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Beta-blockers
Expert reviewer, Dr Tim Cripps, Consultant Cardiologist
Next review due July 2023
Beta-blockers (pronounced beeta-blockers) are medicines which make your heart beat more slowly and with less force. There are many different types of beta-blocker. Doctors prescribe them for a wide variety of conditions, although they’re most commonly known for treating heart problems.
Uses of beta-blockers
Your doctor may recommend you take beta-blockers if you have a condition affecting your heart or blood vessels, such as:
- angina
- arrhythmia – for example atrial fibrillation
- heart failure
- a previous heart attack – to reduce your risk of having another one
- high blood pressure (hypertension) – if other medicines haven’t helped
Beta-blockers are also sometimes used in the treatment of other conditions, including to:
- help manage the symptoms of an overactive thyroid gland
- treat glaucoma (an eye condition caused by a build-up of pressure in your eye)
- help with tremor (an uncontrollable trembling in part of your body) – especially for a condition known as essential tremor
- reduce the number of attacks you have if you get migraine
- relieve the physical symptoms of anxiety
Beta-blockers may not be suitable for everyone. For instance, your doctor may not be able to prescribe you a beta-blocker or will need to monitor you closely, if you have any of the following health conditions.
- Asthma or other breathing problems such as chronic obstructive pulmonary disease (COPD), as beta blockers can sometimes make these problems worse.
- Worsening or unstable heart failure.
- Severe narrowing of the arteries that carry blood to your arms and legs (peripheral arterial disease).
- Low blood pressure.
- Slow heart rate – especially a condition called heart block.
- Diabetes – especially if you regularly have episodes of low blood sugar levels.
Let your doctor know if you’re pregnant or breastfeeding as they may need to take this into account when prescribing a beta-blocker.
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Worried about your heart health?How beta-blockers work
Beta-blockers get their name from the way they work. They block certain hormones (adrenaline and noradrenaline) from attaching to some of their target sites, called beta receptors. You have beta receptors all around your body, which explains why they can help with many different health conditions. Here we just talk about how they affect your heart.
Beta-blockers slow your heart down and make it beat with less force. This means it doesn’t work so hard and uses less oxygen as a result. These effects are helpful if you have angina or heart failure, and can help to protect against further heart attacks.
Beta-blockers can also affect the way electrical signals are passed through your heart, so may be helpful if you have an irregular heart rhythm.
It’s not entirely clear how beta-blockers reduce blood pressure, but some beta-blockers are known to reduce levels of a protein called renin, which helps to control blood pressure.
Types of beta-blocker
There are different types of beta-blocker. Some block beta receptors all around your body, including in your lungs and the blood vessels in your arms and legs as well as those in your heart. These were the first type of beta-blocker to be developed, and are known as non-selective beta-blockers. Examples include propranolol (for example, Inderal).
Newer beta-blockers, such as atenolol (for example, Tenormin) and bisoprolol (for example, Cardicor), selectively block beta receptors in your heart. They tend to be used more often for heart conditions because they’re less likely to cause side-effects elsewhere in your body.
Taking beta-blockers
Beta-blockers are only available on prescription from a doctor. Which one your doctor offers you will depend on why you need them. They come as:
- tablets or capsules
- syrup or solution
- injections – if they’re being used to control an arrhythmia or following a heart attack
- eye drops (for glaucoma)
Some beta-blockers you take once a day, whereas others you may need to take two or three times a day. This will depend on what you’re taking them for and which beta-blocker you’ve been prescribed. Depending on what your medical condition is, your doctor may prescribe beta-blockers in combination with other medicines.
Stopping beta-blockers
If you’re unhappy with your beta-blockers for any reason (for example, because you’re experiencing side-effects) ask your doctor for advice. Don’t stop taking your beta-blocker medicine suddenly because this may be harmful.
If you stop beta-blockers abruptly, your blood pressure may go up suddenly and you may get irregular heart rhythms (palpitations). If you take beta-blockers to treat angina (chest pain), stopping your medicine abruptly could make your chest pain worse. If you need to stop taking beta-blockers, your doctor will tell you how to reduce your dose gradually, and may suggest you switch to a different beta-blocker or another type of medicine.
Always follow the instructions your doctor or pharmacist gives you about when to take your medicines. Read the patient information leaflet that comes with your medicine carefully. If you have any questions about your medicines or how to take them, ask your pharmacist.
Interactions of beta-blockers
Beta-blockers can interact with certain other medicines, including some heart medicines, which can put you at increased risk of certain side-effects. These include hypotension (low blood pressure). Your doctor will make sure that the medicines they prescribe are suitable when used together, and may monitor you if necessary.
