Section 02 · Monograph
Nadolol
Reviewed Nov 2026FDA label
CorgardBeta-blocker
- Forms
- Tab: 20, 40, 80mg
- Dose
- Migraine prevention (off-label): start 20-40mg daily, titrate to 80-240mg/day
- MOA
- Nonselective β1/β2 blockade
Indications
- Hypertension and angina pectorisFDA-labeled
Off-Label Uses
- Migraine preventionOff-label
Mechanism of Action
- Nonselective beta-adrenergic blocker with long half-life; migraine prevention mechanism involves reduced cortical excitability and sympathetic modulation
Full Dosing
Adult / usual
- Migraine prevention (off-label): start 20-40mg once daily; titrate to 80-240mg/day as tolerated
- Do not stop abruptly (rebound tachycardia, angina or MI in ischemic heart disease); taper over 1-2 weeks
Renal
- Reduce dose in renal impairment (renally cleared)
Contraindications
- Bronchial asthma
- Sinus bradycardia and greater than first-degree AV block
- Cardiogenic shock and overt cardiac failure
- Hypersensitivity
Drug Interactions
- Verapamil/diltiazem and other AV nodal agents: bradycardia and AV block
- Insulin and sulfonylureas: masked hypoglycemia
- Epinephrine: unopposed alpha effects
Adverse Effects
- Fatigue, bradycardia, dizziness
- Cold extremities, depression, sleep disturbance
- Bronchospasm
- Exercise intolerance
Monitoring Parameters
- Heart rate and blood pressure
- Renal function
- Mood and fatigue
Pregnancy & Lactation
- Can cause fetal bradycardia and growth restriction; use if benefit justifies risk
- Present in milk