Beta blockers

Beta blockers (beta-adrenoceptor blocking agents) work mainly by decreasing the activity of the heart by blocking the action of hormones like adrenaline.

Beta blockers are prescription-only medicines (POMS), which means they can only be prescribed by a GP or another suitably qualified healthcare professional.

Examples of commonly used beta blockers include:

• atenolol (Tenormin)
• bisoprolol (Cardicor, Emcor)
• carvedilol 
• metoprolol (Betaloc, Lopresor)
• nebivolol (Nebilet)
• propranolol (Inderal)

Uses for beta blockers

Beta blockers may be used to treat:

• angina – chest pain caused by narrowing of the arteries supplying the heart 
• heart failure – failure of the heart to pump enough blood around the body 
• atrial fibrillation – irregular heartbeat 
• heart attack – an emergency where the blood supply to the heart is suddenly blocked
• high blood pressure – when other medicines have been tried, or in addition to other medicines

Less commonly, beta blockers are used to prevent migraine or treat:

• an overactive thyroid (hyperthyroidism)
• anxiety conditions
• tremor 
• glaucoma – as eye drops 

There are several types of beta blocker, and each one has its own characteristics. The type prescribed for you will depend on your condition.

Who can take beta blockers

Before taking beta blockers, make sure your doctor is aware of any other conditions you have, as they may not be suitable to use.

Make sure you tell your doctor if you have a history of:

• asthma or any type of lung disease
• heart disease 
• kidney disease 
• diabetes – particularly if you have frequent episodes of low blood sugar
• allergic reaction to any medication

Your GP can advise you about which medicine to use if you're pregnant or breastfeeding.

It's important not to stop taking beta blockers without seeking your GP's advice. In some cases suddenly stopping the medicine may make your condition worse.

Interactions with other medicines

Beta blockers, including beta blocker eye drops, can interact with other medicines, altering the effects of one of the medicines.

Read the patient information leaflet that comes with your medicine to check that it's safe to take with beta blockers. If you're still unsure, you could also ask your GP or pharmacist.

Some of the more common medicines that can interact with beta blockers include:

• anti-arrhythmics – used to control irregular heartbeats
• antihypertensives – used to lower blood pressure
• antipsychotics – used to treat severe mental health problems
• clonidine – used to treat high blood pressure and migraine
• mefloquine – used to treat or prevent malaria

Side effects of beta blockers

Most people taking beta blockers have either no or very mild side effects that become less troublesome with time.

Contact your GP if you're experiencing symptoms that affect your everyday life. They can discuss whether the symptoms are a result of the medication and what to do. 

Don't drive if you feel dizzy, tired, or your vision is affected.

Symptoms commonly reported both by people taking beta blockers and those taking a dummy medication (placebo) include:

• dizziness
• tiredness
• blurred vision
• cold hands and feet
• slow heartbeat
• diarrhoea and nausea

Less common symptoms include:

• sleep disturbance (insomnia)
• loss of sex drive (libido)
• depression 
• problems getting or maintaining an erection (impotence)

If you feel unwell after taking beta blockers or have concerns, speak to your GP or pharmacist, or call NHS 111.

You can also report suspected side effects using the Yellow Card Scheme.

Missed or extra doses

Contact your GP or call NHS 111 if you accidentally take one or more extra doses of beta blockers. They'll be able to advise you about what to do.

Most beta blockers are taken once a day, apart from certain beta blockers that are used during pregnancy and Sotalol, which is given 2 or 3 times a day.

If you forget to take a dose of your beta blocker, you should check the patient information leaflet that comes with your medicine. It should include advice about what to do in this situation.

Never double up on a dose to make up for a missed or forgotten dose of any beta blocker. 

Your GP or pharmacist can also give you further advice.