Nadolol (Monograph)

Brand name: Corgard
Drug class: alpha-Adrenergic Blocking Agents

Medically reviewed by Drugs.com on Apr 10, 2024. Written by ASHP.

Introduction

Nonselective β-adrenergic blocking agent (β-blocker).^a

Uses for Nadolol

Hypertension

Management of hypertension, alone or in combination with other antihypertensive agents.¹³⁵ ⁶⁰⁰ ¹²⁰⁰ ^a

β-Blockers generally not preferred for first-line therapy of hypertension according to current evidence-based hypertension guidelines, but may be considered in patients who have a compelling indication (e.g., prior MI, ischemic heart disease, heart failure) for their use or as add-on therapy in those who do not respond adequately to the preferred drug classes (ACE inhibitors, angiotensin II receptor antagonists, calcium-channel blockers, or thiazide diuretics).¹⁷⁶ ⁵⁰¹ ⁵⁰² ⁵⁰³ ⁵⁰⁴ ⁵¹⁵ ⁵²³ ⁵²⁴ ⁵²⁷ ⁸⁰⁰ ¹²⁰⁰ Nadolol is one of several β-blockers (including bisoprolol, carvedilol, metoprolol succinate, metoprolol tartrate, propranolol, and timolol) recommended by a 2017 ACC/AHA multidisciplinary hypertension guideline as first-line therapy for hypertension in patients with stable ischemic heart disease/angina.¹²⁰⁰

Individualize choice of therapy; consider patient characteristics (e.g., age, ethnicity/race, comorbidities, cardiovascular risk) as well as drug-related factors (e.g., ease of administration, availability, adverse effects, cost).⁵⁰¹ ⁵⁰² ⁵⁰³ ⁵⁰⁴ ⁵¹⁵ ¹²⁰⁰ ¹²⁰¹

The 2017 ACC/AHA hypertension guideline classifies BP in adults into 4 categories: normal, elevated, stage 1 hypertension, and stage 2 hypertension.¹²⁰⁰ (See Table 1.)

Source: Whelton PK, Carey RM, Aronow WS et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:e13-115.

Individuals with SBP and DBP in 2 different categories (e.g., elevated SBP and normal DBP) should be designated as being in the higher BP category (i.e., elevated BP).

Table 1. ACC/AHA BP Classification in Adults1200
Category	SBP (mm Hg)		DBP (mm Hg)
Normal	<120	and	<80
Elevated	120–129	and	<80
Hypertension, Stage 1	130–139	or	80–89
Hypertension, Stage 2	≥140	or	≥90

The goal of hypertension management and prevention is to achieve and maintain optimal control of BP.¹²⁰⁰ However, the BP thresholds used to define hypertension, the optimum BP threshold at which to initiate antihypertensive drug therapy, and the ideal target BP values remain controversial.⁵⁰¹ ⁵⁰³ ⁵⁰⁴ ⁵⁰⁵ ⁵⁰⁶ ⁵⁰⁷ ⁵⁰⁸ ⁵¹⁵ ⁵²³ ⁵²⁶ ⁵³⁰ ¹²⁰⁰ ¹²⁰¹ ¹²⁰⁷ ¹²⁰⁹ ¹²²² ¹²²³ ¹²²⁹

The 2017 ACC/AHA hypertension guideline generally recommends a target BP goal (i.e., BP to achieve with drug therapy and/or nonpharmacologic intervention) <130/80 mm Hg in all adults regardless of comorbidities or level of atherosclerotic cardiovascular disease (ASCVD) risk.¹²⁰⁰ In addition, an SBP goal of <130 mm Hg generally is recommended for noninstitutionalized ambulatory patients ≥65 years of age with an average SBP of ≥130 mm Hg.¹²⁰⁰ These BP goals are based upon clinical studies demonstrating continuing reduction of cardiovascular risk at progressively lower levels of SBP.¹²⁰⁰ ¹²⁰² ¹²¹⁰

