Nadalol
Administration
- Type: beta blocker
- Dosage Forms:
- Routes of Administration: PO
- Common Trade Names:
Adult Dosing
- 40-160mg PO daily
Pediatric Dosing
Special Populations
Pregnancy Rating
- C
Lactation risk
- Excreted in breastmilk. AAP says compatible with breastfeeding[1]
Renal Dosing
- CrCl 31-50 mL/min: Give q24-36hr
- CrCl 10-30 mL/min: Give q24-48hr
- CrCl <10 mL/min: Give q40-60hr===Hepatic Dosing===
Contraindications
- Allergy to class/drug
- Overt cardiac failure, 2°/3° heart block, cardiogenic shock
- Asthma/COPD
- Avoid during breastfeeding
- Sinus bradycardia
- Sick sinus syndrome without permanent pacemaker
- Caution if:
- Nonallergenic bronchospasm
- Cerebrovascular insufficiency
- Well-compensated CHF
- DM
- Hyperthyroidism/thyrotoxicosis
- Liver disease
- Renal impairment
- Peripheral vascular disease
- Planned surgery
- Pheochromocytoma
- Abrupt cessation may lead to worsened angina and myocardial infarction
Adverse Reactions
Serious
- Bronchospasm
- Hypotension
Common
- Drowsiness, insomnia
- Decreased sexual ability
- Bradycardia
- Dizziness, fatigue
- Hypotension
- Abdominal discomfort, constipation, diarrhea, nausea
- Cough, nasal congestion
- Bronchospasm
- Depression
- Decreased exercise tolerance
- Raynaud's phenomenon
- Increased triglycerides and insulin resistance, decreased HDL
May increase triglyceride levels and insulin resistance, and decrease HDL levels
Pharmacology
- Half-life: 10-24h
- Metabolism: none
- Excretion: urine
Mechanism of Action
- Blocks response to beta-adrenergic stimulation to beta1 and beta2 receptors; may reduce portal pressure through beta2 receptor, which reduces portal blood flow