Non-selective beta blocker used in the treatment of high blood pressure and chest pain
Pharmaceutical compound
Nadolol Clinical data Trade names Corgard, others AHFS /Drugs.com Monograph MedlinePlus a682666 License data Routes of Oral Drug class Beta blocker ;β-Adrenergic receptor antagonist ;Non-selective β1 - andβ2 -adrenergic receptor antagonist ATC code Legal status Legal status Pharmacokinetic dataProtein binding 30% Metabolism Not metabolized Eliminationhalf-life 14–24 hours Excretion Renal and fecal (unchanged)Identifiers *
rel -(2
R ,3
S )-5-{[(2
R )-3-(
tert -butylamino)-2-hydroxypropyl]oxy}-1,2,3,4-tetrahydronaphthalene-2,3-diol
(2R *,3S *)-5-{[(2R *)-3-(tert -butylamino)-2-hydroxypropyl]oxy}-1,2,3,4-tetrahydronaphthalene-2,3-diol CAS Number PubChem CID IUPHAR/BPS DrugBank ChemSpider UNII KEGG ChEMBL CompTox Dashboard (EPA) ECHA InfoCard 100.050.625 Chemical and physical data Formula C 17 H 27 N O 4 Molar mass −1 3D model (JSmol ) InChI=1S/C17H27NO4/c1-17(2,3)18-9-12(19)10-22-16-6-4-5-11-7-14(20)15(21)8-13(11)16/h4-6,12,14-15,18-21H,7-10H2,1-3H3/t12?,14-,15+/m1/s1
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Nadolol , sold under the brand nameCorgard among others, is a medication used to treathigh blood pressure ,heart pain ,atrial fibrillation , and someinherited arrhythmic syndromes .[ 1] migraine headaches and complications ofcirrhosis .[ 2] [ 3] orally .[ 2]
Common side effects include dizziness, feeling tired, aslow heart rate , andRaynaud syndrome .[ 1] heart failure andbronchospasm .[ 1] pregnancy andbreastfeeding is of unclear safety.[ 4] beta blocker and works by blockingβ1-adrenergic receptors in theheart andβ2-adrenergic receptors inblood vessels .[ 1]
Nadolol was patented in 1970 and came into medical use in 1978.[ 5] generic medication .[ 1] thousand prescriptions.[ 6]
Nadolol is used to treathypertension and for long-term treatment ofangina pectoris and is approved by the FDA for these purposes.[ 7]
It is regularly used off-label[ 7] atrial fibrillation ,[ 8] [ 9] portal hypertension caused bycirrhosis ;[ 3] thyroid hormone .[ 10]
Nadolol is the preferredbeta-blocker in the management of patients withLQTS for prevention ofventricular arrhythmia . It is more efficacious thanselective beta blockers orpropranolol in the prevention of breakthrough cardiac events.[ 11] CPVT , as it has been shown to be more efficacious than selective beta blockers, likeatenolol orbisoprolol .[ 12]
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.[ 13] off-label ) for severalneurological disorders such as the prevention ofmigraine attacks,[ 14] attention deficit/hyperactivity disorder (ADHD)[ 15] essential tremor [ 16] Parkinson's disease [ 17] [ 18] [ 19] [ 20] anxiety as well.[ 21] [ 22]
Nadolol and other beta blockers should be used with cautions in people withheart failure and its use should not be abruptly stopped. It is contraindicated for people with asthma, aslow heart rate and certain severe heart problems.[ 23]
The most common side effects include dizziness and fatigue.[ 17]
Four of the stereoisomers of nadolol Nadolol is anon-selective beta blocker ; that is, it non-selectively blocks bothbeta-1 andbeta-2 receptors . It has a preference for beta-1 receptors, which are predominantly located in theheart , thereby inhibiting the effects ofcatecholamines and causing a decrease inheart rate andblood pressure . Its inhibition of beta-2 receptors, which are mainly located in thebronchial smooth muscle of theairways , leads to airway constriction similar to that seen inasthma . Inhibition of beta-1 receptors in thejuxtaglomerular apparatus of thekidney inhibits therenin–angiotensin system , causing a decrease invasoconstriction 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 impairsAV node conduction and decreasessinus rate.
