What is a Beta Blocker? And Other Commonly Asked Questions
Key takeaways:
Beta blockers are commonly used to treat heart-related conditions such as heart failure, high blood pressure, or following a heart attack. But they can also treat other health conditions, like migraines and tremors.
Cardioselective beta blockers are often preferred for heart-related conditions or if you have a history of asthma or COPD. Non-selective beta blockers may be more effective for other conditions, such as migraine prevention and glaucoma.
Common side effects of beta blockers include a slow heart rate, feeling tired, and dizziness. Let your healthcare provider know if side effects are bothersome — don’t stop taking a beta blocker on your own.
Table of contents
Beta blockers are a class of medications used to treat heart-related conditions as well as several other health concerns. But with over 15 different types to choose from, it may seem overwhelming to know which one is right for you. Let’s discuss some beta blocker basics so you can have a clearer idea on what might be best for your situation.
1. What is a beta blocker?
A beta blocker is a medication that binds to and blocks beta receptors (chemical binding sites) in your body. There are two main types of beta-blockers — selective and non-selective.
Selective beta blockers — also known as cardioselective beta blockers — block beta-1 receptors in your heart. They affect how fast your heart beats and how much blood your heart pumps out. So selective beta blockers are typically prescribed for heart-related conditions.
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Examples of cardioselective beta blockers include:
Atenolol (Tenormin)
Metoprolol tartrate (Lopressor)
Metoprolol succinate (Toprol XL)
Non-selective beta blockers block both beta-1 and beta-2 receptors. Beta-2 receptors affect how tight or relaxed your blood vessels and airways are. So these types of beta blockers have an effect throughout the body, as well as on your heart.
Examples of non-selective beta blockers include:
Propranolol (Inderal LA, Innopran XL)
Sotalol (Betapace)
Nadolol (Corgard)
Timolol (Timoptic, Betimol)
Some non-selective beta blockers also have alpha-blocking effects. These beta blockers are more effective at lowering blood pressure. Examples include carvedilol (Coreg) and labetalol.
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Most beta blockers come in oral tablets or capsules. But some are also available as eye drops and can be given by injection. Most are also available as lower-cost generics.
2. What conditions do beta blockers treat?
Beta blockers are FDA approved to treat many health conditions. They can lower the risk of death in people with heart failure, help prevent future heart problems after a heart attack, and help maintain a normal heart rate in people with heart rhythm conditions (arrhythmias). They’re also used to treat high blood pressure and chronic stable angina (chest pain).
Other approved uses for beta blockers include glaucoma, essential tremor, and migraine prevention. They can even treat high thyroid hormone levels (hyperthyroidism) in certain cases.
Beta-blockers are sometimes prescribed to help calm nerves in people who have stage fright. However, this is considered an off-label use — it’s not FDA approved.
This isn’t a complete list of medical conditions beta-blockers can treat. If you have questions about why you’re taking a beta blocker or are wondering if they’re a treatment option for you, talk to your healthcare provider.
3. Which beta blocker is the most effective?
The “best” beta blocker depends on the health condition you have. Other health conditions and medications you take can also affect which beta blocker is right for you.
Heart conditions
Usually, cardioselective beta blockers are preferred for heart conditions. This is because they’re more effective at lowering the risk of heart-related complications. They may also cause fewer side effects than non-selective beta blockers for some people (and more on that later).
For heart failure, research studies show that three beta blockers are considered first-choice options: carvedilol, metoprolol succinate (the long-acting form of metoprolol), and bisoprolol. These beta blockers can lower your risk of death from heart failure complications.
Beta blockers can also be used to treat high blood pressure, but they’re usually not a first-choice option. That’s because beta blockers don’t work as well and have more side effects than other high blood pressure medications.
Migraine headaches
Beta blockers can also be used to prevent migraine headaches. According to the American Academy of Family Physicians, the best beta blockers for migraines are metoprolol, propranolol, and timolol. Atenolol and nadolol (Corgard) are also options, but they’re considered second-choice medications.
Essential tremor
Propranolol is currently the only FDA-approved beta blocker for treating essential tremor — a condition that causes shakiness of the body and voice. However, research shows atenolol, nadolol, and sotalol may also help with this condition.
Anxiety
Beta blockers are not a typical choice for treating anxiety conditions, and none are FDA approved for this use.
