Pindolol (Oral)

Used to lower the blood pressure of patients at a higher risk of heart attacks, kidney problems or stroke, Pindolol works by preventing the action of certain substances on the blood vessels and heart.

Overview

Part of a group of medicines known as beta-blockers, Pindolol is typically used either alone or in combination with other medicines (including hydrochlorothiazide) to counteract the effects of hypertension (high blood pressure). High blood pressure causes problems by placing a strain on a patient's arteries and heart. Over time, this can lead to problems with the normal function of the circulatory system. This, in turn, can lead to problems with the blood vessels that supply the heart, kidneys and brain, which can cause heart failure, kidney failure or stroke. Hypertension is also linked to an increased risk of heart attacks. All of these problems can be managed by controlling the blood pressure.

Beta-blockers (a family of medicines to which Pindolol belongs) work by changing the body's response to nerve impulses in specific areas, including the heart. The reduced response means the heartbeat slows down and the patient's blood pressure is lowered. Lower blood pressure is associated with higher oxygen and blood supplied to the heart.

Pindolol is only available on prescription from a qualified physician and is available in the form of oral tablets.

Conditions Treated

Type Of Medicine

  • Beta-blocker

Side Effects

All medicines come with the risk of causing unwanted side effects alongside their desired functions. Not all the listed side effects may occur, but if they do, they may require medical advice. Patients should consult their physician if they experience any of the following serious side effects:

  • Swelling of the lower legs, feet, face or fingers
  • Crawling, itching, burning, prickling, 'pins and needles', tingling or numbness sensations
  • Difficulties breathing
  • Tightness of the chest
  • Veins dilated in the neck
  • Chest pain
  • Wheezing
  • Difficulties urinating or decreased levels of urine
  • Unusually high levels of fatigue
  • Racing pulse or an irregular, fast or pounding heart rate
  • Breathing irregularities
  • Hallucinations - feeling, hearing or seeing things that aren't real
  • Sudden weight gain.

The following serious side effects may indicate an overdose of Pindolol. If patients experience these, they should consult medical advice immediately:

  • Headaches
  • Nervousness
  • Dizziness
  • Blurred or distorted vision
  • Hearing pounding in the ears
  • An unusually slow heartbeat.

Some side effects may present themselves that typically do not require immediate medical attention. Such side effects may recede as treatment progresses as the patient's body adjusts to the medicine. Patients should be encouraged to consult their physician for ways to lessen their effects or prevent them altogether. The following side effects may persist or become particularly worrisome, in which case, patients should contact their physician for advice and to answer any questions:

  • Muscular pain
  • Pain in the joints
  • Insomnia (sleeplessness)
  • Difficulties maintaining deep sleep
  • Unusual levels of fatigue or weakness
  • Nausea
  • Rash
  • Strange dreams
  • Itchy skin
  • Cramping muscles
  • Abdominal discomfort or soreness
  • Weakness.

Some patients may also experience additional side effects not listed here. These patients should consult their healthcare professional to find out more. New side effects can also be reported to the FDA by calling 1-800-FDA-1088.

Dosage

Different patients will require different dosages, but they should always be encouraged to follow the directions on the label together with their physician's instructions. As dosages vary from patient to patient, the following details average dosing instructions for Pindolol. Patients with different dosages should not change how much of this medicine they take, unless under their physician's advice.

The number of tablets a physician will ask a patient to take will depend on the strength of the tablets. The time between each dose, the total amount of doses daily and the length of treatment time will vary depending on the specific medical issue which Pindolol has been prescribed to treat.

In the treatment of high blood pressure (known as hypertension), oral Pindolol is typically prescribed for adults in a five-milligram dose, taken twice a day initially. A physician may choose to alter this dosage as required. It is not usually used in the treatment of children (pediatric care). Any use with children should be decided by a qualified physician.

If a patient misses a dose of oral Pindolol, they should take it as soon as they realize. However, if the patient realizes they have missed a dose close to when the next dose is due, they should simply take the next dose and avoid the missed dose, continuing as normal. Patients should not double dose.

Interactions

Some medicines should never be used in combination. Others may work alongside one another but can cause interactions. Where interactions are likely, a physician should consider changing the dose or put in place other strategies to mitigate the risks. Patients should fully inform their physician of all medicines they are taking during the consultation before being prescribed Pindolol, including over the counter medications, herbal remedies, narcotics and other substances. The following list of medications are known to cause significant interactions with Pindolol and are not recommended in combination. In these cases, a physician should make a decision on whether to treat the patient with Pindolol at all, or alter some of the other medicines they are taking to reduce the risks.

  • Thioridazine

The following medicines are typically not recommended for use with Pindolol but may be prescribed in some specific cases. A physician may take a decision on changing the doses or how often patients take each medication to avoid interactions.

