Medicine & USMLE

Beta Blockers Side Effects

Cardio Drugs - Blood Pressure
  1. ACE Inhibitors
  2. Angiotensin II Receptor Blockers (ARBs)
  3. Beta Blockers: Mechanisms and Clinical Uses
  4. Beta Blockers: Side Effects
  5. DHP Calcium Channel Blockers
  6. Hydralazine
  7. Aliskiren
  8. Nitroprusside
  9. Alpha-1 Blockers
  10. Clonidine


Side effects of beta blockers include sleep disturbances such as insomnia and nightmares. They may also cause bronchoconstriction, bradycardia, orthostatic hypotension, depression, and heart block. Although beta blockers may be prescribed to manage chronic heart failure, they actually worsen acute heart failure. Beta blockers are known to cause hypotension. They also mask symptoms of hypoglycemia and should be used with caution in diabetic patients. Lastly, they may cause fatigue and erectile dysfunction.

Key Points

  • Beta Blocker Side Effects
    • Bradycardia
      • Check pulse before administration and do not give if heart rate is <60 beats per minute
    • Hypotension
      • Check blood pressure before administration and do not give if patient is hypotensive
    • Orthostatic Hypotension (Dizziness)
      • A drop in blood pressure that occurs after sudden changes in position (e.g. sitting or laying to standing)
      • Teach patients to change positions slowly to avoid dizziness that could potentially lead to falls
    • Heart (AV) Block
      • AV block can cause bradycardia, syncope (fainting), and other cardiac complications
      • Use caution in patients with pre-existing conduction abnormalities or those at risk for AV block
    • Worsens Acute Heart Failure
      • Although beta blockers can be used to treat chronic heart failure, they can actually worse acute heart failure
    • Bronchoconstriction
      • Nonselective only
      • Use with caution in patients with respiratory conditions such as asthma or COPD
      • Monitor for difficulty breathing (dyspnea), wheezing, and other signs of respiratory distress
    • Masks Hypoglycemia
      • A common sign of hypoglycemia is a fast heart rate (tachycardia). Since beta blockers slow the heart rate, patients with diabetes may not experience tachycardia like they usually do when they are hypoglycemic.
      • Use with caution in diabetic patients
      • Closely monitor blood glucose levels
    • Fatigue
      • Tiredness and lack of energy
    • Depression
      • Encourage patient to report any feelings of depression.
    • Nightmares and Insomnia
      • Consider adjusting the timing of doses or switching to a different medication if necessary
    • Erectile Dysfunction
      • A common side effect that might affect a patient’s desire to continue taking the medication.