Propranolol is sometimes used off-label to treat performance-related anxiety. A 2015 review of available research found some evidence that short-term propranolol treatment may be effective for this. But the study also showed that it didn’t have an effect on chronic anxiety that’s unrelated to stage fright.
In most cases, a beta blocker won’t be the first choice for performance anxiety. Other options — such as selective serotonin reuptake inhibitors (SSRIs) or buspirone — are preferred. But a beta blocker may be an option if you’re unable to tolerate the side effects of these medications or they’re ineffective for you. They’re also a helpful option when you only need treatment every once in a while, rather than on a regular basis.
4. Are beta blockers safe?
Beta-blockers are generally well-tolerated, but they do have side effects to be aware of. Some may go away over time once your body adjusts to the medication. Other side effects may cause problems for people with certain health conditions.
It’s not safe to stop taking a beta blocker abruptly on your own in most cases. Doing so can be dangerous, and cause serious withdrawal symptoms such as:
Chest pain
Anxiety
Fast heartbeat
High blood pressure
Heart attack
If you feel that you need to stop taking your beta blocker, talk to your healthcare provider first. They can determine if it’s OK for you to stop taking it and help you do so safely.
Who should avoid taking beta blockers?
If you have a chronic lung condition, such as asthma or chronic obstructive pulmonary disease (COPD), you may have a higher risk of breathing difficulties with non-selective beta blockers. This is because they can cause your airways to tighten, which can make it harder for you to breathe.
If you have these lung conditions, cardioselective beta blockers are usually preferred, since they don’t affect your airways as much. But if your COPD or asthma is severe, beta blockers may not be the best choice for you.
Some beta blockers can raise blood glucose (sugar) levels. They can also hide most signs of low blood sugar (hypoglycemia), including tremors, confusion, and irritability. This is important to know if you have diabetes.
You may need to check your blood glucose more often if you have diabetes and start taking a beta blocker. If your glucose levels drop, sweating is one symptom of hypoglycemia that beta blockers don’t affect. So if you have diabetes and take a beta blocker, it’s a good idea to check your blood sugar if you start sweating unexpectedly.
If you experience Raynaud’s phenomenon, a condition that causes certain areas of your body to become numb and cold, beta blockers can worsen your symptoms.
It’s a good idea to discuss your complete medical history with your healthcare provider before starting a beta blocker. They can help make sure it’s a safe option for you.
5. What are common side effects of beta blockers?
When starting a beta blocker, you may experience common side effects, such as:
Slow heart rate
Low blood pressure
Dizziness
Nausea
Constipation
Feeling tired when exercising
Erectile dysfunction
Higher triglyceride levels
If you notice persistent or worsening side effects, let your healthcare provider know right away. They may adjust your dose, try a different type of beta blocker, or switch you to a different medication altogether.
Do some beta blockers have fewer side effects than others?
There’s not really one beta blocker that’s least likely to cause side effects. Some experts believe that cardioselective beta blockers may have a lower risk of side effects such as fatigue, but there’s no clear evidence for this.
The one exception is when it comes to breathing-related side effects. As mentioned, cardioselective beta blockers are less likely to cause breathing problems if you have a lung condition like asthma or COPD. If you have one of these conditions and need to take a beta blocker, your healthcare provider may prefer one that’s cardioselective.
6. How long can you take beta blockers?
If you’re taking a beta blocker to treat a heart condition, it’s likely that it will be a lifetime medication for you. The benefits of beta blockers over time make them a common long-term medication for many people.
But if you’re taking a beta blocker for performance anxiety or to prevent migraines, it’s likely just an as-needed medication for you. You’ll only need to take it short-term for the symptoms you’re treating.
The bottom line
Beta blockers are important medications for certain heart conditions, such as high blood pressure, heart failure, and arrhythmias. They can also be used for migraine prevention, glaucoma, and tremors. Cardioselective beta blockers are often preferred for heart-related conditions or if you have a history of asthma or COPD. Non-selective beta blockers may be more effective for other conditions, such as migraine prevention and glaucoma.
Beta blockers are well-tolerated by most people, but they can make you feel more tired than normal. They can also make you feel dizzy if you sit up or stand too quickly. These side effects may go away over time, but let your healthcare provider know if they worsen or become bothersome. And don’t stop taking a beta blocker on your own — it can be dangerous to stop it abruptly.
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References
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