Beta Blockers Health Article

Special conditions

People who have certain medical conditions or who are taking certain other medicines may have problems if they take beta blockers. Before taking these drugs, be sure to let the physician know about any of these conditions:

ALLERGIES. Anyone who has had unusual reactions to beta blockers in the past should let his or her physician know before taking the drugs again. The physician should also be told about any allergies to insect stings, medicines, foods, dyes, preservatives, or other substances. In people with allergies to medicines, foods, or insect stings, beta blockers may make the allergic reactions more severe and harder to treat. Anyone who has an allergic reaction while taking beta blockers should get medical attention right away and should make sure the

physician in charge knows that he or she is taking this medicine.

Beta blockers may also cause serious reactions in people who take allergy shots. Anyone taking this medicine should be sure to alert the physician before having any allergy shots.

DIABETES. Beta blockers may make blood sugar levels rise and may hide some symptoms of low blood sugar. Diabetic patients should discuss these possible problems with their physicians.

PREGNANCY. Some studies of beta blockers show that these drugs cause problems in newborns whose mothers use them during pregnancy. Other studies do not show such effects. Women who are pregnant or who may become pregnant should check with their physicians about the use of beta blockers.

BREASTFEEDING. Some beta blockers pass into breast milk and may cause breathing problems, slow heartbeat, and low blood pressure in nursing babies whose mothers take the drugs. Women who need to take beta blockers and who want to breastfeed their babies should check with their physicians.

OTHER MEDICAL CONDITIONS. Beta blockers may increase breathing problems or make allergic reactions more severe in people who have allergies, bronchitis,or emphysema.

In people with an overactive thyroid, stopping beta blockers suddenly may cause an increase in symptoms.

Also, taking this medicine may hide a fast heartbeat, which is one of the symptoms of overactive thyroid.

Effects of these drugs may be greater in people with kidney or liver disease because the medicine is cleared from the body more slowly.

Beta blockers may also make the following medical conditions worse:

• Heart or blood vessel disease
• Unusually slow heartbeat (bradycardia)
• Myasthenia gravis (chronic disease causing muscle weakness and possibly paralysis)
• Psoriasis (itchy, scaly, red patches of skin)
• Depression (now, or in the past).

Before using beta blockers, people with any of the medical problems listed in this section should make sure their physicians are aware of their conditions.

USE OF CERTAIN MEDICINES. Taking beta blockers with certain other drugs may affect the way the drugs work or may increase the chance of side effects.

Side effects

The most common side effects are dizziness, drowsiness, lightheadedness, sleep problems, unusual tiredness or weakness, and decreased sexual ability. In men, this can occur as impotence or delayed ejaculation. These problems usually go away as the body adjusts to the drug and do not require medical treatment unless they persist or they interfere with normal activities.

More serious side effects are possible. If any of the following side effects occur, check with the physician who prescribed the medicine as soon as possible:

• Breathing problems
• Slow heartbeat
• Cold hands and feet
• Swollen ankles, feet, or lower legs.
• Mental depression.

Other side effects may occur. Anyone who has unusual symptoms after taking beta blockers should get in touch with his or her physician.

Interactions

Beta blockers may interact with a number of other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Anyone who takes beta blockers should let the physician know all other medicines he or she is taking. Among the drugs that may interact with beta blockers are:

• Calcium channel blockers and other blood pressure drugs. Using these drugs with beta blockers may cause unwanted effects on the heart.
• Insulin and diabetes medicines taken by mouth. Beta blockers cause high blood sugar or hide the symptoms of low blood sugar.
• Monoamine oxidase inhibitors (MAO) such as phenelzine (Nardil) or tranylcypromine (Parnate), used to treat conditions including depression and Parkinson's disease. Taking beta blockers at the same time or within two weeks of taking MAO inhibitors may cause severe high blood pressure.
• Airway-opening drugs (bronchodilators) such as aminophylline (Somophyllin), dyphylline (Lufyllin) oxtriphylline (Choledyl), or theophylline (Somophyllin-T). When combined with beta blockers, the effects of both the beta blockers and the airway-opening drugs may be lessened.
• Cocaine. High blood pressure, fast heartbeat, and heart problems are possible when cocaine and beta blockers are combined. Also, cocaine may interfere with the effects of beta blockers.
• Allergy shots or allergy skin tests. Beta blockers may increase the chance of serious reactions to these medicines.

The list above may not include every drug that interacts with beta blockers. Be sure to check with a physician or pharmacist before combining beta blockers with any other prescription or nonprescription (over-thecounter) medicine.

Nancy Ross-Flanigan