Nadolol Side Effects: What's Normal and What's Not

Nadolol (brand name Corgard) is a non-selective beta-blocker prescribed for hypertension, angina, and several other conditions. Like all beta-blockers, it comes with potential side effects — most are mild and manageable, but some require immediate medical attention. Here's what you need to know.

What Is Nadolol?

Nadolol blocks both beta-1 and beta-2 adrenergic receptors, which slows your heart rate, lowers blood pressure, and reduces the workload on your heart. It has a long half-life of 20-24 hours, allowing once-daily dosing. For a deeper dive, see our guide on how Nadolol works.

Common Side Effects

These side effects are relatively common, especially when you first start taking Nadolol or after a dose increase. They often improve within a few weeks as your body adjusts:

• Fatigue and tiredness — The most frequently reported side effect. Nadolol slows your heart, which can make you feel more tired than usual, particularly during the first week or two.
• Dizziness or lightheadedness — Especially when standing up quickly (orthostatic hypotension). This happens because Nadolol lowers your blood pressure.
• Cold hands and feet — Beta-2 blockade can reduce blood flow to your extremities. This is more noticeable in cold weather.
• Slow heart rate (bradycardia) — Nadolol is supposed to slow your heart rate. A resting rate of 50-60 bpm is common and usually not dangerous, but rates below 50 bpm should be discussed with your doctor.
• Nausea — Usually mild and improves with time. Taking Nadolol with food may help.
• Diarrhea or constipation — GI effects are relatively common but typically mild.
• Itching — Some patients report mild skin itching.

Serious Side Effects — When to Call Your Doctor

These side effects are less common but require prompt medical attention:

• Severe bradycardia — If your heart rate drops below 50 bpm and you feel faint, dizzy, or extremely fatigued, call your doctor. If it drops below 40 bpm or you feel like you might pass out, seek emergency care.
• Heart failure symptoms — New or worsening shortness of breath, rapid weight gain (more than 2-3 pounds in a day), and swelling in your ankles, feet, or legs can indicate that Nadolol is worsening heart failure. Contact your doctor immediately.
• Bronchospasm — Wheezing, difficulty breathing, or tightness in the chest. This is especially concerning if you have a history of asthma or COPD (which are contraindications for Nadolol).
• Severe dizziness or fainting — If you faint or feel like you're about to faint, this could indicate your blood pressure or heart rate is too low.
• Chest pain — Particularly if you suddenly stop taking Nadolol. Never stop this medication abruptly — it must be tapered gradually over 1-2 weeks to avoid rebound angina or even heart attack.
• Severe allergic reactions — Rash, hives, swelling of the face or throat, difficulty breathing. These are rare but require emergency care.

Side Effects in Specific Populations

Older Adults

Elderly patients may be more sensitive to Nadolol's effects on heart rate and blood pressure. Falls due to dizziness are a particular concern. Doctors often start with a lower dose and increase slowly.

People with Diabetes

Nadolol can mask the symptoms of low blood sugar (hypoglycemia), particularly rapid heartbeat and trembling. If you have diabetes, monitor your blood sugar more frequently, especially when starting Nadolol or adjusting your insulin dose.

People with Kidney Problems

Nadolol is primarily eliminated through the kidneys. If you have reduced kidney function, your doctor should adjust your dose to prevent the drug from building up in your system, which can increase side effects.

Pregnant or Breastfeeding Women

Nadolol is Pregnancy Category C — it should be used only if the potential benefit justifies the risk. It is excreted in breast milk, so breastfeeding while taking Nadolol requires careful discussion with your doctor.

How to Manage Common Side Effects

Most side effects of Nadolol are manageable with simple strategies:

• For fatigue: Give it time — most people adjust within 2-3 weeks. Take your dose at bedtime if daytime drowsiness is a problem (ask your doctor first).
• For dizziness: Stand up slowly from sitting or lying positions. Stay hydrated. Avoid alcohol, which can worsen the blood-pressure-lowering effect.
• For cold extremities: Wear warm gloves and socks. Avoid smoking, which further constricts blood vessels.
• For nausea: Take Nadolol with food. If nausea persists beyond the first few weeks, talk to your doctor.
• For slow heart rate: A resting heart rate of 50-60 bpm is generally fine. If it drops lower or you feel symptoms, contact your doctor about a dose adjustment.

What NOT to Do

Never stop Nadolol suddenly. Abruptly stopping a beta-blocker can cause rebound effects including chest pain, rapid heartbeat, and in rare cases, heart attack. If you need to stop taking Nadolol, your doctor will taper the dose over 1-2 weeks.

Final Thoughts

Most people tolerate Nadolol well, and common side effects like fatigue and dizziness often improve within a few weeks. The key is knowing the difference between normal adjustment effects and warning signs that need medical attention.

If you're having trouble with side effects, talk to your doctor before making any changes. There may be dose adjustments or alternative medications that work better for you.

Need help finding Nadolol at a pharmacy near you? Medfinder can help you check stock availability without calling around.