Use caution when taking Beta Blockers.
Medication names:
  • Bisoprolol (Zebeta®)
  • Carvedilol (Coreg®)
  • Metoprolol succinate (Toprol-XL®)

Why this medication is prescribed?

A beta-blocker improves the heart’s ability to relax, decreases the production of harmful substances produced by the body in response to heart failure, and slows the heart rate. Over time, a beta-blocker may improve the heart’s pumping ability.

A beta-blocker is essential for people with heart failure -- even if they do not have symptoms. A beta-blocker is prescribed for patients with systolic heart failure (when the heart muscle does not contract with enough force) and improves survival even in people with severe symptoms. A beta-blocker is also used to control high blood pressure and slow the heart rate in conditions that cause "tachycardia" or fast heart rate and in heart failure with preserved left ventricle function (diastolic dysfunction).

When to take

This medication can be taken with meals, at bedtime, or in the morning. Food delays how fast beta-blockers are absorbed and may reduce side effects. Follow the label directions on how often to take this medication.

The number of doses you take each day, the time allowed between doses, and how long you need to take the medication will depend on your condition.

Special directions

  • If you have any lung congestion, your health care provider will treat your congestion before prescribing a beta-blocker.
  • A beta-blocker should not be used if you have extremely low blood pressure (hypotension) or a slow pulse (bradycardia) that causes you to feel dizzy or light-headed.
  • While you are taking this medication, your health care provider may tell you to take and record your pulse daily. He or she will tell you how rapid your pulse should be. If your pulse is slower than it should be, contact your doctor or nurse about taking your beta-blocker that day.
  • Do not stop taking your medication, even if you feel that it is not working. When you start taking a beta-blocker, your heart failure symptoms may become worse (for about 2½ weeks) while your heart adjusts to the medication. This is a normal effect, but let your doctor or nurse know if you become extremely tired, gain more than 5 pounds, have trouble breathing, or have other signs of congestion or swelling. Once your heart adjusts, you will feel better.
Food and drug interactions

A beta-blocker is often prescribed with a diuretic, ACE inhibitor, or angiotensin receptor blocker (ARB). If you have side effects after taking your medications together, contact your health care provider. You may need to change the times you are taking each medication.

Side effects and how to manage them

  • Dizziness or lightheadedness—This side effect may be strongest when you get out of bed or rise from a chair. Get up more slowly. Contact your doctor or nurse if these symptoms persist or are severe.
  • Tiredness, cold hands and feet, headache, nightmares, difficulty sleeping, nausea, heartburn, diarrhea or constipation, gas—Contact your doctor or nurse if these symptoms are severe or persist.
  • Sudden weight gain—Weight gain is common as your doctor increases your medication dose. Call your doctor or nurse if you gain 3 or more pounds in one day or if you continue to gain weight for more than 2 days.
  • Increased shortness of breath; wheezing; difficulty breathing; skin rash, slow, fast or irregular heartbeat; swelling of feet and lower legs; sudden weight gain; chest pain—Contact your doctor or nurse right away.
  • Vomiting or diarrhea—If you have severe vomiting or diarrhea, you may become dehydrated (lose too much water from the body), which can lead to low blood pressure. Contact your doctor or nurse.

Contact your doctor or nurse if you have any other symptoms that cause concern.


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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 9/1/2010...#12879

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