Nadolol: a Review of Its Pharmacological Properties and Therapeutic Efficacy in Hypertension and Angina Pectoris

Nadolol is a nonselective beta-adrenoceptor blocking drug without intrinsic sympathomimetic or membrane stabilising activity. Its inherently long duration of activity makes it suitable for once daily administration in both hypertension and angina pectoris, and in these conditions it has been as effective as propranolol given in a traditional regimen 4 times daily. However, other beta-blocking drugs can also be given with reduced frequency, especially in hypertension; and some, such as atenolol (a longer acting 'cardioselective' agent) or long-acting preparations of other beta-blockers, have also been given once daily in angina prophylaxis. Nevertheless, nadolol is one of a few beta-blocking drugs which have clearly been shown to be effective in both hypertension and angina with once daily administration. Other specific properties of nadolol, such as its excretion entirely in unmetabolised form, may offer advantages over other existing beta-blocking drugs in specific patients, while some properties (such as lack of 'cardioselectivity') may be disadvantageous in others. The choice of a beta-blocking drug should thus be based on a knowledge of the pharmacodynamic and pharmacokinetic properties of the different beta-blocking drugs, and a careful consideration of how such properties can best be applied to benefit the individual patient.