Other hypertension guidelines generally have based target BP goals on age and comorbidities.⁵⁰¹ ⁵⁰⁴ ⁵³⁶ Guidelines such as those issued by the JNC 8 expert panel generally have targeted a BP goal of <140/90 mm Hg regardless of cardiovascular risk and have used higher BP thresholds and target BPs in elderly patients⁵⁰¹ ⁵⁰⁴ compared with those recommended by the 2017 ACC/AHA hypertension guideline.¹²⁰⁰

Some clinicians continue to support previous target BPs recommended by JNC 8 due to concerns about the lack of generalizability of data from some clinical trials (e.g., SPRINT study) used to support the 2017 ACC/AHA hypertension guideline and potentials harms (e.g., adverse drug effects, costs of therapy) versus benefits of BP lowering in patients at lower risk of cardiovascular disease.¹²²² ¹²²³ ¹²²⁴ ¹²²⁹

Consider potential benefits of hypertension management and drug cost, adverse effects, and risks associated with the use of multiple antihypertensive drugs when deciding a patient's BP treatment goal.¹²⁰⁰ ¹²²⁰ ¹²²⁹

For decisions regarding when to initiate drug therapy (BP threshold), the 2017 ACC/AHA hypertension guideline incorporates underlying cardiovascular risk factors.¹²⁰⁰ ¹²⁰⁷ ASCVD risk assessment is recommended by ACC/AHA for all adults with hypertension.¹²⁰⁰

ACC/AHA currently recommend initiation of antihypertensive drug therapy in addition to lifestyle/behavioral modifications at an SBP ≥140 mm Hg or DBP ≥90 mm Hg in adults who have no history of cardiovascular disease (i.e., primary prevention) and a low ASCVD risk (10-year risk <10%).¹²⁰⁰

For secondary prevention in adults with known cardiovascular disease or for primary prevention in those at higher risk for ASCVD (10-year risk ≥10%), ACC/AHA recommend initiation of antihypertensive drug therapy at an average SBP ≥130 mm Hg or an average DBP ≥80 mm Hg.¹²⁰⁰

Adults with hypertension and diabetes mellitus, chronic kidney disease (CKD), or age ≥65 years are assumed to be at high risk for cardiovascular disease; ACC/AHA state that such patients should have antihypertensive drug therapy initiated at a BP ≥130/80 mm Hg.¹²⁰⁰ Individualize drug therapy in patients with hypertension and underlying cardiovascular or other risk factors.⁵⁰² ¹²⁰⁰

In stage 1 hypertension, experts state that it is reasonable to initiate drug therapy using the stepped-care approach in which one drug is initiated and titrated and other drugs are added sequentially to achieve the target BP.¹²⁰⁰ Initiation of antihypertensive therapy with 2 first-line agents from different pharmacologic classes recommended in adults with stage 2 hypertension (SBP ≥140 mm Hg or DBP ≥90 mm Hg) and average BP >20/10 mm Hg above BP goal.¹²⁰⁰

Black hypertensive patients generally tend to respond better to monotherapy with calcium-channel blockers or thiazide diuretics than to β-blockers.¹⁵⁴ ¹⁵⁸ ¹⁵⁹ ⁵⁰¹ ⁵⁰⁴ ¹²⁰⁰ However, diminished response to β-blockers is largely eliminated when administered concomitantly with a thiazide diuretic.⁵⁰⁰

Chronic Stable Angina

Long-term management of chronic stable angina.⁶⁰⁰ ^a

β-Blockers are recommended as first-line anti-ischemic drugs in most patients with chronic stable angina; despite differences in cardioselectivity, intrinsic sympathomimetic activity, and other clinical factors, all β-blockers appear to be equally effective for this use.¹¹⁰¹

Supraventricular Tachyarrhythmias

Has been used for management of frequent VPCs, paroxysmal atrial tachycardia, and sinus tachycardia and to decrease heart rate in patients with atrial flutter or fibrillation^{† [off-label]}.^a

Vascular Headache

Prophylaxis of migraine headache^{† [off-label]}.¹⁰⁰ ¹⁰¹ ¹⁴⁸

US Headache Consortium states there is evidence of efficacy, and clinical experience suggests clinically important improvement in most patients.¹⁴⁸

Nadolol Dosage and Administration

General

Individualize dosage according to patient response.⁶⁰⁰ ^a
If long-term therapy is discontinued, reduce dosage gradually over 1–2 weeks.⁶⁰⁰ ^a (See Abrupt Withdrawal of Therapy under Cautions.)

