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Heart Failure and Beta-Blockers

Drugs called beta-blockers improve the heart's ability to relax, decrease the production of harmful substances produced by the body in response to heart failure, and slow the heart rate. Over time, beta-blockers improve the heart's pumping ability.

Beta-blockers are essential for people with heart failure -- even if they do not have symptoms. Beta-blockers are prescribed for patients with systolic heart failure (ejection fraction below 40%) and improve survival, even in people with severe symptoms.

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Understanding Heart Failure -- Symptoms

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There are several different types of beta-blockers, but only three are specifically approved by the FDA to treat heart failure:

  • Zebeta (bisoprolol)
  • Coreg (carvedilol)
  • Toprol-XL (metoprolol succinate)


How Should I Take Beta-Blockers for Heart Failure?

These medications may be taken with meals, at bedtime, or in the morning. Food delays how beta-blockers are absorbed but may reduce side effects. Follow the label directions on how often to take this drug. The number of doses you take each day, the time allowed between doses, and how long you need to take the medication will depend on your condition.

Beta-blockers should not be used if you have extremely low blood pressure (hypotension) or a slow pulse (bradycardia) that may cause you to feel dizzy or light-headed. If you have severe lung congestion, your health care provider will treat your congestion before prescribing a beta-blocker.

While you are taking this drug, your doctor may tell you to take and record your pulse daily. He will tell you how rapid your pulse should be. If your pulse is slower than it should be, contact your doctor about taking your beta-blocker that day.

Never stop taking your medication without speaking to your doctor first, even if you feel that it is not working. When you start taking beta-blockers, your heart failure symptoms may become slightly worse while your heart adjusts to the medication. This is a normal effect, but let your doctor or nurse know if you become extremely tired, gain more than 5 pounds, have trouble breathing, or have other signs of congestion or swelling. Once your heart adjusts, you will feel better.


What Are the Side Effects of Beta-Blockers?

  • Dizziness or lightheadedness. This side effect may be strongest when you get out of bed or rise from a chair. Get up more slowly. Contact your doctor or nurse if these symptoms persist or are severe.
  • Tiredness, cold hands and feet, headache, nightmares, difficulty sleeping, heartburn, diarrhea or constipation, gas. Contact your doctor or nurse if these symptoms are persistent or severe.
  • Sudden weight gain. Weight gain is common as your doctor increases your medication dose. Call your doctor if you gain three or more pounds in one day or if you continue to gain weight for more than two days.
  • Increased shortness of breath; wheezing; difficulty breathing; skin rash; slow, fast, or irregular heartbeat; swelling of feet and lower legs; chest pain. Contact your doctor or nurse right away.
  • Severe vomiting or diarrhea. If you have severe vomiting or diarrhea, you may become dehydrated, which can lead to low blood pressure. Contact your doctor or nurse.

Also contact your doctor or nurse if you have any other symptoms that cause concern.

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