Published on 20 March 2023

Beta Blockers: Complete Guidance From Experts

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Beta-blockers, beta-adrenergic blocking substances, or beta-adrenergic antagonists are widely prescribed for treating cardiovascular and other conditions. These are the most commonly prescribed medications in the United States, with approximately 30 million adults using a beta-blocker. 

Beta-blockers are FDA-approved for treating hypertension, tachycardia, myocardial infarction, congestive heart failure, hyperthyroidism, cardiac arrhythmias, coronary artery disease, and other conditions. This blog will teach you about the various beta-blocker types, their working side effects, and their interactions.

What Are Beta-Blockers?

Beta-blockers are the most widely prescribed anxiety medicines commonly used to treat many problems involving your heart and circulatory system. These are prescription-only medicines that can only be prescribed by a GP (General practitioner) or qualified healthcare professional. They are also sometimes used to treat conditions related to your brain and nervous system. Beta-blockers may help to treat:

  • High blood pressure
  • Angina
  • Atrial fibrillation,
  • Heart failure,
  • Heart attack

Other rare uses of beta blockers include the following:

  • Anxiety
  • Glaucoma- as eyedrops
  • Tremor
  • An overactive thyroid (hyperthyroidism)

There are several types of beta blockers, each with its properties. The type of beta-blocker prescribed for you will depend on your health condition.

Frequently Asked Questions

Yes, Beta-blockers are commonly prescription-only medicines that can only be prescribed by a GP or qualified healthcare professional.
People who suffer from a heart attack usually take beta-blockers for one year. However, some may remain on these medications for life. Speak to your doctor in case of any side effects are observed.
The initial recommended dose is 80mg (max. 160 mg), taken twice daily. Taking more than the recommended dose can reduce your heart rate, cause dizziness, and make breathing difficult.

How Do Beta Blockers Work?

Beta-blockers, also known as beta-adrenergic blocking agents, show their therapeutic action by blocking the movement of the adrenaline (epinephrine) and noradrenaline in specific body parts. This causes the heart to beat with less force and more slowly, lowering blood pressure. They also help open up blood vessels to improve blood flow.

Some beta-blockers majorly affect the heart. At the same time, others affect both heart and the blood vessels. Beta-blockers also affect kidney functioning. They inhibit kidneys from producing angiotensin II hormone, which results in lowering your blood pressure.

When Should You Be Prescribed Beta Blockers?

Beta-blockers aren't usually recommended as a first-line treatment in people with only high blood pressure. Unless medications, like diuretics, haven't worked well. Also, the concerned doctor might prescribe a beta-blocker as one of the several medications to reduce blood pressure.

Beta-blockers may not work as effectively for black and older people, especially without other blood pressure medications. Beta-blockers are highly effective in preventing, improving, or treating symptoms in people with:

  • Migraine
  • Irregular heart rhythm (arrhythmia)
  • Heart failure
  • Heart attacks
  • Chest pain (Angina)
  • Certain types of tremors
  • Your healthcare professional may prescribe beta-blockers along with other medications.

What Are The Different Types Of Beta Blockers?

Beta-blockers or beta-adrenergic blocking substances causes the heart to relax and beat much slower. These are available in different formulas with different routes of administration, including oral, ophthalmic, and intravenous. These are classified as selective and non-selective. 

Cardiologists use selective beta-blockers more commonly because their activity affects the heart and has less pronounced effects on other body parts.

Non-selective beta-blockers block adrenaline and noradrenaline in other heart and body areas. This can cause undesired side effects, including cold hands and a predisposition to asthma attacks.

Examples of Selective beta-blockers include-

  • Acebutolol
  • Metoprolol
  • Atenolol
  • Bisoprolol
  • Esmolol

Examples of Non-Selective beta-blockers include-

  • Pindolol
  • Carvedilol
  • Propanolol
  • Labetalol
  • Timolol

These beta-blockers have unique properties. Examples of these include:

  1. Esmolol: This medicine is available only in an IV form, which limits its use in hospitals and similar medical settings.
  2. Carvedilol and labetalol: Both of these can also block some alpha receptors. This can help lower heart rate and blood pressure, making these medications more effective.

Difference Between Beta Blockers

Beta-blockers help manages various conditions by blocking beta receptors throughout the body. There are three types of beta receptors, including beta-1 (B1), beta-2 (B2), and beta-3 (B3) receptors. The difference in Beta-blockers lies in which receptors are blocked.

  • First-generation beta-blockers are non-selective, i.e., they block both beta-1 (β1) and beta-2 (β2) receptors and will subsequently affect lungs, kidneys, heart, liver, uterus, gastrointestinal tract, skeletal muscles, and vascular smooth muscle. This results in reduced cardiac and renal output, among other actions. Examples include- nadolol, pindolol, propranolol, etc.
  • Second-generation beta-blockers are selective, i.e., they block only the β1 receptor and primarily affect the heart and cause reduced cardiac output. Examples include- acebutolol hydrochloride, metoprolol, etc.
  • Blocking the α1-adrenergic receptors and the β-blocker lowers blood pressure, providing additional vasodilatory action in the arteries. Example of such beta-blocker includes carvedilol and labetalol hydrochloride.

How to Take Beta-Blockers?

