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Specific Beta Blocker Warnings and Precautions

Some warnings and precautions to be aware of include the following:
  • Beta blockers that are taken by mouth should not suddenly be stopped, as serious problems (including heart attacks) may result. Your healthcare provider will advise you about how to safely stop taking these medications.

It is usually recommended to slowly reduce the dose over a period of one to two weeks, with careful monitoring, and to minimize physical activity during this time. Let your healthcare provider know if you develop chest pain or any other problems while stopping a beta blocker. These precautions are not necessary for beta blocker eye drops.

  • Beta blockers can worsen heart failure in some situations. However, beta blockers are also useful for the treatment of heart failure. If you have heart failure, your healthcare provider may need to monitor you very closely while you take beta blockers. Let your healthcare provider know immediately if your heart failure symptoms seem to worsen.
  • Beta blockers can worsen breathing problems such as asthma or COPD. If you have breathing problems, check with your healthcare provider before taking a beta blocker. Even "cardioselective" beta blockers (which are designed to have less of an effect on the airways) can cause problems, especially at higher doses. While people with well-controlled, mild asthma or COPD may be able to safety take a beta blocker, beta blockers should be avoided in people with severe breathing problems.
  • If you have an upcoming surgery, make sure your surgeon and anesthesiologist know you are taking a beta blocker, as it may affect the choice of medications used during the surgery.
  • Beta blockers can mask some of the symptoms of low blood sugar (hypoglycemia), particularly the "racing heart" feeling. This can cause serious problems for people with diabetes, who need to be able to sense that they have low blood sugar (in order to correct it before it becomes life-threatening).
  • Beta blockers can mask some of the symptoms of an overactive thyroid (hyperthyroidism). Stopping beta blockers suddenly could cause symptoms of a "thyroid storm" (a sudden and severe worsening of hyperthyroidism symptoms).
  • For most beta blockers, the kidneys and liver help remove the medication from the body. If you have kidney or liver disease, your healthcare provider may need to monitor your response to the beta blocker more closely (and a lower dosage may be recommended).
  • Beta blockers could potentially cause problems for people with poor blood circulation in the brain (such as people who have had a stroke or transient ischemic attack) or the legs (such as with peripheral artery disease). If you have had such problems in the past, check with your healthcare provider before taking a beta blocker.
  • If you have an anaphylactic allergy (the type that affects the entire body and often interferes with breathing), beta blockers may make you more sensitive to the allergen and can make the usual treatments (such as epinephrine or an EpiPen®) less effective.
  • Beta blockers might worsen myasthenia gravis. If you have this condition, you may need to be monitored more closely.
  • Beta blockers are considered pregnancy Category B, C, or D medications (depending on the particular beta blocker). This means that they may not be safe for use during pregnancy, although the full risks are not currently known (see Beta Blockers and Pregnancy).
  • Most beta blockers pass through breast milk (although it is unknown if this is true for all beta blockers). Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking a beta blocker (see Beta Blockers and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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