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Side Effects of
Beta Blockers


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Beta blockers are commonly used in the treatment of hypertension (high blood pressure) and can also be used to prevent migraines and heart problems in those suffering from chest pain. They are so-called as they are what is termed a “competitive antagonists” at beta adrenergic receptors.

Serious Side Effects of Beta Blockers

Serious potential side effects of beta blockers in genetically susceptible individuals include cardiac arrhythmia, seizures, renal insufficiency, and difficulty breathing. These require immediate emergency treatment. Our DNA test identifies whether you are at risk for these side effects based on how well you metabolize beta blockers, one of over 50 medication classes tested on our panel.

Common Side Effects of Beta Blockers

Common side effects (occur in more than 1% of patients):

  • Hypotension (low blood pressure)
  • Cold extremities
  • Raynaud’s syndrome (can result in cold extremities)
  • Fatigue
  • Sleep disturbances
  • Nightmares
  • Sleep disorder
  • Agitation
  • Somnolence
  • Irritability
  • Less Common Side Effects

  • Dizziness
  • Paresthesia (pins and needles)
  • Seizures
  • Renal insufficiency (inadequate blood perfusion of the kidneys)
  • Dyspnea (difficulty breathing)
  • Bronchospasm (fasciculations of the bronchus)
  • Hypoglycaemia (low blood glucose levels)
  • Anorexia
  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Flatulence (excessive gas)
  • Decreased appetite
  • Depression
  • Hallucinations
  • Psychosis
  • Mood changes
  • Confusion
  • Memory loss
  • Anaphylaxis (allergic reaction)
  • Contact dermatitis (rash from contact with irritants like clothes watches etc)
  • Dry eyes
  • Visual disturbances
  • (Physicians’ Desk Reference, 70th Ed., 2016)

    Understand Your Risks with the Rxight® Genetic Test

    Most patients tolerate beta blockers well. However some may suffer from severe side effects. This interpatient variability is partially accounted for by pharmacogenetics. Polymorphisms (variants) in genes that code for enzymes and receptors that interact with beta blockers can increase the probability of developing adverse reactions.

    The Rxight® pharmacogenetic test identifies genes that modulate how well your body processes specific medications, including beta blockers, and can therefore guide prescribers in finding a dose or alternative medication to decrease the probability of the patient suffering from adverse reactions or experiencing no therapeutic benefit. Specifically, Rxight® is based on the analysis of over a dozen genes and their alleles across hundred of clinically relevant over-the-counter and prescription medications and nearly 50 medication classes, including beta blockers, to establish how patients are likely to react. A simple cheek swab of your DNA is all that is required for this test.

    How Does Pharmacogenetic Testing Work?

    Pharmacogenetic testing is the science of how your body processes medications based on your unique genetic makeup. Individual variation in genes that code for enzymes in the liver and receptors that interact with beta blockers can increase the probability of developing adverse reactions. For instance, beta blockers are mainly metabolized by the cytochrome P450 superfamily of enzymes. Polymorphisms in CYP2D6 have been suggested to increase the likelihood of developing adverse reactions when taking some beta blockers (e.g., propranolol/Inderal). Identifying these alleles can therefore decrease the patient’s probability of suffering from medication side effects.

    Contributors to this Article:
    Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry

    Beta Blockers Tested Include:

    • Carvedilol (Coreg)
    • Labetalol (Normodyne, Trandate)
    • Metoprolol (Lopressor, Toprol)
    • Metoprolol (Lopressor, Toprol)
    • Mirabegron (Myrbetriq)
    • Nebivolol (Bystolic)
    • Propranolol (Inderal)
    • Timolol (Blocadren, Timoptic)

    Read more about Rxight® DNA Testing For Medication Tolerance