BP Monitoring and Treatment Goals

Monitor BP regularly (i.e., monthly) during therapy and adjust dosage of the antihypertensive drug until BP controlled.¹²⁰⁰
If unacceptable adverse effects occur, discontinue drug and initiate another antihypertensive agent from a different pharmacologic class.¹²¹⁶
If adequate BP response not achieved with a single antihypertensive agent, either increase dosage of single drug or add a second drug with demonstrated benefit and preferably a complementary mechanism of action (e.g., ACE inhibitor, angiotensin II receptor antagonist, calcium-channel blocker, thiazide diuretic).¹²⁰⁰ ¹²¹⁶ Many patients will require ≥2 drugs from different pharmacologic classes to achieve BP goal; if goal BP still not achieved, add a third drug.¹²⁰⁰ ¹²¹⁶

Administration

Oral Administration

Administer orally once daily without regard to meals.^a ¹³⁵ ⁶⁰⁰

Dosage

Adults

Hypertension

Nadolol Therapy

Oral

Initially, 20–40 mg daily, either alone or in combination with a diuretic.⁶⁰⁰ ^a

May gradually increase by 40–80 mg daily at 2- to 14-day intervals until optimum BP response is achieved.^a

Manufacturers recommend usual maintenance dosage of 40–80 mg daily; dosages up to 240 or 320 mg daily may be needed.⁶⁰⁰ ^a

Some experts state usual dosage range is 40–120 mg once daily;¹²⁰⁰ may be preferable to add another antihypertensive agent to the regimen rather than to continue increasing nadolol dosage.¹⁵⁷

Nadolol/Bendroflumethiazide Fixed-combination Therapy

Oral

Initially 40 mg of nadolol and 5 mg of bendroflumethiazide once daily.¹³⁵ If needed, increase to 80 mg of nadolol and 5 mg of bendroflumethiazide once daily.¹³⁵

If BP is not adequately controlled with the fixed combination alone, may gradually add another nondiuretic hypotensive agent, starting with 50% of the usual recommended starting dosage to avoid excessive reduction in BP.¹³⁵

Manufacturers state fixed-combination preparations should not be used for initial antihypertensive therapy.⁶⁰¹

Chronic Stable Angina

Oral

Initially, 40 mg daily.⁶⁰⁰ ^a Gradually increase by 40–80 mg daily at 3- to 7-day intervals until optimum control of angina is obtained or there is pronounced slowing of the heart rate (i.e., <55 bpm).⁶⁰⁰ ^a

Usual maintenance dosage is 40 or 80 mg daily.⁶⁰⁰ ^a Up to 160 or 240 mg daily may be needed.⁶⁰⁰ ^a

Periodically evaluate chronic therapy for angina to determine need for dosage alteration or continued therapy.^a

Supraventricular Tachyarrhythmias† [off-label]

Various Cardiac Arrhythmias† [off-label]

Oral

Maintenance dose: 60–160 mg daily in single or divided doses has been used.^a

Vascular Headache† [off-label]

Prevention of Migraine†

Oral

Usual effective dosage: 80–240 mg daily.¹⁴⁸

Prescribing Limits

Adults

Chronic Stable Angina

Oral

Safety and efficacy of dosages >240 mg daily not established.⁶⁰⁰ ^a

Special Populations

Renal Impairment

Adjust intervals for usual dosage of nadolol alone or in fixed combination with bendroflumethiazide:⁶⁰⁰

Cl_cr (mL/minute per 1.73 m²)	Dosage Interval
>50	24 h
31–50	24–36 h
10–30	24–48 h
<10	40–60 h

Cautions for Nadolol

Contraindications

Bronchial asthma.⁶⁰⁰ ^a
Sinus bradycardia and heart block greater than first degree.⁶⁰⁰ ^a
Cardiogenic shock.⁶⁰⁰ ^a
Overt heart failure.⁶⁰⁰ ^a

