Nadalol

Administration

• Type: beta blocker
• Dosage Forms:
• Routes of Administration: PO
• Common Trade Names:

Adult Dosing

• 40-160mg PO daily

Special Populations

Pregnancy Rating

• C

Lactation risk

• Excreted in breastmilk. AAP says compatible with breastfeeding

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