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Oral Beta-Blockers for Hypertension

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Medication	Selected Adverse Effects	Comments
Acebutolol*, †	Bronchospasm, fatigue, insomnia, sexual dysfunction, exacerbation of heart failure, masking of symptoms of hypoglycemia, triglyceridemia, increased total cholesterol and decreased high-density lipoprotein cholesterol (except for pindolol, acebutolol, carteolol, and labetalol)	Contraindicated in patients with greater than 1st-degree atrioventricular block, or sick sinus syndrome Should be avoided in patients with asthma Should be used cautiously in patients with COPD with severe disease, heart failure, or who are taking insulin Should not be stopped abruptly in patients with coronary artery disease Bisoprolol, carvedilol, and metoprolol can be used to treat heart failure
Atenolol*
Betaxolol*
Bisoprolol*
Carvedilol‡
Carvedilol (controlled-release)‡
Labetalol‡, §
Metoprolol*
Metoprolol (extended-release)
Nadolol
Nebivolol
Pindolol†
Propranolol
Propranolol, long-acting
Timolol
* Cardioselective.
† With intrinsic sympathomimetic activity.
‡ Alpha-beta-blockers. Labetalol can also be given IV for hypertensive emergencies.
§ Can also be given for hypertensive emergencies.