Warnings/Precautions

Warnings

Heart Failure

Possible precipitation of heart failure.⁶⁰⁰ ^a Avoid use in patients with overt heart failure;⁶⁰⁰ ^a may use cautiously in patients with inadequate myocardial function and, if necessary, in patients with well-compensated heart failure (e.g., those controlled with cardiac glycosides and/or diuretics).⁶⁰⁰ ^a

Adequate treatment (e.g., with a cardiac glycoside and/or diuretic) and close observation recommended if signs or symptoms of impending heart failure occur; if heart failure continues, discontinue therapy, gradually if possible.⁶⁰⁰ ^a

Abrupt Withdrawal of Therapy

Abrupt withdrawal of nadolol not recommended as it may exacerbate angina symptoms or precipitate MI in patients with angina pectoris and/or CAD.⁶⁰⁰ ^a Avoid abrupt discontinuance, even when used only for hypertension.⁶⁰⁰ ^a Abrupt withdrawal may cause transient symptoms (e.g., tremulousness, sweating, palpitation, headache, malaise) in patients without CAD.^a

Discontinue long-term therapy gradually (particularly in patients with myocardial ischemia); decrease dosage over 1–2 weeks and monitor carefully.⁶⁰⁰ ^a If exacerbation of angina occurs or acute coronary insufficiency develops, reinstitute therapy promptly, at least temporarily, and initiate appropriate measures for the management of unstable angina.⁶⁰⁰ ^a

Bronchospastic Disease

Possible inhibition of bronchodilation produced by endogenous or exogenous catecholamines;⁶⁰⁰ ^a use not recommended in patients with bronchial asthma.⁶⁰⁰ (See Contraindications under Cautions.)

Generally, β-blockers should not be used in patients with bronchospastic disease.⁶⁰⁰ ^a Use with caution in patients with a history of nonallergic bronchospasm (e.g., chronic bronchitis, emphysema).⁶⁰⁰ ^a

Major Surgery

Possible increased risks associated with general anesthesia and surgical procedures due to decreased ability of the heart to respond to reflex β-adrenergic stimuli.⁶⁰⁰ Use with caution in major surgery involving general anesthesia.^a Manufacturer states that chronically administered β-blocking therapy should not be routinely withdrawn prior to major surgery.⁶⁰⁰ If nadolol is continued during surgery, inform the anesthesiologist.^a

Diabetes and Hypoglycemia

Possible masked signs and symptoms of acute hypoglycemia (e.g., tachycardia and BP changes but not sweating), impaired glucose tolerance, delayed rate of recovery of blood glucose concentration following drug-induced hypoglycemia, altered hemodynamic response to hypoglycemia (possibly resulting in an exaggerated hypertensive response), and impaired peripheral circulation.⁶⁰⁰ ^a

Use with caution in patients with diabetes mellitus (especially those with labile diabetes or those prone to hypoglycemia).⁶⁰⁰ ^a If used with hypoglycemic agents, may need to adjust hypoglycemic agent dosage.^a

Thyrotoxicosis

Signs of hyperthyroidism (e.g., tachycardia) may be masked.⁶⁰⁰ ^a Possible thyroid storm if therapy is abruptly withdrawn; carefully monitor patients having or suspected of developing thyrotoxicosis.⁶⁰⁰ ^a

General Precautions

History of Anaphylactic Reactions

Possible increased reactivity to a variety of allergens; patients may be unresponsive to usual doses of epinephrine used to treat anaphylactic reactions.⁶⁰⁰ ^a

Other Precautions

Shares the toxic potentials of β-blockers; observe usual precautions of these agents.^a In addition, when used in fixed-combination with bendroflumethiazide, consider the cautions, precautions, and contraindications associated with thiazide diuretics.^a

Specific Populations

Pregnancy

Category C.⁶⁰⁰ ¹³⁵

Lactation

Distributed into milk.⁶⁰⁰ ^a Discontinue nursing or the drug.⁶⁰⁰ ^a

Pediatric Use

Safety and efficacy not established.⁶⁰⁰ ^a

Hepatic Impairment

Use with caution.^a

Renal Impairment

Use with caution.⁶⁰⁰

Clearance may be decreased; dosage adjustments necessary depending on degree of renal impairment.⁶⁰⁰ ^a (See Renal Impairment under Dosage and Administration)

