Contents
Side Effects of Corgard (nadolol)
Norepinephrine and epinephrine (adrenaline) are chemicals released within the body that attach to receptors on several types of cells and change the way the cells function, either stimulating or suppressing them. Corgard prevents norepinephrine and epinephrine from binding to beta receptors on nerves.
Beta-blockers reduce heart rate, force of heart contractions, and blood pressure by blocking the effects of norepinephrine and epinephrine.
Heart pain (angina) occurs when the heart requires more oxygen than the blood can supply. Corgard reduces the heart’s demand for oxygen by slowing heart rate and decreasing the force of contractions.
Beta-blockers may cause difficulty breathing by contracting the muscles surrounding the air passages of the lung, making it more difficult for air to pass through.
Common side effects of Corgard include:
- abdominal cramps,
- diarrhea,
- constipation,
- fatigue,
- insomnia,
- nausea,
- depression,
- impotence,
- lightheadedness,
- slow heart rate,
- low blood pressure,
- cold extremities,
- sore throat, and
- shortness of breath or wheezing.
Serious side effects of Corgard include:
- increased breathing difficulties in patients with asthma, chronic bronchitis, or emphysema;
- dangerously slow heart rates, and shock in patients with existing slow heart rates and heart blocks; and
- increased symptoms of heart failure.
Drug interactions of Corgard include diltiazem, amiodarone, or digoxin, which can cause complete block of the heart’s electrical system.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the blood pressure lowering effects of beta-blockers.
- Corgard can mask early warning symptoms of low blood sugar (hypoglycemia) and should be used with caution in patients with diabetes.
Safe use of Corgard during pregnancy has not been established.
Corgard is excreted into breast milk and should not be used while breastfeeding because of the potential risk of adverse effects in the nursing infant.
Important Side Effects of Corgard (nadolol)
Nadolol is generally well tolerated. Side effects include:
- abdominal cramps,
- diarrhea,
- constipation,
- fatigue,
- insomnia,
- nausea,
- depression,
- impotence,
- lightheadedness,
- slow heart rate,
- low blood pressure,
- cold extremities,
- sore throat, and
- shortness of breath or wheezing.
Nadolol can increase breathing difficulties in patients with:
In patients with existing slow heart rates and heart blocks, nadolol can cause dangerously slow heart rates and even shock. Nadolol also increases symptoms of heart failure.
In patients with coronary artery disease, abruptly stopping nadolol can worsen angina and occasionally precipitate heart attacks. If discontinuation is necessary, the dose should be reduced gradually.
Corgard (nadolol) Side Effects in Healthcare Professionals
Most adverse effects have been mild and transient and have rarely required withdrawal of therapy.
Cardiovascular
Bradycardia occurs commonly, and heart rates below 40 beats per minute and/or symptomatic bradycardia were seen in about 2 of 100 patients.
Symptoms of peripheral vascular insufficiency, usually of the Raynaud type, have occurred in approximately 2 of 100 patients. Cardiac failure, hypotension, and rhythm/conduction disturbances have each occurred in about 1 of 100 patients. Instances of first degree and third degree heart block have been reported; intensification of AV block is a known effect of beta-blockers.
Central Nervous System
Dizziness or fatigue has been reported in about 2 of 100 patients; paresthesias, sedation, and change in behavior have each been reported in about 6 of 1000 patients.
Respiratory
Bronchospasm has been reported in about 1 of 1000 patients.
Gastrointestinal
Nausea, diarrhea, abdominal discomfort, constipation, vomiting, indigestion, anorexia, bloating, and flatulence have been reported in 1 to 5 of 1000 patients.
Miscellaneous
Each of the following has been reported in 1 to 5 of 1000 patients: rash; pruritus; headache; dry mouth, eyes, or skin; impotence or decreased libido; facial swelling; weight gain; slurred speech; cough; nasal stuffiness; sweating; tinnitus; blurred vision. Reversible alopecia has been reported infrequently.
The following adverse reactions have been reported in patients taking nadolol and/or other beta-adrenergic blocking agents, but no causal relationship to nadolol has been established.
Central Nervous System
Reversible mental depression progressing to catatonia; visual disturbances; hallucinations; an acute reversible syndrome characterized by disorientation for time and place, short-term memory loss, emotional lability with slightly clouded sensorium, and decreased performance on neuropsychometrics.
Gastrointestinal
Mesenteric arterial thrombosis; ischemic colitis; elevated liver enzymes.
Hematologic
Agranulocytosis; thrombocytopenic or nonthrombocytopenic purpura.
Allergic
Fever combined with aching and sore throat; laryngospasm; respiratory distress.
Miscellaneous
Pemphigoid rash; hypertensive reaction in patients with pheochromocytoma; sleep disturbances; Peyronie’s disease.
The oculomucocutaneous syndrome associated with the beta-blocker practolol has not been reported with nadolol.
Drug Interactions with Corgard (nadolol)
The following drugs may interact with beta-adrenergic receptor blocking agents:
Anesthetics, general
exaggeration of hypotension induced by general anesthetics.
Antidiabetic drugs (oral agents and insulin)
hypoglycemia or hyperglycemia; adjust dosage of antidiabetic drug accordingly.
Catecholamine-depleting drugs (e.g., reserpine)
additive effect; monitor closely for evidence of hypotension and/or excessive bradycardia (e.g., vertigo, syncope, postural hypotension).
Digitalis glycosides
Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.
Response to Treatment for Anaphylactic Reaction
Patients with a history of severe anaphylactic reaction to allergens may be more reactive to repeated challenge while taking beta-blockers. Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reactions.
Summary
Corgard (nadolol) is a beta-blocker used to treat high blood pressure (hypertension) and heart pain (angina). Common side effects of Corgard include abdominal cramps, diarrhea, constipation, fatigue, insomnia, nausea, depression, impotence, lightheadedness, slow heart rate, low blood pressure, cold extremities, sore throat, and shortness of breath or wheezing. Safe use of Corgard during pregnancy has not been established. Corgard is excreted into breast milk and should not be used while breastfeeding because of the potential risk of adverse effects in the nursing infant.