Table of ContentsView AllTable of ContentsWhat They DoUse in Asthma/COPDEffect on BreathingTypes and Drug ListRisksContraindicationsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What They Do
Use in Asthma/COPD
Effect on Breathing
Types and Drug List
Risks
Contraindications
Frequently Asked Questions
Beta-blockersare a type of medication used in the treatment of heart disease andhypertension(high blood pressure). Your medical team may be cautious about prescribing beta-blockers for you if you have a respiratory condition such asasthmaorchronic obstructive pulmonary disease(COPD).If you have asthma or COPD, you might have an increased risk of experiencing harmful side effects from beta-blockers, such as shortness of breath or anexacerbationof other respiratory symptoms.What’s tricky is that these drugs are oftenbeneficialif you have bothheart disease and pulmonary (lung)disease, which is common.This article goes over what you need to know about taking beta-blockers if you have asthma or COPD. It also includes a list of different beta-blockers and what they do.Circle Creative Studio / Getty ImagesWhat Beta-Blockers DoBeta-blockers, also known as beta-adrenergic receptor blockers, decrease heart rate and blood pressure. This is helpful if you have hypertension and/or heart failure. Beta-blockers are often used toreduce the risk of a heart attackin people who have heart disease.They are also used to treat certain arrhythmias, and, in some instances, forpreventing migraines.These prescription drugs block the effects of epinephrine, the hormone responsible for increasing heart rate and raising blood pressure. By binding to molecules on the surface of the heart and blood vessels—known as beta-1 receptors—beta-blockers decrease the effects of epinephrine. As a result, the heart rate is slowed, the force of heart contractions is reduced, and blood pressure is decreased.How Beta-Blockers Affect Heart RateHow Beta-Blockers Help Asthma and COPDPatients with lung disease sometimes benefit from taking beta-blockers.If you have asthma or COPD, taking beta-blockers might be beneficial because:They can help maintain optimal blood pressure and heart function, helping you avoiddyspnea(shortness of breath).COPD is associated with an increased risk ofheart failure, which beta-blockers can help treat.Heart disease is a leading cause of death among people who have pulmonary disease, and these drugs can reduce that risk.Some research has shown that taking beta-blockers might be linked to fewer COPD exacerbations and even reduce the chances of dying from the condition (COPD mortality).The benefits must be carefully weighed against notable risks of using beta-blockers if you have asthma or COPD.Pulmonary Side EffectsThere can be side effects of taking beta-blockers if you have lung disease because beta receptors are also found in lung tissue. When epinephrine binds to beta receptors in the lungs, the airways relax (open). That is why you might use anEpiPento treat a respiratory emergency.Beta-blockers cause the airways in the lungs to contract (narrow), making it difficult to breathe. This isn’t usually a problem unless you already have blockage or narrowing in your airways from a lung condition like asthma or COPD.Respiratory side effects of beta-blockers can include:Shortness of breathRapid breathingShallow breathingWheezingAnxietyAsthma exacerbationStudies have also shown that beta-blockers do not always cause asthma exacerbations. It depends on the type of beta-blocker, the dose, and how long a person takes them.If you experience any of these issues, it is important that you discuss your symptoms with your healthcare provider. Sometimes, a dose reduction can alleviate the medication side effects. Get immediate medical attention if you experience severe symptoms.Types and List of Beta-BlockersBeta-blockers are either selective or non-selective. The difference is in which receptors each one acts on. Beta-blockers can act on beta-1 receptors, beta-2 receptors, or both.In general, beta-1 receptors are more prevalent in the heart, while beta-2 receptors are more prevalent in the lungs.Non-Selective (First Generation)First-generation beta-blockers are non-selective. They block both beta-1 and beta-2 receptors.Here is a list of first-generation beta-blockers:Inderal (propranolol)Trandate (labetalol)Corgard (nadolol)Coreg (carvedilol)Selective (Second Generation)Second-generation beta-blockers are newer medications and are generally preferred for people with COPD or asthma. They are consideredcardioselective, meaning they have a greater affinity for beta-1 receptors.Here is a list of second-generation, cardioselective beta-blockers:Brevibloc (esmolol)Tenormin (atenolol)Toprol XL (metoprolol succinate)Zebeta (bisoprolol fumarate)Bystolic (nebivolol)Risks Associated With Beta-BlockersPeople often worry taking a beta-blocker will make asthma or COPD worse. While selective beta-blockers are not as likely to cause pulmonary side effects as non-selective beta-blockers, theycancause pulmonary side effects, especially at high doses.When taking these drugs, you may experience shortness of breath, wheezing, or more subtle respiratory effects that can be measured with diagnostic