  • Lacosamide
  • Diltiazem
  • Bupropion
  • Verapamil
  • Crizotinib
  • Fingolimod
  • Epinephrine
  • Rivastigmine
  • Clonidine
  • Oxymetazoline
  • Fenoldopam
  • Dronedarone.

Using Pindolol together with any of the following medications may raise the risk of some side effects, but a physician may decide that using both medicines together is in the best interests of the patient. When used in combination, a physician may alter the dose of one or both medicines, or change the frequency of treatment.

  • Rofecoxib
  • Choline Salicylate
  • Albiglutide
  • Glimepiride
  • Lumiracoxib
  • Acarbose
  • Valdecoxib
  • Naproxen
  • Pioglitazone
  • Etodolac
  • Miglitol
  • Insulin Human Regular
  • Urapidil
  • Canagliflozin
  • Feprazone
  • Phenoxybenzamine
  • Tiaprofenic Acid
  • Digoxin
  • Aceclofenac
  • Diflunisal
  • Insulin Glulisine
  • Metformin
  • Arbutamine
  • Lornoxicam
  • Proglumetacin
  • Salicylic Acid
  • Chlorpropamide
  • Vildagliptin
  • Insulin Aspart, Recombinant
  • Bufexamac
  • Nimesulide
  • Acemetacin
  • Oxyphenbutazone
  • Felbinac
  • Sitagliptin
  • Tenoxicam
  • Amiodarone
  • Bromfenac
  • Acetyldigoxin
  • Etoricoxib
  • Indomethacin
  • Bunazosin
  • Droxicam
  • Empagliflozin
  • Alfuzosin
  • Dipyrone
  • Insulin Detemir
  • Mibefradil
  • Flurbiprofen
  • Loxoprofen
  • Alogliptin
  • Dexketoprofen
  • Liraglutide
  • Amtolmetin Guacil
  • Clonixin
  • Oxaprozin
  • Nepafenac
  • Celecoxib
  • Etofenamate
  • Prazosin
  • Aspirin
  • Moxisylyte
  • Dapagliflozin
  • Digitoxin
  • Ibuprofen
  • Meloxicam
  • Diclofenac
  • Insulin Human Isophane (NPH)
  • Deslanoside
  • Fepradinol
  • Lixisenatide
  • Pranoprofen
  • Dulaglutide
  • Nimesulide Beta Cyclodextrin
  • Morniflumate
  • Exenatide
  • Tamsulosin
  • Dexibuprofen
  • Trimazosin
  • Insulin Degludec
  • Flufenamic Acid
  • Mefenamic Acid
  • Doxazosin
  • Niflumic Acid
  • Parecoxib
  • Floctafenine
  • Fenoprofen
  • Linagliptin
  • Saxagliptin
  • Piroxicam
  • Repaglinide
  • Glipizide
  • Metildigoxin
  • Ketoprofen
  • Pramlintide
  • Insulin Human Inhaled
  • Ketorolac
  • Insulin Glargine, Recombinant
  • Phenylbutazone
  • Piketoprofen
  • Salsalate
  • Glyburide
  • Tolmetin
  • Insulin Lispro, Recombinant
  • Phentolamine
  • Proquazone
  • Terazosin
  • Meclofenamate
  • Nateglinide
  • Rosiglitazone
  • Tolbutamide
  • Nabumetone
  • Tolfenamic Acid
  • Propyphenazone
  • Tolazamide
  • St John's Wort
  • Sulindac
  • Sodium Salicylate.

Some medicines should also not be used at mealtimes or around the time of eating specific types of food since they may cause interactions. Smoking or drinking alcohol may also cause problems with some medicines. Patients should talk to their physician to find out more about the effects of alcohol, tobacco or food on their medicines.

Warnings

Treatments to combat high blood pressure (hypertension) often also include changes to a patient's diet and exercise regimen and a reduction of foods high in sodium, alongside beta-blockers such as Pindolol. A physician will instruct each patient on how to tackle their dietary requirements and lifestyle changes individually. Patients with high blood pressure typically do not experience many symptoms of the condition, but it is important that patients who have been prescribed beta-blockers follow their treatment plan as directed by their physician, even if they feel normal.

It is important to note that Pindolol alone will not resolve a patient's high blood pressure, but it can help to bring it under control. Patients should continue to take it as instructed throughout the duration of treatment - which may be for the rest of their life. Leaving high blood pressure untreated may cause significant issues, including vascular disease of the blood vessels, stroke, heart failure or kidney disease.

