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Nadolol

Also indexed as: Alti-Nadolol®, Apo-Nadol®, Corgard®, Novo-Nadolol®

Combination drug: Corgaretic®

Illustration

Nadolol is used to treat both angina pectoris (chest pain) and high blood pressure, and it is in a class of drugs known as beta-adrenergic blockers. Since nadolol is related to propranolol, it may have similar interactions with dietary supplements and herbs.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, a herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Beneficial May be Beneficial: Depletion or interference—The medication may deplete or interfere with the absorption or function of the nutrient. Taking these nutrients may help replenish them.

Pleurisy root*

Avoid Avoid: Reduced drug absorption/bioavailability—Avoid these supplements when taking this medication since the supplement may decrease the absorption and/or activity of the medication in the body.

Calcium*

Willow*

Avoid Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.

High-potassium foods*

Potassium*

Side effect reduction/prevention

None known

Supportive interaction

None known

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An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

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Interactions with Dietary Supplements

Calcium
Calcium supplements, if taken at the same time as some beta-blocker drugs, may reduce blood levels of the drug.1 However, whether calcium affects nadolol in this manner is unknown. Until more information is available, people on nadolol should take calcium supplements an hour before or two hours after the drug.

Potassium
People taking nadolol may experience significant increases in blood levels of potassium,2 though it is unknown whether supplementation with potassium might enhance this effect. People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of high-potassium foods, such as fruit (e.g., bananas), unless directed to do so by their doctor.

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Interactions with Herbs

Pleurisy root
As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as beta-blockers.3

Willow  (Salix alba)
The active compound in willow, salicin, is converted to salicylic acid in the body. Taking salicylates with other beta-adrenergic blocking drugs has resulted in decreased absorption of the drugs.4 Therefore, until more is known about the interaction between willow and nadolol, they should not be taken at the same time.

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Interactions with Foods and Other Compounds

Potassium
People taking nadolol may experience significant increases in blood levels of potassium,5 though it is unknown whether supplementation with potassium might enhance this effect. People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of high-potassium foods, such as fruit (e.g., bananas), unless directed to do so by their doctor.

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References
(To view, roll mouse over heading; to hide, click on heading)

1. Burnham TH, ed. Cardiovascular Agents, Antiadrenergics/Sympatholytics, Beta-Adrenergic Blocking Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 2000, 467–79.

2. Wheeldon NM, McDevitt DG, Lipworth BJ. The effects of lower than conventional doses of oral nadolol on relative beta 1/beta 2-adrenoceptor blockade. Br J Clin Pharmacol 1994;38:103–8.

3. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213–4.

4. Burnham TH, ed. Cardiovascular Agents, Antiadrenergics/Sympatholytics, Beta-Adrenergic Blocking Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 2000, 467–79.

5. Wheeldon NM, McDevitt DG, Lipworth BJ. The effects of lower than conventional doses of oral nadolol on relative beta 1/beta 2-adrenoceptor blockade. Br J Clin Pharmacol 1994;38:103–8.

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