tests.Non-selective beta-blockers may lead to asthma or COPD exacerbations.If you have asthma or COPD, your provider might suggest selective beta-blockers instead of non-selective beta-blockers. However, cardioselective beta-blockers have risks and side effects as well.For example, they may reduceforced expiratory volume(FEV1). This is more common when you first start taking them. FEV1 is a measure of the volume of air that you can expire with maximal effort in one second. In most cases, the FEV1 will normalize within a week or two once your body adapts to the drug.General Risks of UseThere are risks of taking beta-blockers for anyone, not just people with asthma or COPD. Some of the general risks of beta-blockers include:Circulation problems that may cause you to have cold hands and feetWeight changes and digestive symptomsLow blood pressure that causes you to feel dizzy or lightheadedSexual side effects like erectile dysfunctionTrouble breathingHigh blood sugarTrouble sleeping or nightmaresFeeling depressedHeart problemsLiver problemsKidney problemsTaking Beta-Blockers With Asthma or COPD MedicationIt’s possible that the medications you use to treat asthma, COPD, or other conditions might not be safe to mix with beta-blockers.For example, research has shown that beta-blockers can make asthma inhalers not work as well. If a person’s asthma treatment doesn’t work as it should, they may have more frequent and severe attacks.Other medications that can change how beta-blockers work include the following:Drugs used to treat blood pressureSome antidepressantsAllergy medicationsDiabetes medicationsOver-the-counter medications that have caffeine in themOver-the-counter cold symptom productsAntihistaminesAntacids with aluminum in themBeta-Blocker Use ContraindicationsSome people cannot safely take beta-blockers. Your provider will talk to you about the risks and benefits of using them based on your situation.Taking beta-blockers can sometimes make asthma or COPD worse. There have been reports of beta-blockers triggering asthma attacks.People with severe cases may not be able to take beta-blockers because the medication could make it harder to control their symptoms.There are also other health problems that can make it unsafe for you to use beta-blockers, such as:Being older (over the age of 60)Being pregnant, breastfeeding, or wanting to conceiveHaving a slow heartbeatHaving diabetes or blood sugar problemsHaving thyroid conditionsHaving problems with your kidneys or liverHaving allergies to food colorings and dyes or having seasonal allergiesA Word From VerywellThere are risks and benefits to taking beta-blockers if you have asthma or COPD. Cardioselective beta-blockers might be a better option if you have pulmonary disease. You may need a prescription for a non-cardioselective beta-blocker if you have asthma or COPD. Keep in mind that people react differently to different drugs.If you have asthma or COPD and take beta-blockers, watch for any new respiratory symptoms, such as changes in your breathing pattern or increases in the severity or frequency of your asthma or COPD exacerbations, and tell your provider right away if they happen.Frequently Asked QuestionsA beta-blocker that acts on beta-1 receptors, which are common in the heart, is considered to be selective or cardioselective.Inderal (propranolol), Trandate (labetalol), Corgard (nadolol), and Coreg (carvedilol) are not cardioselective.The research on beta-blockers, asthma, and COPD is a little mixed. It really depends on how severe the conditions are, which beta-blockers are being used, and other medications a person might be taking.
Beta-blockersare a type of medication used in the treatment of heart disease andhypertension(high blood pressure). Your medical team may be cautious about prescribing beta-blockers for you if you have a respiratory condition such asasthmaorchronic obstructive pulmonary disease(COPD).
If you have asthma or COPD, you might have an increased risk of experiencing harmful side effects from beta-blockers, such as shortness of breath or anexacerbationof other respiratory symptoms.What’s tricky is that these drugs are oftenbeneficialif you have bothheart disease and pulmonary (lung)disease, which is common.
This article goes over what you need to know about taking beta-blockers if you have asthma or COPD. It also includes a list of different beta-blockers and what they do.
Circle Creative Studio / Getty Images
What Beta-Blockers Do
Beta-blockers, also known as beta-adrenergic receptor blockers, decrease heart rate and blood pressure. This is helpful if you have hypertension and/or heart failure. Beta-blockers are often used toreduce the risk of a heart attackin people who have heart disease.They are also used to treat certain arrhythmias, and, in some instances, forpreventing migraines.
These prescription drugs block the effects of epinephrine, the hormone responsible for increasing heart rate and raising blood pressure. By binding to molecules on the surface of the heart and blood vessels—known as beta-1 receptors—beta-blockers decrease the effects of epinephrine. As a result, the heart rate is slowed, the force of heart contractions is reduced, and blood pressure is decreased.
