A List Of 8 Common Beta Blockers And Their Differences

Beta blockers are a group of medications used to treat high blood pressure (hypertension), heart failure, and other heart-related conditions. Some are also used for migraine prevention, glaucoma, and essential tremor. They come in various forms such as pills, injections, and eye drops. Most are available as generics.

Beta blockers fall into two categories: selective or non-selective. Selective beta blockers mainly target beta-1 receptors (chemical binding sites). These receptors affect your heart rate and how hard your heart works to pump blood. Non-selective beta blockers attach to beta-1, beta-2, and sometimes alpha receptors. These types of beta blockers affect blood vessels throughout the body, not just on the heart.

With so many types of beta blockers available, it’s hard to tell them apart. Below, we'll provide you with a list of beta blockers and the differences between them.

1. Metoprolol

Metoprolol is a selective beta blocker. Selective beta blockers like metoprolol are often called “cardioselective” because they mainly act on the heart. They may be preferred over non-selective beta blockers for certain heart conditions.

Metoprolol is available in two forms: metoprolol tartrate (Lopressor) and metoprolol succinate (Toprol XL). Metoprolol tartrate is an immediate-release (IR) form that’s taken twice a day. Metoprolol succinate is an extended-release (ER) form that’s taken once a day. You should take both forms with food to lower the risk of side effects.

Both forms of metoprolol are FDA approved to treat and manage hypertension and chest pain (angina). Metoprolol tartrate is also approved to lower the risk of death after a heart attack. And metoprolol succinate is approved to lower the risk of death and hospitalization in some people with heart failure.

Read more like this

Explore these related articles, suggested for readers like you.

5 Foods to Avoid When Taking Carvedilol (and Other Beta Blockers)

7 Things You Should Know Before Starting a Beta Blocker

7 Beta Blocker Interactions to Be Aware Of

11 Side Effects of Beta Blockers You Should Know About

View more

Metoprolol begins to work quickly. Both the IR and ER formulations usually start to work within 1 hour of use.

Good to know: It’s worth noting that metoprolol succinate (the ER form) is a first-choice medication for heart failure caused by a weak heart muscle (heart failure with reduced ejection fraction, or HFrEF). It’s 1 of 3 beta blockers that lowers the risk of death in patients living with heart failure. The other two beta blockers that are preferred for HFrEF are carvedilol (Coreg) and bisoprolol.

2. Carvedilol

Carvedilol is a non-selective beta blocker. It also blocks alpha-1 receptors. Blocking alpha-1 receptors helps widen your blood vessels, which can help lower blood pressure. In theory, beta blockers that block alpha-1 receptors should have greater blood pressure lowering abilities. But in real life, this isn't always true.

Carvedilol is FDA approved to treat hypertension and heart failure. It’s also used after a heart attack. It comes in IR tablets and ER capsules. The IR tablets are taken twice a day. The ER capsules are only taken once a day.

Carvedilol can cause a sudden drop in blood pressure when you sit up or stand quickly. This is known as orthostatic hypotension, and it can make you feel dizzy. Taking carvedilol with food helps slow down its absorption and lower the risk for this problem.

3. Atenolol

Atenolol (Tenormin) is a selective beta blocker. It’s FDA-approved to treat high blood pressure and angina. It can also lower your risk of death after a heart attack.

Currently, atenolol only comes in tablet form and is usually taken once a day. Unlike some of the other beta blockers, atenolol isn't broken down by the liver. So if you have liver problems, you may still be able to take atenolol. However, the kidneys remove most of the medication from the body. For this reason, it’s not recommended for people who have kidney problems.

4. Propranolol

Propranolol is a non-selective beta blocker. It’s FDA approved to treat several heart conditions including angina, hypertension, and atrial fibrillation. It’s also approved to prevent migraines and treat tremors. And it has another unique off-label use that we’ll talk about later.

Oral propranolol forms include an oral IR tablet, ER capsule, and solution.

5. Labetalol

Labetalol is a non-selective beta blocker that also blocks alpha-1 receptors. It’s FDA approved to treat hypertension. It’s available as an oral tablet and it’s best to take it with food for maximum absorption.

