Nadolol

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Date: July 2024, Version 4

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Nadolol can be used in pregnancy if recommended by a doctor.

What is it?

Nadolol is used to treat high blood pressure (hypertension), some heart conditions, migraine, and a thyroid problem called thyrotoxicosis.

Benefits

What are the benefits of taking nadolol in pregnancy?

Nadolol reduces the risks of harm from high blood pressure, heart conditions, including angina and arrhythmia (irregular heartbeat), and a thyroid problem called thyrotoxicosis. This is important as these conditions can get worse during pregnancy and/or may lead to complications. 

Nadolol used for migraine can improve pain and quality of life.

Some women will already be taking nadolol before pregnancy. If so, it should be continued but reviewed as soon as possible by a GP or specialist.

Risks

Are there any risks of taking nadolol during pregnancy?

Very few pregnant women taking nadolol have been studied. 

Nadolol belongs to a family of medicines called beta blockers. Studies have shown that beta blockers do not cause birth defects, stillbirth or preterm birth. Women taking beta blockers may be more likely to have a smaller baby. However, a small baby can be due to underlying health conditions that beta blockers are commonly used to treat, like high blood pressure. It is therefore difficult to know if a beta blocker could affect your baby’s weight. 

Occasionally, beta blockers used in late pregnancy can affect your baby for a short while after birth (for example, causing low blood sugar). Your baby may require an extra day or two in hospital following birth to look out for any problems. If these occur, they can be treated and usually settle quickly.

Alternatives

Are there any alternatives to taking nadolol?

Possibly. There may be other medicines that are suitable to treat your medical condition. Please let your GP and/or obstetrician know that you are taking nadolol so that they can make sure it is still right for you. If you have any questions about a medicine that you are offered in pregnancy you can discuss them with your doctor or midwife.

No treatment

What if I prefer not to take medicines during pregnancy?

It is very important to take any medicines prescribed for high blood pressure, heart problems, or thyrotoxicosis. High blood pressure can lead to a potentially serious condition called pre-eclampsia. Heart problems and thyrotoxicosis can be dangerous to both you and your baby and must be as well-controlled as possible. 

Migraine sometimes gets better on its own during pregnancy so some women can stop migraine medication. Please do not stop nadolol without first speaking to your doctor.

Your doctor will only prescribe medicines when absolutely necessary and will be happy to talk to you about any concerns that you might have.

Will my baby need extra monitoring?

You will be offered a detailed scan at around 20 weeks of pregnancy as part of your routine antenatal care. If you take a beta blocker in pregnancy, you may be offered additional scans at around 32 and 36 weeks to check that your baby is growing normally.

Are there any risks to my baby if the father has taken nadolol?

We would not expect any increased risk to your baby if the father takes nadolol.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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