Beta-Blocker Dos and Don’ts

In order to reap the biggest benefits of beta-blockers and minimize their possible side effects, there are certain things you should — and shouldn’t — do.

Before you start taking a beta-blocker, share with your doctor a complete list of every medication and dietary supplement you’re taking.

“Electronic medical records allow for you to confirm medications, but most clinics will double-check with you during a visit,” says Dr. Lloyd. His recommendation: Take pictures of your medication and supplement bottles with your phone to show your doctor. If you’d rather bring the medications into your appointment, be sure to bring the bottles rather than just the pills in a pillbox or pill organizer. “A given medication can have a variety of shapes, sizes, and colors, which might lead to confusion,” says Lloyd.

Stopping beta-blocker use suddenly can cause your heart rate to spike, says Jennifer Wong, MD, cardiologist and medical director of noninvasive cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California. If you need to stop taking your beta-blocker for whatever reason, let your doctor know so you can come up with a plan together for cutting back your use slowly to give your body necessary time to adjust. In most situations, Dr. Wong says a person should gradually reduce their dose by 50 percent every few days.

“I tell my patients to increase the frequency of their blood sugar monitoring, especially during the first few weeks on beta-blockers,” says Lloyd. “Occasionally, diabetic medications need to be adjusted.”

When and how often you take your medication depends on the type of beta-blocker your doctor prescribes as well as other factors. But sticking to a consistent dosing schedule helps your beta-blocker work as efficiently as possible, says Wong.

You and your doctor can work together to figure out the best dosing times for you. “If [you] feel fatigue or dizziness from beta-blocker use, it’s best to take it at night,” says Wong. “If the beta-blocker is being used to help with anxiety, it may be better to take it in the morning.”

Skipping doses of any prescribed medication, including beta-blockers, can make it less effective, but that doesn’t mean if you forget to take a dose that you should take twice as much the next time around.

So what should you do if you miss a dose? Wong says if you remember shortly after your typical medication time, take the missed dose at that point. If it’s getting close to the time of your next dose, she recommends forgetting about the missed dose and just taking your usual dose at your usual time. If you have questions or aren’t sure what to do, reach out to your healthcare team for help.

“Luckily, most of these side effects get better after a few weeks,” says Lloyd. But you should let your doctor know if the side effects aren’t getting better or if they’re disrupting your daily life, he adds. Together you can find ways to manage these effects so you can continue to take your beta-blocker.

“Long-term alcohol use can raise blood pressure as well as induce arrhythmias,” says Wong.

While some medical authorities say moderate alcohol consumption (no more than two drinks per day for men and no more than one drink per day for women) is okay if you’re on a beta-blocker, Wong recommends people with heart conditions and high blood pressure avoid drinking altogether.

• Beta-blockers are important for the treatment of hypertension and several other conditions, but to maximize their benefits and minimize their possible side effects, there are certain things you should (and shouldn’t) do.
• Before you start taking a beta-blocker, share with your doctor a complete list of every medication and dietary supplement you’re taking to avoid any medication interactions.
• If you have diabetes, keep a close eye on your blood sugar, especially during your first few weeks on beta-blockers, to avoid swings outside the normal range.
• It’s important to take beta-blockers exactly as prescribed and at the same time every day. Skipping or doubling doses can be unsafe. Track any side effects you experience so you can share them with your doctor.