Patients should not miss doses or stop taking Pindolol abruptly without checking with their physician first. Their doctor may instruct them to gradually reduce the dose before stopping completely. Stopping beta-blockers suddenly can cause issues with certain conditions, which may be dangerous for the patient.

A physician should regularly review a patient's progress while taking Pindolol to check for side effects, new interactions, and that the beta-blocker is achieving the desired effect.

Pindolol carries the risk of heart failure for some patients. Patients who experience pain in the chest or sudden discomfort, unusual fatigue, difficulties or irregular breathing, irregular heartbeats, dilated veins in their neck, facial swelling, shortness of breath, swelling around their feet, fingers or lower legs, wheezing or unexplained weight gain should seek medical attention immediately.

Pindolol can also cause issues with patients who have difficulty maintaining stable blood sugar levels. It may disguise the symptoms of low blood sugar (including a rapid heartbeat). Patients who have diabetes or experience a change in their blood or urine sugar tests should contact their physician.

Patients should ensure that any medical personnel, including dentists, know that they are using Pindolol before any other treatment. They may need to pause or stop taking Pindolol ahead of any surgical procedures.

Patients should also fully inform their physician or pharmacist about any allergies before taking Pindolol for the first time, including allergies to other beta-blockers (including acebutolol) or other substances. Depending on the formulation, Pindolol may contain additional inactive ingredients, which have been known to trigger allergic reactions or other issues in patients with allergies. Patients with questions about allergies should talk to their pharmacist or physician.

Pindolol is also not recommended for use in patients with specific medical conditions. Patients who have heart problems that slow the heart (such as second or third-degree atrioventricular block or sinus bradycardia), asthma, uncontrolled severe heart failure or the serious heart condition cariogenic shock should consult their pharmacist or physician.

Patients should give their physician a full and thorough medical history before accepting Pindolol, including any history of severe allergic reactions (such as anaphylaxis), emphysema, chronic obstructive lung disease, chronic bronchitis, coronary artery disease, transient ischemic attack, heart failure, kidney disease, Raynaud's disease, stroke, diabetes, heart attack, depression, anxiety, other mood disorders, hyperthyroidism, pheochromocytoma, peripheral vascular disease, liver disease or myasthenia gravis.

Pindolol may also make some patients feel drowsy or dizzy. If so, they should be advised not to use machinery, drive or do any activity requiring alertness to be safe, and they should limit their alcohol consumption. It may help the dizziness or drowsiness to rise slowly from lying down or sitting.

It is important that patients taking Pindolol make any medical professionals (including dentists) aware of that fact before any surgical procedures.

Rarely, Pindolol can cause a patient's blood sugar levels to rise, which may trigger or increase the impact of diabetes. Patients experiencing an increased need to urinate or increased thirst (the symptoms of raised blood sugar) should inform their physician immediately.

For patients who already have diabetes, Pindolol may make it harder to identify the signs of falling blood sugar levels (hypoglycemia), including an increased heart rate and pounding sensation. Other known symptoms, such as sweating and dizziness, are not masked by this medicine.

With age, kidney function becomes impaired gradually. Pindolol exits the body by being processed by the liver and kidneys, so elderly patients may be at higher risk of side effects (such as dizziness) while taking Pindolol.

Pindolol is not recommended for use in pregnancy, and should only be prescribed where absolutely necessary, as deemed by a qualified physician. Beta-blockers may harm an unborn baby, so it is important for pregnant patients to discuss the benefits and risks with their physician before accepting a prescription.

Similarly, Pindolol has been found in breast milk when given to breastfeeding patients. It may cause problems for nursing babies. Patients who are breastfeeding should discuss this with their physician.

Storage

Pindolol, like most medicines, should be kept at room temperature, in its original sealed packaging, away from direct light, moisture and heat. It should also be kept from freezing. Medicines should always be stored out of the reach of children and vulnerable adults. Patients should not keep medicines they no longer use, or which have gone out of date. They should ask a physician or pharmacist for ways to safely dispose of any medicines they no longer need.

Pindolol should not be stored in the bathroom, where it may be exposed to high levels of moisture. Patients should always keep medicines away from pets and children. Unless specifically instructed, patients should not dispose of medicines by flushing them down the toilet or into a drain.

Summary

Oral Pindolol is available in either five-milligram or 10-milligram tablets, which may also, depending on the formulation, contain croscarmellose sodium, microcrystalline cellulose, sodium lauryl sulfate, colloidal silicon dioxide, pregelatinized starch and magnesium stearate. A beta-blocker, Pindolol works to reduce hypertension, and therefore the risk of stroke, heart attack and other conditions for patients. As with any medicine, there are known side effects - some of which are serious - and it may interact with a wide variety of other medicines and conditions. Patients who wish to know more about Pindolol should ask their physician or pharmacist for advice.