Labetalol is unique because the intravenous formulation is used in hypertensive crises. This is when there’s a rapid and severe rise in your blood pressure.

6. Bisoprolol

Bisoprolol is a selective beta blocker that’s approved to treat high blood pressure. It only comes in a tablet form. Because bisoprolol lasts a long time in the body, it’s typically only taken once a day.

7. Timolol

Timolol is a non-selective beta blocker. It’s most commonly used as an eye drop (Betimol, Timoptic). But it’s also available as an oral tablet that’s taken twice a day.

Timolol eye drops are commonly used to treat glaucoma or high blood pressure in the eye. Drops are available with timolol alone or in combination with other medications.

The tablet form is FDA approved to treat hypertension and prevent migraines. It can also be used after a heart attack to lower the risk of death.

8. Nadolol

Nadolol (Corgard) is a non-selective beta blocker that’s FDA approved to treat hypertension and angina. This medication is only available in tablet form and taken once a day.

Nadolol stays in the body longer than most other beta blockers. And it’s removed from the body by the kidneys. So those with kidney problems should probably avoid it. But it may be OK for people with liver problems to take it.

What are the common side effects of beta blockers?

Beta blockers are generally well-tolerated by most people. If you do experience side effects, it’s likely that they’ll go away as your body adjusts to the medication. Some common side effects include:

• Slow heart rate

• Low blood pressure

• Dizziness

• Fatigue

• Constipation

• Nausea

• Insomnia

More serious (but rare) side effects include:

• Heart block (extremely slow heart rate or skipped heartbeats)

• Masking symptoms of hypoglycemia (low blood glucose) such as shaking, irritability, and confusion. Untreated hypoglycemia can lead to serious complications such as coma, seizures, and even death. But sweating is a low blood glucose symptom that’s not masked by beta blockers. So if you have diabetes, it’s a good idea to check your blood glucose if you feel sweaty or clammy.

• Difficulty breathing due to tightening of the muscles lining your airways. This is more likely with non-selective beta blockers.

Which beta blocker is right for you?

There are many beta blockers, so knowing which one is best for you can be hard to figure out. The two main factors to consider when selecting a beta blocker are:

• The medical condition you’re treating

• Your personal medical history

If you need a beta blocker, your prescriber will determine if it’s safe to start taking one. And they’ll help determine if one specific beta blocker is best for you. For example, selective beta blockers (like metoprolol, atenolol, and bisoprolol) are often a better choice than non-selective beta blockers if you have asthma.

Below, we’ll cover a few scenarios where one beta blocker from the list above may be preferred over another:

• Hypertension: In general, beta blockers aren’t first-choice options for hypertension. But if you have certain health conditions (for example, coronary artery disease), beta blockers may be needed. Many beta blockers are good options in this case, except research shows atenolol isn’t as good as other beta blockers at preventing heart-related events.

• Heart failure: Current research shows that the best beta blockers for heart failure are carvedilol, metoprolol succinate, and bisoprolol.

• Essential tremors: Propranolol is a common first-choice medication for essential tremors. Nadolol and atenolol are also possible treatment options.

• Performance anxiety: Propranolol is the most commonly used beta blocker to prevent physical symptoms of performance anxiety. This is an off-label use.

• Migraine prevention: Propranolol, metoprolol, and timolol are some beta blockers that may help prevent migraines.

• High blood pressure in pregnancy: Labetalol is a first-choice medication for hypertension in pregnancy. But this is an off-label use.

How to save

There are many ways to save on your beta blocker medication. GoodRx can help you navigate your options, which may include GoodRx discounts, copay savings cards, and patient assistance programs. You can find beta blocker prices as low as $6 with a free GoodRx discount.

You can also save on certain brand-name products. For instance, anyone with a valid prescription, regardless of insurance status, can use GoodRx to purchase a 30-day supply of Toprol XL at an exclusive cash price as low as $39.

Why trust our experts?

Written by:

ThienLy Neal, PharmD

ThienLy Neal, PharmD, has over 10 years experience in the pharmacy field, including in such settings as retail, hospital, compounding, and managed care. She has led various clinical programs while focusing on medication adherence programs, specialty drug initiatives, and polypharmacy safety initiatives.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Our editorial standards

Meet our experts