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Nadolol is a synthetic, non-selective beta-adrenergic receptor antagonist (beta-blocker) used primarily for the treatment of hypertension and the long-term management of patients with angina pectoris. It competitively blocks both beta-1 and beta-2 adrenergic receptors, leading to a reduction in heart rate, cardiac output, and blood pressure. Unlike some other beta-blockers, nadolol lacks intrinsic sympathomimetic activity (ISA) and membrane-stabilizing activity. It is distinguished by its relatively long half-life (approximately 20 to 24 hours), which allows for once-daily dosing. Beyond cardiovascular indications, nadolol is FDA-approved for migraine prophylaxis and is frequently used off-label for the management of portal hypertension to prevent variceal bleeding and for essential tremor. It was originally developed by Bristol Myers Squibb and is now available in various generic formulations.
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