How Beta-Blockers Affect Heart Rate
How Beta-Blockers Help Asthma and COPD
Patients with lung disease sometimes benefit from taking beta-blockers.If you have asthma or COPD, taking beta-blockers might be beneficial because:
Some research has shown that taking beta-blockers might be linked to fewer COPD exacerbations and even reduce the chances of dying from the condition (COPD mortality).
The benefits must be carefully weighed against notable risks of using beta-blockers if you have asthma or COPD.
Pulmonary Side Effects
There can be side effects of taking beta-blockers if you have lung disease because beta receptors are also found in lung tissue. When epinephrine binds to beta receptors in the lungs, the airways relax (open). That is why you might use anEpiPento treat a respiratory emergency.
Beta-blockers cause the airways in the lungs to contract (narrow), making it difficult to breathe. This isn’t usually a problem unless you already have blockage or narrowing in your airways from a lung condition like asthma or COPD.
Respiratory side effects of beta-blockers can include:
Studies have also shown that beta-blockers do not always cause asthma exacerbations. It depends on the type of beta-blocker, the dose, and how long a person takes them.
If you experience any of these issues, it is important that you discuss your symptoms with your healthcare provider. Sometimes, a dose reduction can alleviate the medication side effects. Get immediate medical attention if you experience severe symptoms.
Types and List of Beta-Blockers
Beta-blockers are either selective or non-selective. The difference is in which receptors each one acts on. Beta-blockers can act on beta-1 receptors, beta-2 receptors, or both.
In general, beta-1 receptors are more prevalent in the heart, while beta-2 receptors are more prevalent in the lungs.
Non-Selective (First Generation)
First-generation beta-blockers are non-selective. They block both beta-1 and beta-2 receptors.
Here is a list of first-generation beta-blockers:
Selective (Second Generation)
Second-generation beta-blockers are newer medications and are generally preferred for people with COPD or asthma. They are consideredcardioselective, meaning they have a greater affinity for beta-1 receptors.
Here is a list of second-generation, cardioselective beta-blockers:
Risks Associated With Beta-Blockers
People often worry taking a beta-blocker will make asthma or COPD worse. While selective beta-blockers are not as likely to cause pulmonary side effects as non-selective beta-blockers, theycancause pulmonary side effects, especially at high doses.
When taking these drugs, you may experience shortness of breath, wheezing, or more subtle respiratory effects that can be measured with diagnostic tests.Non-selective beta-blockers may lead to asthma or COPD exacerbations.
If you have asthma or COPD, your provider might suggest selective beta-blockers instead of non-selective beta-blockers. However, cardioselective beta-blockers have risks and side effects as well.
For example, they may reduceforced expiratory volume(FEV1). This is more common when you first start taking them. FEV1 is a measure of the volume of air that you can expire with maximal effort in one second. In most cases, the FEV1 will normalize within a week or two once your body adapts to the drug.
General Risks of Use
There are risks of taking beta-blockers for anyone, not just people with asthma or COPD. Some of the general risks of beta-blockers include:
Taking Beta-Blockers With Asthma or COPD Medication
It’s possible that the medications you use to treat asthma, COPD, or other conditions might not be safe to mix with beta-blockers.For example, research has shown that beta-blockers can make asthma inhalers not work as well. If a person’s asthma treatment doesn’t work as it should, they may have more frequent and severe attacks.
Other medications that can change how beta-blockers work include the following:
Beta-Blocker Use Contraindications
Some people cannot safely take beta-blockers. Your provider will talk to you about the risks and benefits of using them based on your situation.
Taking beta-blockers can sometimes make asthma or COPD worse. There have been reports of beta-blockers triggering asthma attacks.People with severe cases may not be able to take beta-blockers because the medication could make it harder to control their symptoms.There are also other health problems that can make it unsafe for you to use beta-blockers, such as:
A Word From Verywell
There are risks and benefits to taking beta-blockers if you have asthma or COPD. Cardioselective beta-blockers might be a better option if you have pulmonary disease. You may need a prescription for a non-cardioselective beta-blocker if you have asthma or COPD. Keep in mind that people react differently to different drugs.
If you have asthma or COPD and take beta-blockers, watch for any new respiratory symptoms, such as changes in your breathing pattern or increases in the severity or frequency of your asthma or COPD exacerbations, and tell your provider right away if they happen.