Common Adverse Effects

Bradycardia (heart rate <60 bpm), peripheral vascular insufficiency (usually Raynaud’s type), dizziness, fatigue.^a

Drug Interactions

Specific Drugs

Drug	Interaction	Comments
Antidiabetic agents	Potential for altered antidiabetic response⁶⁰⁰	Adjust antidiabetic agent dosage if needed⁶⁰⁰
Cardiovascular drugs (e.g., cardiac glycosides, nondihydropyridine calcium-channel blocking agents)	Possible additive negative effects on SA or AV nodal conduction¹¹⁶ ¹¹⁷
Catecholamine-depleting drugs (e.g., reserpine)	Potential for additive effects (increased hypotension and marked bradycardia) ⁶⁰⁰ ^a	Monitor closely for symptoms (e.g., vertigo, syncope, postural hypotension)⁶⁰⁰
Diuretics	Possible increased hypotensive effect^a	Careful dosage adjustments recommended^a
Drugs with anticholinergic effects	Potential for antagonism of cardiac β-adrenergic blocking effects
Hypotensive agents	Possible increased hypotensive effect ^a	Careful dosage adjustments recommended^a
Mibefradil (no longer commercially available in the US)	Slowing or complete suppression of SA node activity with development of slow ventricular rates¹¹⁶ ¹¹⁷	Reported principally in geriatric patients with concomitant β-adrenergic blocker therapy¹¹⁶ ¹¹⁷
Myocardial depressant general anesthetics	Increased risk of hypotension, myocardial depression, and heart failure⁶⁰⁰	See Major Surgery under Cautions
Neuromuscular blocking agents (e.g., tubocurarine chloride)	High doses of nadolol may increase effects of neuromuscular blocking agents^a
Phenothiazines	Possible additive hypotensive effect, especially when large phenothiazine doses are used^a
Sympathomimetic agents (e.g., isoproterenol, epinephrine)	Possible antagonism of β-adrenergic stimulating effects^a	Administer epinephrine with caution; decreased pulse rate with first- and second-degree heart block and hypertension may occur^a Very large doses of isoproterenol may be needed to overcome β-adrenergic blocking effects^a

Nadolol Pharmacokinetics

Absorption

Bioavailability

Following oral administration, absorption is variable; averages about 30–40%.¹³⁵ ⁶⁰⁰ ^a

Duration

Following doses of 40–320 mg daily, duration of antihypertensive and antianginal effects is ≥24 hours.^a

Food

Food does not affect the rate or extent of absorption.⁶⁰⁰ ^a

Distribution

Extent

Widely distributed; minimal amounts detected in the brain of dogs.^a Distributed into bile.^a

Nadolol crosses the placenta in rats^a and is distributed into human milk.⁶⁰⁰

Plasma Protein Binding

About 30%.¹³⁵ ⁶⁰⁰ ^a

Elimination

Metabolism

Not metabolized.⁶⁰⁰ ^a

Elimination Route

Excreted principally unchanged in feces (about 76.9%) and urine (about 24.6%) in 4 days.^a

Half-life

10–24 hours.⁶⁰⁰ ¹³⁵ ^a

Special Populations

Increased half-life in patients with renal impairment.⁶⁰⁰ ^a Removed by hemodialysis.^a