Beta-blockers shall be taken as prescribed by your medical practitioner. The following things should be considered while taking any beta blocker:

  • Follow the directions on the label on how often to take it. The number of daily doses, the time allowed between the quantities, and how long you need to take medicine will depend on your condition. Older people typically take lower doses. 
  • Do not take double doses to compensate for the missed dose.
  • Beta-blockers can be taken in the morning, at meals, or bedtime. Taking them with food may have fewer side effects as your body steadily absorbs the drug. 
  • While taking a beta blocker, check your pulse rate daily. If it's slower than the standard rate, immediately contact your doctor about taking your beta blocker that day.
  • Never discontinue taking a beta blocker without speaking to your doctor first, even if you feel it is not working. Abrupt withdrawal can worsen angina and cause a heart attack or cardiac arrest.

Advantages Of Beta-Blockers

Beta-blockers offer several advantages:

  • They have been studied extensively. Beta-blockers have been used for decades, because of which their effects are better understood, and it's easier to use them safely and avoid adverse effects.
  • They're effective for a broader medical problem. Because so many heart and circulatory issues are connected, using a beta-blocker to treat one problem can often benefit multiple related topics.
  • Most beta-blockers (especially generics) are inexpensive. Beta-blockers are typically affordable, making it easier to ensure patients aren't going without medicines because they can't afford them.

Possible Side Effects

Beta-blockers usually cause either no or very mild side effects that become less bothersome with time. Contact your GP if you have annoying symptoms.

Some common side effects of taking beta blockers include the following:

  • Difficulty sleeping or nightmares
    feeling dizzy, tired, or lightheaded (these can be signs of a slower heart rate)
  • Difficulties with sex or getting an erection
  • Feeling sick
  • Cold fingers or toes (as beta-blockers may affect the blood supply to your limbs) 

Some people might also experience some severe side effects while taking beta blockers. Although, these are not all the side effects of beta-blockers. Speak to your doctor immediately if you experience the following:

  • Shortness of breath, tightening of your chest, and wheezing can be signs of lung problems.
  • Shortness of breath, a cough that worsens while exercising, an irregular heartbeat, or swollen ankles or legs can be signs of heart problems.
  • Yellowish skin or the whites of your eyes turning yellow can be signs of liver problems.

Who Can Not Take Beta Blockers?

Beta-blockers are not prescribed for every individual. Tell your medical practitioner if you have the following:

  • Lung disease or asthma
  • uncontrolled heart failure
  • Low blood pressure or any condition that would affect your heart rhythm
  • Are you allergic to a beta blocker or any medicine
  • Metabolic acidosis 

Also, inform your doctor if you are pregnant, are likely to get pregnant, or are breastfeeding.
It is essential to seek your doctor's advice before discontinuing taking beta-blockers. In some cases, suddenly stopping the medicine may make your health condition worse.

Precautions Of Beta Blockers

Some medicines, including beta-blocker eye drops, may interfere with how beta-blockers work. Inform your doctor if you're taking:

  • Other medications, such as flecainide or amiodarone for an irregular heartbeat
  • Other drugs for high blood pressure- Their combination with beta-blockers can sometimes
  • lower your blood pressure, making you feel dizzy or faint.
  • Treatments for chronic obstructive pulmonary disease (COPD) or asthma
  • Some antidepressants, baclofen (a muscle relaxant), nitrates (for chest pain), levodopa for
  • Parkinson's disease, or medication for an enlarged prostate gland like tamsulosin
  • Medicines for diabetes, particularly insulin–beta blockers
  • Anti-allergics such as ephedrine, noradrenaline, or adrenaline
  • Treatments for nose or sinus congestion or other cold remedies 
  • Ibuprofen, as it can elevate your blood pressure 

How To Stop Taking Beta Blockers?

People should not abruptly stop taking beta-blockers without seeking a doctor's advice and close supervision. Suddenly stopping beta-blocker treatment may worsen a person's symptoms, especially after a heart attack or during the treatment of Angina. It may cause problems such as palpitations or a rise in blood pressure.

Drug Interactions

Beta-blockers may interact with other medications and alter the effects of other medicines. Be sure to discuss with your doctor all the medicines (prescription, non-prescription, herbal drugs, or supplements) you are taking.

Some of the following categories of medications can interact with beta-blockers including:

  • Allergy shots
  • Antiarrhythmics
  • Medicines for asthma, COPD, or chronic bronchitis
  • Antihypertensives
  • Medicines for diabetes, including insulin
  • Antipsychotics
  • Clonidine (for high blood pressure and migraine)
  • Mefloquine (for malaria)
  • ACE inhibitors
  • Warfarin
  • Neuroleptic drugs
  • Calcium channel blockers
  • Rifampicin

While on beta-blockers, avoid eating or drinking products containing caffeine or taking over-the-counter cough and cold medicines, antacids that contain aluminum, and antihistamines. You should also avoid drinking alcohol, as it may decrease beta-blocker effects.

Bottom Line From Practical Anxiety Solutions

Beta-blockers are a first-line treatment for several conditions. They are beneficial for improving cardiovascular symptoms like high blood pressure, angina, heart failure, and heart attack.

People should always follow a doctor's instructions when using beta-blockers and ensure that their doctor knows about any health conditions they have or other medications they are using. If you want to try beta-blockers for other states, consult your doctor. They can advise on the best treatment plan to help manage your symptoms.