Precautions and Warnings With Nadolol
There are many precautions and warnings with nadolol that you should be aware of before starting the medicine. It is important to talk to your healthcare provider before using nadolol if you have asthma, heart failure, or hyperthyroidism (as the medication can worsen these conditions). You should avoid taking nadolol altogether if you have cardiogenic shock, bradycardia, or second- or third-degree heart block.
- Chronic obstructive pulmonary disease (COPD)
- Kidney disease, such as kidney failure (renal failure)
- Heart failure
- A slow heart rate (bradycardia)
- Heart block
- An upcoming surgery
- Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Some warnings and precautions to be aware of prior to taking nadolol include the following:
- As with all beta blockers, you should not abruptly stop taking nadolol, as serious problems (including heart attacks) may result. Your healthcare provider will advise you about how to safely stop taking this medication. It is usually recommended to slowly reduce the dose over a period of one to two weeks, with careful monitoring, and to minimize physical activity during this time. Let your healthcare provider know if you develop chest pain or any other problems while stopping nadolol.
- Beta blockers can worsen breathing problems like asthma or COPD. If you have breathing problems, check with your healthcare provider before taking nadolol. In general, it is not recommended for people with such problems to take nadolol.
- Like all beta blockers, nadolol can worsen heart failure in some situations. However, beta blockers are also useful for the treatment of heart failure. If you have heart failure, your healthcare provider may need to monitor you very closely while you take nadolol. Let your healthcare provider know immediately if your heart failure symptoms seem to worsen.
- If you will be having surgery, make sure your surgeon and anesthesiologist know you take nadolol, as it may affect the choice of medications used during the surgery.
- Beta blockers can mask some of the symptoms of low blood sugar (hypoglycemia), particularly the "racing heart" feeling. This can cause serious problems for people with diabetes, who need to be able to sense that they have low blood sugar (in order to correct it before it becomes life-threatening).
- Beta blockers can mask some of the symptoms of an overactive thyroid (hyperthyroidism). Stopping nadolol suddenly could cause symptoms of a "thyroid storm" (a sudden and severe worsening of hyperthyroidism symptoms).
- Nadolol can potentially interact with many other medications (see Drug Interactions With Nadolol).
- The kidneys help remove nadolol from the body. If you have kidney disease, your healthcare provider may need to monitor your response to nadolol more closely (and a lower nadolol dosage may be recommended).
- If you have an anaphylactic allergy (the type that affects the entire body and often interferes with breathing), nadolol may make you more sensitive to the allergen and may make the usual treatments (such as epinephrine or an EpiPen®) less effective.
- Nadolol is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not currently known (see Nadolol and Pregnancy).
- Nadolol passes through breast milk in humans. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Nadolol and Breastfeeding).