Nadolol may also increaseplasma triglycerides and decreaseHDL -cholesterol levels.[citation needed
Nadolol is classified as a beta blocker with lowlipophilicity and hence lower potential for crossing theblood–brain barrier .[ 24] central nervous system as well as fewerneuropsychiatric side effects.[ 24]
Nadolol is a mixture ofstereoisomers . It ispolar andhydrophilic , with lowlipid solubility.[ 25] log P is 0.71 to 1.2 per different sources.[ 26]
Nadolol waspatented in 1970 and came into medical use in 1978.[ 5]
^a b c d e "Nadolol Monograph for Professionals" .Drugs.com . American Society of Health-System Pharmacists. Retrieved3 March 2019 .^a b British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 148.ISBN 9780857113382 ^a b Giannelli V, Lattanzi B, Thalheimer U, Merli M (2014)."Beta-blockers in liver cirrhosis" .Annals of Gastroenterology .27 (1):20– 26.PMC 3959530 PMID 24714633 . ^ "Nadolol Pregnancy and Breastfeeding Warnings" .Drugs.com . Retrieved3 March 2019 .^a b Fischer J, Ganellin CR (2006).Analogue-based Drug Discovery ISBN 9783527607495 ^ "Nadolol - Drug Usage Statistics" .ClinCalc . Retrieved7 October 2022 .^a b Nadolol entry in AccessMedicine. McGraw-Hill Global Education Holdings, LLC. Accessed 8 November 2014 ^ January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC, et al. (December 2014)."2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society" .Circulation .130 (23):e199 – e267 .doi :10.1161/CIR.0000000000000041 .PMC 4676081 PMID 24682347 . ^ Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E (April 2012)."Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society" .Neurology .78 (17):1337– 1345.doi :10.1212/WNL.0b013e3182535d20 .PMC 3335452 PMID 22529202 . ^ Bahn Chair RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, et al. (June 2011). "Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists".Thyroid .21 (6):593– 646.doi :10.1089/thy.2010.0417 .PMID 21510801 .S2CID 29669311 . ^ Mazzanti A, Maragna R, Vacanti G, Monteforte N, Bloise R, Marino M, et al. (April 2018)."Interplay Between Genetic Substrate, QTc Duration, and Arrhythmia Risk in Patients With Long QT Syndrome" .Journal of the American College of Cardiology .71 (15):1663– 1671.doi :10.1016/j.jacc.2018.01.078 hdl :20.500.12105/10498 PMID 29650123 . ^ Mazzanti A, Kukavica D, Trancuccio A, Memmi M, Bloise R, Gambelli P, et al. (May 2022)."Outcomes of Patients With Catecholaminergic Polymorphic Ventricular Tachycardia Treated With β-Blockers" .JAMA Cardiology .7 (5):504– 512.doi :10.1001/jamacardio.2022.0219 .PMC 8968697 PMID 35353122 .S2CID 247792342 . ^ "Corgard (nadolol) dosing, indications, interactions, adverse effects, and more" .reference.medscape.com . Retrieved27 May 2017 .^ "Nadolol - a beta-blocker - Corgard. High blood pressure drugs" .patient.info . Retrieved27 May 2017 .^ Barkley RA, Murphy KR (27 May 2017).Attention-deficit Hyperactivity Disorder: A Clinical Workbook ISBN 9781593852276 . Retrieved27 May 2017 – via Google Books. ^ Zesiewicz TA, Elble RJ, Louis ED, Gronseth GS, Ondo WG, Dewey RB, et al. (November 2011)."Evidence-based guideline update: treatment of essential tremor: report of the Quality Standards subcommittee of the American Academy of Neurology" .Neurology .77 (19):1752– 1755.doi :10.1212/WNL.0b013e318236f0fd .PMC 3208950 PMID 22013182 . ^a b U.S. National Library of MedicineNadolol entry in Medline Plus ^ Foster NL, Newman RP, LeWitt PA, Gillespie MM, Larsen TA, Chase TN (October 1984). "Peripheral beta-adrenergic blockade treatment of parkinsonian tremor".Annals of Neurology .16 (4):505– 508.doi :10.1002/ana.410160412 .PMID 6149724 .S2CID 24179607 . ^ "Nadolol: MedlinePlus Drug Information" .www.nlm.nih.gov . Retrieved27 May 2017 .^ "Nadolol Dosage Guide with Precautions - Drugs.com" .drugs.com . Retrieved27 May 2017 .^ Boyce TG, Ballone NT, Certa KM, Becker MA (2021). "The Use of β-Adrenergic Receptor Antagonists in Psychiatry: A Review".J Acad Consult Liaison Psychiatry .62 (4):404– 412.doi :10.1016/j.jaclp.2020.12.009 .PMID 34210401 . ^ Archer C, Wiles N, Kessler D, Turner K, Caldwell DM (January 2025)."Beta-blockers for the treatment of anxiety disorders: A systematic review and meta-analysis" .J Affect Disord .368 :90– 99.doi :10.1016/j.jad.2024.09.068 PMID 39271062 . ^ "Corgard Label" (PDF) .fda.gov . Retrieved27 May 2017 .^a b Cojocariu SA, Maștaleru A, Sascău RA, Stătescu C, Mitu F, Leon-Constantin MM (February 2021)."Neuropsychiatric Consequences of Lipophilic Beta-Blockers" .Medicina (Kaunas) .57 (2): 155.doi :10.3390/medicina57020155 PMC 7914867 PMID 33572109 . ^ Bragg W, Norton D, Shamsi SA (November 2008)."Optimized separation of beta-blockers with multiple chiral centers using capillary electrochromatography-mass spectrometry" .Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences .875 (1):304– 316.doi :10.1016/j.jchromb.2008.06.028 .PMC 2680439 PMID 18619928 . ^ "1(2H)-Naphthalenone, 5-3-(1,1-dimethylethyl)amino-2-hydroxypropoxy-3,4-dihydro-" .PubChem . Retrieved22 June 2025 ."Nadolol" .Drug Information Portal . U.S. National Library of Medicine. Archived fromthe original on April 10, 2019.