Beta blockers may cause a reaction if you drink too much alcohol. For more information, see our FAQ below: Can I drink alcohol when taking beta-blockers?
Always check with your doctor or pharmacist before you take any other medicines at the same time as a beta-blocker.
Side-effects of beta-blockers
Like all medicines, beta-blockers can cause side-effects, but these aren’t usually serious. They may also lessen over time as your body gets used to your beta-blocker.
This section doesn’t include every possible side-effect of beta-blockers. Please read the patient information leaflet that comes with your medicine for more details. The following are some of the more common side-effects.
- You may feel tired or even exhausted. This may be most obvious when you first start taking beta-blockers or if your dose is increased. It usually gets better after a while.
- Your hands and feet may feel cold. You may need to wear gloves and thick socks in cold weather.
- You may feel dizzy if your heart rate becomes too slow. See your doctor if this happens.
- You may have disturbed sleep, including nightmares or vivid dreams.
Side-effects often wear off with time, as your body gets used to the medicines. But if side-effects from your beta-blocker medicine are bothering you, talk to your doctor. They may be able to reduce the dose or switch you to a different medicine. For more information, see our section above on Taking beta-blockers.
Medicines checklist
Our handy medicines checklist helps you see what to check for before taking a medicine.
Bupa's medicines checklist PDF opens in a new window (0.8MB)
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Can I drink alcohol when taking beta-blockers?
Always check the patient information leaflet that comes with your medicine to find out how to take it and if you need to take any precautions like not drinking alcohol. If you’re unsure, you can check this with your pharmacist or doctor.
Beta-blockers slow down your heart rate and cause it to beat with less force. This lowers your blood pressure. If you drink while you’re taking beta-blockers, your blood pressure can drop even further. This may make you feel dizzy and you might even faint. So, it’s important to be careful about how much alcohol you’re drinking if you’re taking beta-blockers.
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Why aren’t beta-blockers generally used to treat high blood pressure?
Although they do reduce blood pressure, beta-blockers aren’t used as the first choice to treat high blood pressure (hypertension). Your doctor will usually try other medicines to treat high blood pressure first. These include diuretics, angiotensin-converting enzyme (ACE) inhibitors and calcium-channel blockers. This is because these medicines are better at reducing the complications of high blood pressure, including stroke and heart attack.
Your doctor will usually only suggest beta-blockers as a treatment for your high blood pressure if:
- your blood pressure is still high after trying other types of blood pressure medication (you’re said to have ‘resistant hypertension’)
- you’re pregnant or trying to get pregnant
- you have other heart problems such as angina or have had a previous heart attack or arrhythmia
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Will taking a beta-blocker affect my ability to exercise?
Taking beta-blockers will usually mean you can exercise for longer than you did before, without getting symptoms. Taking regular exercise is good for you – it helps keep your body healthy and your mind well. When you first start taking a beta-blocker, you might find that you feel very tired and less like doing exercise. This should pass as your body gets used to the medicine.
Don’t forget – beta-blockers slow your heart rate. If you used to aim for a target heart rate when exercising, you’ll need to adjust this. It’s important that you don’t push yourself too hard trying to reach it.
If you’re concerned about the effects of your medicines on how well you can exercise, talk to your doctor. They may be able to make changes to your medication that might help.
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Will taking beta-blockers make me put on weight?
Weight gain isn’t usually a problem with beta-blockers, but it’s possible you may put on a small amount of weight in the first few months while taking them.
Studies have found that some people do put on a little weight when they start taking beta-blockers, especially the older ones like propranolol, atenolol and metoprolol. But this isn’t very common, and the amounts may not be significant.
There could be other factors linked to the weight gain. For instance, taking beta-blockers can make you tired, which may lead to you resting more and being less active. It’s important to keep active while you’re taking these medicines. Being physically active can actually make you feel better and is important for maintaining a healthy weight.
If you’re worried about gaining weight while you’re taking a beta-blocker, speak with your doctor. They’ll be able to give you advice about maintaining a healthy weight.
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Related information
Angina
Angina is when you have chest pain or an uncomfortable tight feeling in your chest.
Heart attack
You’re more at risk of a heart attack if you smoke, are inactive, obese, or have high blood pressure.
High blood pressure (hypertension)
High blood pressure (hypertension) is a serious condition that can affect anyone.
Heart failure
Heart failure is when your heart doesn’t pump blood around your body as well as it should.
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Other helpful websites
- British Heart Foundation
0300 330 3311
www.bhf.org.uk
- British Heart Foundation
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Author information
Reviewed by Pippa Coulter, Freelance Health Editor, July 2020
Expert reviewer, Dr Tim Cripps, Consultant Cardiologist
Next review due July 2023
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