Exacerbation of Ischemic Heart Disease Following Abrupt Withdrawal
Hypersensitivity to catecholamines has been observed in patients withdrawn from beta-blocker therapy; exacerbation of angina and, in some cases, myocardial infarction have occurred after abrupt discontinuation of such therapy. When discontinuing chronically administered nadolol, particularly in patients with ischemic heart disease, the dosage should be gradually reduced over a period of 1 to 2 weeks and the patient should be carefully monitored. If angina markedly worsens or acute coronary insufficiency develops, nadolol administration should be reinstituted promptly, at least temporarily, and other measures appropriate for the management of unstable angina should be taken. Patients should be warned against interruption or discontinuation of therapy without the physician's advice. Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue nadolol therapy abruptly even in patients treated only for hypertension.
NADOLOL TABLETS, USP
20 mg, 40 mg and 80 mg
Nadolol is a synthetic nonselective beta-adrenergic receptor blocking agent.
Nadolol Tablets are indicated for the following:
Angina Pectoris: Nadolol Tablets are indicated for the long-term management of patients with angina pectoris.
Hypertension: Nadolol Tablets are indicated in the management of hypertension; it may be used alone or in combination with other antihypertensive agents, especially thiazide-type diuretics.
Published Studies Related to Nadolol
Controlled trial of ligation plus nadolol versus nadolol alone for the prevention of first variceal bleeding. [2010.07]
CONCLUSION: The addition of ligation to nadolol may increase adverse events and did not enhance effectiveness in the prophylaxis of first variceal bleeding.
Nadolol plus isosorbide mononitrate alone or associated with band ligation in the prevention of recurrent bleeding: a multicentre randomised controlled trial. [2009.08]
CONCLUSIONS: Adding EBL to pharmacological treatment did not reduce recurrent bleeding, the need for rescue therapy, or mortality, and was associated with more adverse events. Furthermore, associating EBL to drug therapy did not reduce the high rebleeding risk of HVPG non-responders. ISRCTN26221020.
Clinical trial: a randomized controlled study on prevention of variceal rebleeding comparing nadolol + ligation vs. hepatic venous pressure gradient-guided pharmacological therapy. [2009.02.15]
BACKGROUND: Hepatic venous pressure gradient (HVPG) monitoring of therapy to prevent variceal rebleeding provides strong prognostic information. Treatment of nonresponders to beta-blockers +/- nitrates has not been clarified. AIM: To assess the value of HVPG-guided therapy using nadolol + prazosin in nonresponders to nadolol + isosorbide-5-mononitrate (ISMN) compared with a control group treated with nadolol + ligation... CONCLUSIONS: In patients treated to prevent variceal rebleeding, the association of nadolol and prazosin effectively rescued nonresponders to nadolol and ISMN, improving the haemodynamic response observed in controls receiving nadolol and endoscopic variceal ligation. Our results also suggest that ligation may rescue nonresponders.
Comparison of endoscopic variceal ligation and nadolol plus isosorbide-5-mononitrate in the prevention of first variceal bleeding in cirrhotic patients. [2006.10]
BACKGROUND: Both drug therapy and banding ligation are widely used in the prevention of first variceal bleeding. This study compared the efficacy and safety of band ligation vs. combination of beta-blocker and nitrate for the prevention of first bleeding in patients with cirrhosis and high-risk esophageal varices... CONCLUSION: Our preliminary results suggest that endoscopic variceal ligation is similar to the combination of nadolol plus ISMN with regard to effectiveness and safety in the prevention of first variceal bleeding in patients with cirrhosis.
Comparative study between nadolol and 5-isosorbide mononitrate vs. endoscopic band ligation plus sclerotherapy in the prevention of variceal rebleeding in cirrhotic patients: a randomized controlled trial. [2006.08.15]
BACKGROUND: After variceal bleeding, cirrhotic patients should receive secondary prophylaxis. AIM: To compare nadolol plus 5-isosorbide mononitrate (5-ISMN) with endoscopic band ligation. The end points were rebleeding, treatment failure and death... CONCLUSION: This trial suggests no superiority of endoscopic band ligation over nadolol plus 5-ISMN mononitrate for the prevention of rebleeding in cirrhotic patients.
Clinical Trials Related to Nadolol
Nadolol for Proliferating Infantile Hemangiomas [Recruiting]
The purpose of this study is to explore the efficacy and safety of Nadolol in hemangiomas of
The secondary objective is to assess the feasibility of conducting a randomized controlled
trial comparing nadolol with corticosteroids and propranolol.
Endoscopic Cyanoacrylate Obliteration vs. Nadolol Treatment in the Prevention of Gastric Variceal Rebleeding [Recruiting]
Gastric variceal bleeding has a very high rebleeding rate even after endoscopic variceal
injection of cyanoacrylate (GVO) which is considered the first choice of endoscopic
treatment. Beta-blocker (BB) is effective to lower portal pressure. We hypothesized
combination of GVO and BB can further decrease the rebleeding rate.
Treatment for Prevention of Variceal Rebleeding Guided by the Hemodynamic Response [Recruiting]
This is a prospective trial of random distribution, open, parallel group, in which patients
with esophagic variceal bleeding will be randomized into two treatment groups, after
controlling acute bleeding. All patients received standard medical therapy with b-blockers
and endoscopic ligation (LEV) of esophageal varices.
The control group will be assigned to receive LEV + Nadolol + MNI. The experimental group
will be assigned to receive treatment according to the hemodynamic response.
All patients included in the experimental group received LEV and pharmacological treatment
nadolol alone or combined with MNI or Prazosin (PZ)
Secondary Prophylaxis After Variceal Bleeding in Non-Responders [Completed]
Controlled and randomized study comparing combined treatment (nadolol and endoscopic
ligation) versus nadolol associated with isosorbide mononitrate or prazosin according to
hemodynamic response, in the prevention of esofagic verices rebleeding.
Fasting Study of Nadolol/Bendroflumethiazide Tablets 80 mg/5 mg and CorzideŽ Tablets 80 mg/5 mg [Completed]
The objective of this study was to investigate the bioequivalence of Mylan's
nadolol/bendroflumethiazide 80 mg/5 mg tablets to King's CorzideŽ 80 mg/5 mg tablets
following a single, oral 80 mg/5 mg (1 x 80 mg/5 mg) dose administered under fasting
Reports of Suspected Nadolol Side Effects
Completed Suicide (15),
Respiratory Arrest (6),
Cardiac Arrest (6),
Left Ventricular Dysfunction (4),
Toxicity TO Various Agents (4),
Skin Exfoliation (3),
Somnolence (3), more >>