Can't Find Pindolol? Here Are Your Options

If you've been prescribed Pindolol and your pharmacy can't fill it, you may be wondering what alternatives are available. Whether the issue is a local supply issue or a broader availability problem, knowing your options can help you and your doctor make a quick decision so you don't miss doses.

In this guide, we'll explain what Pindolol is, how it works, and walk through several alternative medications that may work for you.

Important: Never switch medications on your own. Always talk to your doctor before changing or stopping any prescription medication, especially a beta blocker.

What Is Pindolol?

Pindolol is a nonselective beta blocker that was originally sold under the brand name Visken (now discontinued). It is FDA-approved to treat high blood pressure (hypertension) and is sometimes used off-label for angina prevention and as an augmentation strategy for SSRI antidepressants.

Pindolol is available as generic tablets in 5 mg and 10 mg strengths. The typical dose ranges from 10 to 60 mg per day, taken in two divided doses.

How Does Pindolol Work?

Pindolol blocks both beta-1 and beta-2 adrenergic receptors in the heart and blood vessels. By blocking these receptors, it:

• Slows the heart rate
• Reduces the force of heart contractions
• Lowers blood pressure

What sets Pindolol apart from many other beta blockers is its intrinsic sympathomimetic activity (ISA). This means it partially stimulates the beta receptors even while blocking them. The result is that Pindolol tends to cause less slowing of the resting heart rate compared to beta blockers without ISA.

Pindolol also has activity at serotonin 5-HT1A receptors, which is why it's sometimes used alongside antidepressants — a use that most other beta blockers cannot replicate.

Alternative Medications to Pindolol

If you can't get Pindolol, here are the most commonly considered alternatives. Your doctor will choose the best option based on why you're taking Pindolol and your overall health profile.

1. Propranolol (Inderal)

Propranolol is another nonselective beta blocker and is one of the closest alternatives to Pindolol. Like Pindolol, it blocks both beta-1 and beta-2 receptors.

• Used for: High blood pressure, angina, tremors, migraine prevention, performance anxiety
• How it differs from Pindolol: Propranolol does not have intrinsic sympathomimetic activity, so it may slow the resting heart rate more than Pindolol. It is much more widely prescribed and easier to find.
• Available forms: Immediate-release tablets (10 mg, 20 mg, 40 mg, 60 mg, 80 mg), extended-release capsules (60 mg, 80 mg, 120 mg, 160 mg), and oral solution
• Cost: Generic Propranolol is widely available and typically costs $4 to $15 for a 30-day supply with a discount coupon

2. Metoprolol (Lopressor, Toprol XL)

Metoprolol is a selective beta-1 blocker, meaning it primarily targets the heart without as much effect on the lungs and blood vessels. It is one of the most commonly prescribed beta blockers in the United States.

• Used for: High blood pressure, heart failure, angina, heart attack prevention
• How it differs from Pindolol: Because it's beta-1 selective, Metoprolol may be a better choice for patients with mild asthma or COPD who need a beta blocker. It does not have ISA or serotonin receptor activity.
• Available forms: Immediate-release tablets (Lopressor: 25 mg, 50 mg, 100 mg) and extended-release tablets (Toprol XL: 25 mg, 50 mg, 100 mg, 200 mg)
• Cost: Very affordable — generic Metoprolol costs as little as $4 to $10 for a 30-day supply

3. Atenolol (Tenormin)

Atenolol is another selective beta-1 blocker that is widely available and commonly prescribed for hypertension.

• Used for: High blood pressure, angina
• How it differs from Pindolol: Atenolol is beta-1 selective (like Metoprolol) and taken once daily, which may be more convenient. It does not have ISA or serotonin activity.
• Available forms: Tablets (25 mg, 50 mg, 100 mg)
• Cost: Generic Atenolol is very affordable, typically $4 to $10 for a 30-day supply

4. Nadolol (Corgard)

Nadolol is a nonselective beta blocker like Pindolol, but without the intrinsic sympathomimetic activity.

• Used for: High blood pressure, angina, off-label for tremors and migraine prevention
• How it differs from Pindolol: Nadolol has a much longer half-life, allowing for once-daily dosing. It does not have ISA, so it may slow the heart rate more at rest. It can also be harder to find than Metoprolol or Atenolol.
• Available forms: Tablets (20 mg, 40 mg, 80 mg)
• Cost: Moderate — generic Nadolol typically costs $15 to $40 for a 30-day supply

What About the Antidepressant Augmentation Use?

If you're taking Pindolol specifically to boost the effects of an SSRI antidepressant, the alternatives above may not be direct replacements for that purpose. Pindolol's activity at serotonin 5-HT1A receptors is unique among beta blockers.

If this is your situation, talk to your psychiatrist about other augmentation strategies, which may include:

• Adding a different medication like Buspirone or Aripiprazole
• Adjusting your SSRI dose
• Switching to a different antidepressant class

For more on how Pindolol works in this context, see our post on Pindolol's mechanism of action.

How to Decide Which Alternative Is Right for You

The best alternative to Pindolol depends on several factors:

• Why you're taking it: High blood pressure? Angina? Depression augmentation?
• Other health conditions: Do you have asthma, diabetes, or heart failure?
• Side effect concerns: Are you sensitive to fatigue or low heart rate?
• Cost and availability: Some alternatives are much cheaper and easier to find

Your doctor knows your full medical history and can guide you to the safest, most effective switch.

Final Thoughts

Not being able to fill your Pindolol prescription is stressful, but there are good alternatives available. Propranolol is the closest match as a nonselective beta blocker, while Metoprolol and Atenolol are widely available selective options that work well for most people with high blood pressure.

Before making any changes, talk to your doctor. And if you'd like to try finding Pindolol first, use Medfinder to check pharmacy availability near you, or read our guide on how to find Pindolol in stock.

For more information about Pindolol, check out our posts on Pindolol side effects and drug interactions to avoid.