Nadolol Is a Long-Acting Beta-Blocker Used for Blood Pressure and Heart Conditions

Nadolol is a non-selective beta-adrenergic blocker (beta-blocker) that lowers blood pressure, reduces heart rate, and decreases the heart's workload. It's one of the longest-acting beta-blockers available, which allows convenient once-daily dosing.

What Is Nadolol?

Nadolol is the generic name for the medication originally marketed as Corgard by Pfizer. It belongs to the class of non-selective beta-blockers, meaning it blocks both beta-1 receptors (in the heart) and beta-2 receptors (in the lungs and blood vessels).

Key facts about Nadolol:

• Generic name: Nadolol
• Brand name: Corgard
• Drug class: Non-selective beta-adrenergic blocker
• Manufacturers (generic): Amneal Pharmaceuticals, Greenstone LLC
• FDA-approved indications: Hypertension, angina pectoris
• Controlled substance: No — Nadolol is not a controlled substance
• Available strengths: 20 mg, 40 mg, 80 mg, and 160 mg tablets

What sets Nadolol apart from other beta-blockers is its long half-life of 20-24 hours. This means it stays active in your body longer, so you only need to take it once a day. It's also less likely to cause central nervous system side effects (like vivid dreams or depression) because it doesn't cross the blood-brain barrier as easily as other beta-blockers. For more on this, see how Nadolol works.

What Is Nadolol Used For?

FDA-Approved Uses

• Hypertension (high blood pressure) — Nadolol is used alone or with other medications to lower blood pressure and reduce the risk of heart attack, stroke, and kidney damage.
• Angina pectoris — Nadolol reduces the frequency and severity of chest pain caused by reduced blood flow to the heart.

Common Off-Label Uses

Doctors frequently prescribe Nadolol for conditions beyond its FDA-approved indications:

• Migraine prevention — Beta-blockers are a first-line option for preventing migraines, and Nadolol's once-daily dosing makes it convenient.
• Portal hypertension — Gastroenterologists use Nadolol to reduce portal vein pressure and prevent esophageal variceal bleeding in patients with liver cirrhosis.
• Atrial fibrillation — Used to help control heart rate in some patients.
• Essential tremor — Can reduce tremor severity.
• Thyrotoxicosis — Manages rapid heart rate and tremor associated with an overactive thyroid.
• Long QT syndrome — Used to reduce the risk of dangerous arrhythmias.
• Performance anxiety — Sometimes used off-label for situational anxiety, though Propranolol is more commonly prescribed for this purpose.

How Is Nadolol Taken?

Nadolol is taken as an oral tablet, once daily. Here's what you need to know about dosing:

• Starting dose for hypertension: 40 mg once daily
• Starting dose for angina: 40 mg once daily
• Dose range: 40-320 mg daily for hypertension; 40-240 mg daily for angina
• Take it at the same time each day for consistent blood levels
• Can be taken with or without food
• Swallow tablets whole

Important: Never stop taking Nadolol suddenly. Abrupt discontinuation can cause rebound effects including worsening chest pain and, in rare cases, heart attack. If you need to stop, your doctor will taper the dose over 1-2 weeks. For more on what to watch for, see our side effects guide.

Who Should Not Take Nadolol?

Nadolol is not appropriate for everyone. You should not take Nadolol if you have:

• Bronchial asthma or severe COPD — Blocking beta-2 receptors can trigger bronchospasm
• Sinus bradycardia or heart block (greater than first-degree) — Nadolol further slows heart conduction
• Cardiogenic shock
• Uncompensated heart failure
• Known allergy to Nadolol

Special caution is needed for:

• Diabetic patients — Nadolol can mask signs of low blood sugar
• Patients with kidney disease — Dose adjustment required since Nadolol is cleared by the kidneys
• Pregnant women — Category C; use only if benefits outweigh risks
• Breastfeeding mothers — Nadolol passes into breast milk

Always tell your doctor about all medications you're taking. Nadolol has significant drug interactions with calcium channel blockers, clonidine, digoxin, and other medications.

How Much Does Nadolol Cost?

Cost depends on whether you have insurance and which pharmacy you use:

• Generic Nadolol with a discount card: Approximately $26-$50 for 90 tablets (20 mg)
• Generic Nadolol without discounts: $90-$150 for a 30-day supply
• Brand-name Corgard: Can exceed $500 per month (rarely prescribed now)
• With insurance: Generic Nadolol is typically Tier 1 or Tier 2, meaning low copays. Prior authorization is generally not required for the generic.

For tips on reducing your out-of-pocket costs, see our complete Nadolol savings guide.

Final Thoughts

Nadolol is a well-established, effective beta-blocker with the advantage of once-daily dosing and fewer central nervous system side effects compared to alternatives like Propranolol. It's available as an affordable generic and is covered by most insurance plans.

If you have a Nadolol prescription and need help finding it in stock, Medfinder can show you which pharmacies near you carry it — helpful given occasional supply disruptions.