Detailed Drug Information:

DRUG CLASS AND MECHANISM: Nadolol is a beta-adrenergic receptorblocking agent that primarily blocks the action of the sympathetic nervoussystem on the heart. Nadolol reduces the heart rate and the force ofcontractions of the heart's muscle, thereby lowering blood pressure.Angina (heart pain) occurs when the heart's need for oxygen exceeds thesupply of oxygen. By slowing the heart rate and decreasing the force ofmuscle contractions, nadolol reduces the demand of the heart's muscle foroxygen and thereby prevents angina.

PREPARATIONS: Round tablets: 20mg, 40mg, 80mg, 120mg, 160mg.

STORAGE: Tablets should be stored between 2° (36°F)and 30°C (86°F) and protected from light.

PRESCRIBED FOR: Nadolol is prescribed for patients with highblood pressure (hypertension). It is used to treat chest pain (angina)related to coronary artery disease. Nadolol also has been used to treatpatients with tremor, to prevent migraine headaches, and to preventanxiety in anxiety-provoking situations.

DOSING: Nadolol usually is taken once each day and may be takenwith or without meals. When used to prevent anxiety, it can be taken twohours prior to the anxiety-provoking situation. In persons with even amoderate degree of reduced kidney function (as detected by laboratorytests), the dose of nadolol may be reduced or the interval between doses(usually about 24 hours) may need to be extended (e.g. to 36 or 48 hours).

DRUG INTERACTIONS: The blood pressure-lowering effects ofnadolol are additive with other medications that lower blood pressure, andcombinations of these other medications with nadolol often is usedpurposefully in treating persons with high blood pressure. When used incombination with diltiazem (Cardizem; Tiazac; Dilacor), verapamil (Calan; Isoptin; Verelan; Covera), amiodarone (Cordarone), or digoxin (Lanoxin),however, nadolol or other beta-blockers can cause complete block of theheart's electrical system. Nonsteroidal anti-inflammatory drugs (NSAIDs)such as ibuprofen (Motrin; Advil) and naproxen (Naprosyn; Anaprox; Aleve),can prevent the blood pressure-reducing effects of beta-blockers such asnadolol.

PREGNANCY: There is very little information about nadolol givento pregnant women. Physicians may elect to use it if its benefits aredeemed to outweigh potential risks.

NURSING MOTHERS: Nadolol is excreted into breast milk. Themanufacturers do not recommend the use of nadolol while breast-feedingbecause of the potential risk of toxicity in the nursing infant.

SIDE EFFECTS: Nadolol is generally well tolerated, and sideeffects are mild and transient. Rare side effects include abdominalcramps, diarrhea, constipation, fatigue, insomnia, nausea, depression,dreaming, memory loss, fever, impotence, lightheadedness, slow heart rate,low blood pressure, numbness, tingling, cold extremities, sore throat, andshortness of breath or wheezing.

If it is necessary to discontinue nadolol, the dose usually is reducedgradually over several weeks. Nadolol can mask the early warning symptomsof low blood sugar (hypoglycemia), especially in diabetics who are proneto hypoglycemia, and can increase or decrease blood sugar. Therefore, itshould be used with caution in diabetic patients.