Beta Blockers (Oral)-Atenolol, Metoprolol, Nadolol, Propranolol, Timolol
Atenolol, Metoprolol, Nadolol, Propranolol, Timolol (Oral Dosage Forms)
Avoid Abrupt Withdrawal
- Abrupt Withdrawal not advised in patients with angina pectoris, CAD or ischemic heart disease. Severe exacerbation of angina and the occurrence of MI and ventricular arrythymias jave been reported in angina patients following abrupt discontinuation.
- When discontinuation of these drugs is planned, patients should be carefully observed and advised to limit physical activity to a minimum.
- If the angina worsens or acute coronary insufficiency develops, it is recommended that atenolol be promptly reinstituted, at least temporarily.
- Because CAD is common and unrecognized it may be prudent not to discontinue atenolol/nadolol/metoprolol therapy abruptly in patients treated only for hypertension and in patients considered at risk of having occult atherosclerotic heart disease who are given propranolol for other reasons.
- Gradually reduce dosage over at least a few weeks (1 to 2 weeks)
- If angina markedly worsens or acute coronary insufficiency develops on drug withdrawal, reinstate therapy, at least temporarily.
- Advise patient against cessation or interruption of therapy without MD advice
Propranolol - Black Box Warning Removed 8/17/2021
Updated January 2018