Stability

Storage

Oral

Tablets

Tight, light-resistant containers at room temperature.⁶⁰⁰ ^a

Actions

Inhibits response to adrenergic stimuli by competitively blocking β₁-adrenergic receptors within the myocardium and β₂-adrenergic receptors within bronchial and vascular smooth muscle.⁶⁰⁰ ^a
Decreases resting heart rate, inhibits exercise-induced increases in heart rate, and decreases cardiac output at rest and during exercise.^a
Decreases AV node conduction velocity and decreases myocardial automaticity.^a
No intrinsic sympathomimetic activity, little direct myocardial depressant activity, and no membrane-stabilizing effect on the heart.^a
Reduces BP by blocking peripheral (especially cardiac) adrenergic receptors (decreasing cardiac output), by decreasing sympathetic outflow from the CNS, and/or by suppressing renin release.^a
Decreases BP in both supine and standing positions.^a
In patients with angina, blocks catecholamine-induced increases in heart rate, velocity and extent of myocardial contraction, and BP resulting in a net decrease in myocardial oxygen consumption.^a
May increase oxygen requirements by increasing left ventricular fiber length and end diastolic pressure in patients with heart failure.^a
Increases airway resistance (especially in asthmatic patients) and inhibits the release of free fatty acids and insulin.^a

Advice to Patients

Importance of taking exactly as prescribed.^a
Importance of not interrupting or discontinuing therapy without consulting clinician.^a
Importance of immediately informing clinician at the first sign or symptom of impending cardiac failure or if any difficulty in breathing occurs.^a
Importance of patient informing anesthesiologist or dentist about nadolol therapy before undergoing major surgery.^a
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.^a
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.^a
Importance of informing patients of other important precautionary information. (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Nadolol
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets	20 mg*	Corgard (scored)	Pfizer
			Nadolol Tablets
		40 mg*	Corgard (scored)	Pfizer
			Nadolol Tablets
		80 mg*	Corgard (scored)	Pfizer
			Nadolol Tablets

Nadolol Combinations
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets	40 mg with Bendroflumethiazide 5 mg	Corzide (scored)	Pfizer
			Nadolol and Bendroflumethiazide Tablets
		80 mg with Bendroflumethiazide 5 mg	Corzide (scored)	Pfizer
			Nadolol and Bendroflumethiazide Tablets

† Off-label: Use is not currently included in the labeling approved by the US Food and Drug Administration.

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502. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31:1281-357. http://www.ncbi.nlm.nih.gov/pubmed/23817082?dopt=AbstractPlus

503. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014; 63:878-85. http://www.ncbi.nlm.nih.gov/pubmed/24243703?dopt=AbstractPlus

504. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014; 16:14-26. http://www.ncbi.nlm.nih.gov/pubmed/24341872?dopt=AbstractPlus

505. Wright JT, Fine LJ, Lackland DT et al. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014; 160:499-503. http://www.ncbi.nlm.nih.gov/pubmed/24424788?dopt=AbstractPlus

506. Mitka M. Groups spar over new hypertension guidelines. JAMA. 2014; 311:663-4. http://www.ncbi.nlm.nih.gov/pubmed/24549531?dopt=AbstractPlus

507. Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes?. JAMA. 2014; 311:474-6. http://www.ncbi.nlm.nih.gov/pubmed/24352710?dopt=AbstractPlus

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515. Thomas G, Shishehbor M, Brill D et al. New hypertension guidelines: one size fits most?. Cleve Clin J Med. 2014; 81:178-88. http://www.ncbi.nlm.nih.gov/pubmed/24591473?dopt=AbstractPlus

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526. Kernan WN, Ovbiagele B, Black HR et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014; :. http://www.ncbi.nlm.nih.gov/pubmed/24788967?dopt=AbstractPlus

527. O'Gara PT, Kushner FG, Ascheim DD et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013; 127:e362-425. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=3695607&blobtype=pdf

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536. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl. 2012: 2: 337-414.

600. Pfizer. Corgard (nadolol) tablets prescribing information. New York, NY; 2013 July.

601. Pfizer. Corzide (nadolol and bendroflumethiazide) tablets prescribing information. New York, NY; 2013 July.

800. Yancy CW, Jessup M, Bozkurt B et al. 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2016; :. http://circ.ahajournals.org/content/134/13/e282.long

1101. Fihn SD, Gardin JM, Abrams J et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012; 126:e354-471.

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a. AHFS Drug Information 2018. McEvoy GK, ed. Nadolol. Bethesda, MD: American Society of Health-System Pharmacists; 2018:.

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Pill N 20 is Nadolol 20 mg — Nadolol 20 mg (N 20)

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