propranolol in the prevention of breakthrough cardiac events.
Nadolol has the advantage of once daily dosing and thus improved patient compliance. For patients with decreased kidney function, nadolol may be dosed less often.[U.S. National Library of Medicine Nadolol entry in Medline Plus] but neither is well established.
Contraindications
Nadolol and other beta blockers should be used with cautions in people with heart failure and its use should not be abruptly stopped. It is contraindicated for people with asthma, a bradycardia and certain severe heart problems.
Side effects
The most common side effects include dizziness and fatigue.[
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Pharmacology
Pharmacodynamics
Nadolol is a non-selective beta blocker; that is, it non-selectively blocks both beta-1 and beta-2 receptors. It has a preference for beta-1 receptors, which are predominantly located in the heart, thereby inhibiting the effects of and causing a decrease in heart rate and blood pressure. Its inhibition of beta-2 receptors, which are mainly located in the bronchus smooth muscle of the , leads to airway constriction similar to that seen in asthma. Inhibition of beta-1 receptors in the juxtaglomerular apparatus of the kidney inhibits the renin–angiotensin system, causing a decrease in vasoconstriction and a decrease in water retention. Nadolol's inhibition of beta-1 receptors in the heart and kidney leads to its effects on lowering blood pressure.
The drug impairs AV node conduction and decreases sinoatrial node rate.
Nadolol may also increase blood plasma and decrease HDL-cholesterol levels.
Pharmacokinetics
Nadolol is classified as a beta blocker with low lipophilicity and hence lower potential for crossing the blood–brain barrier.
Chemistry
Nadolol is a mixture of . It is polar and Hydrophile, with low lipid solubility.
History
Nadolol was in 1970 and came into medical use in 1978.
External links
