Beta-Adrenoceptor Blocking Drugs

NHSL Medicines Guidance
NHS Lanarkshire

Beta-Blockers

Preferred list (P)

ATENOLOL

BISOPROLOL

  • Bisoprolol has a long half-life and may provide better 24 hour blood pressure control in hypertensive patients.

 

Total list (T)

CARVEDILOL

  • Restriction: For the treatment of heart failure with reduced left ventricular systolic function.

Prescribing Notes:

  • Beta-blockers have a class effect and so choice should be based on licensed indication (see link to BNF) and factors such as co-morbidities, compliance and cost-effectiveness.

  • Beta-blockers may cause bronchospasm and should be avoided in patients with asthma or COPD with reversibility. Where use of a beta-blocker is deemed necessary caution should be exercised and a selective beta-blocker chosen.

  • All patients prescribed a beta-blocker should have their heart rate and blood pressure regularly monitored. A heart rate less than 60bpm is an indication of beta-blockade.

  • Refer to Class 2 Anti-Arrhythmics for NHS Lanarkshire recommendations on choice of beta-blocker in the management of arrhythmias.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.