5-HT1A R Tooltip 5-HT1A receptor agonists GABAA R Tooltip GABAA receptor PAMs Tooltip positive allosteric modulators Gabapentinoids (α2 δ VDCC blockers ) Antidepressants Sympatholytics (Antiadrenergics ) Alpha-1 blockers (e.g.,prazosin )Alpha-2 agonists (e.g.,clonidine ,dexmedetomidine ,guanfacine )Beta blockers (e.g.,propranolol ,atenolol ,betaxolol ,nadolol ,oxprenolol ,pindolol )Others
α1
Agonists Antagonists Abanoquil ADRIANA Ajmalicine Alfuzosin Anisodamine Anisodine Atiprosin Atypical antipsychotics (e.g.,brexpiprazole ,clozapine ,olanzapine ,quetiapine ,risperidone )Benoxathian Beta blockers (e.g.,adimolol ,amosulalol ,arotinolol ,carvedilol ,eugenodilol ,labetalol )Buflomedil Bunazosin Corynanthine Dapiprazole Domesticine Doxazosin Ergolines (e.g.,acetergamine ,ergotamine ,dihydroergotamine ,lisuride ,nicergoline ,terguride )Etoperidone Fenspiride Hydroxyzine Indoramin Ketanserin L-765,314 mCPP Mepiprazole Metazosin Monatepil Moxisylyte Naftopidil Nantenine Neldazosin Niaprazine Niguldipine Pardoprunox Pelanserin Perlapine Phendioxan Phenoxybenzamine Phentolamine Phenylpiperazine antidepressants (e.g.,hydroxynefazodone ,nefazodone ,trazodone ,triazoledione )Piperoxan Prazosin Quinazosin Quinidine Silodosin Spegatrine Spiperone Talipexole Tamsulosin Terazosin Tiodazosin Tolazoline Tetracyclic antidepressants (e.g.,amoxapine ,maprotiline ,mianserin )Tricyclic antidepressants (e.g.,amitriptyline ,clomipramine ,doxepin ,imipramine ,trimipramine )Trimazosin Typical antipsychotics (e.g.,chlorpromazine ,fluphenazine ,loxapine ,thioridazine )Urapidil WB-4101 Zolertine
α2
Agonists Antagonists 1-PP Adimolol Amesergide Aptazapine Atipamezole Atypical antipsychotics (e.g.,asenapine ,brexpiprazole ,clozapine ,lurasidone ,olanzapine ,paliperidone ,quetiapine ,risperidone ,zotepine )Azapirones (e.g.,buspirone ,gepirone ,ipsapirone ,tandospirone )BRL-44408 Buflomedil Cirazoline Efaroxan Esmirtazapine Fenmetozole Fluparoxan Idazoxan Ketanserin Lisuride mCPP Mianserin Mirtazapine NAN-190 Pardoprunox Phentolamine Phenoxybenzamine Piperoxan Piribedil Rauwolscine Rotigotine Setiptiline Spegatrine Spiroxatrine Sunepitron Terguride Tolazoline Typical antipsychotics (e.g.,chlorpromazine ,fluphenazine ,loxapine ,thioridazine )Yohimbine
β