Frequently Asked QuestionsA beta-blocker that acts on beta-1 receptors, which are common in the heart, is considered to be selective or cardioselective.Inderal (propranolol), Trandate (labetalol), Corgard (nadolol), and Coreg (carvedilol) are not cardioselective.The research on beta-blockers, asthma, and COPD is a little mixed. It really depends on how severe the conditions are, which beta-blockers are being used, and other medications a person might be taking.
A beta-blocker that acts on beta-1 receptors, which are common in the heart, is considered to be selective or cardioselective.
Inderal (propranolol), Trandate (labetalol), Corgard (nadolol), and Coreg (carvedilol) are not cardioselective.
The research on beta-blockers, asthma, and COPD is a little mixed. It really depends on how severe the conditions are, which beta-blockers are being used, and other medications a person might be taking.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mersfelder TL, Shiltz DL.β-Blockers and the Rate of Chronic Obstructive Pulmonary Disease Exacerbations.Ann Pharmacother.2019;53(12):1249-1258. doi:10.1177/1060028019862322American Heart Association.Cardiac Medications. Updated July 31, 2015.Zvizdic F, Begic E, Mujakovic A, et al.Beta-blocker Use in Moderate and Severe Chronic Obstructive Pulmonary Disease.Med Arch. 2019;73(2):72–75. doi:10.5455/medarh.2019.73.72-75Du Q, Sun Y, Ding N, Lu L, Chen Y.Beta-blockers reduced the risk of mortality and exacerbation in patients with COPD: a meta-analysis of observational studies.PLoS One. 2014;9(11):e113048. Published 2014 Nov 26. doi:10.1371/journal.pone.0113048Agostoni P, Palermo P, Contini M.Respiratory effects of beta-blocker therapy in heart failure.Cardiovasc Drugs Ther.2009;23(5):377-84. doi:10.1007/s10557-009-6195-2Morales DR, Lipworth BJ, Donnan PT, Jackson C, Guthrie B.Respiratory effect of beta-blockers in people with asthma and cardiovascular disease: population-based nested case control study.BMC Med. 2017;15(1):18. Published 2017 Jan 27. doi:10.1186/s12916-017-0781-0Tiotiu A, Novakova P, Kowal K, et al.Beta-blockers in asthma: myth and reality.Expert Rev Respir Med.2019;13(9):815-822. doi:10.1080/17476348.2019.1649147National Library of Medicine.Metoprolol.Morales DR, Jackson C, Lipworth BJ, Donnan PT, Guthrie B.Adverse respiratory effect of acute β-blocker exposure in asthma: a systematic review and meta-analysis of randomized controlled trials.Chest. 2014;145(4):779-786. doi:10.1378/chest.13-1235Texas Heart.Beta-Blockers.Huang KY, Tseng PT, Wu YC, et al.Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials.Scientific Reports. 2021;11(1). doi:10.1038/s41598-020-79837-3Finks SW, Rumbak MJ, Self TH.Treating Hypertension in Chronic Obstructive Pulmonary Disease.N Engl J Med. 2020;382(4):353-363. doi:10.1056/NEJMra1805377
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mersfelder TL, Shiltz DL.β-Blockers and the Rate of Chronic Obstructive Pulmonary Disease Exacerbations.Ann Pharmacother.2019;53(12):1249-1258. doi:10.1177/1060028019862322American Heart Association.Cardiac Medications. Updated July 31, 2015.Zvizdic F, Begic E, Mujakovic A, et al.Beta-blocker Use in Moderate and Severe Chronic Obstructive Pulmonary Disease.Med Arch. 2019;73(2):72–75. doi:10.5455/medarh.2019.73.72-75Du Q, Sun Y, Ding N, Lu L, Chen Y.Beta-blockers reduced the risk of mortality and exacerbation in patients with COPD: a meta-analysis of observational studies.PLoS One. 2014;9(11):e113048. Published 2014 Nov 26. doi:10.1371/journal.pone.0113048Agostoni P, Palermo P, Contini M.Respiratory effects of beta-blocker therapy in heart failure.Cardiovasc Drugs Ther.2009;23(5):377-84. doi:10.1007/s10557-009-6195-2Morales DR, Lipworth BJ, Donnan PT, Jackson C, Guthrie B.Respiratory effect of beta-blockers in people with asthma and cardiovascular disease: population-based nested case control study.BMC Med. 2017;15(1):18. Published 2017 Jan 27. doi:10.1186/s12916-017-0781-0Tiotiu A, Novakova P, Kowal K, et al.Beta-blockers in asthma: myth and reality.Expert Rev Respir Med.2019;13(9):815-822. doi:10.1080/17476348.2019.1649147National Library of Medicine.Metoprolol.Morales DR, Jackson C, Lipworth BJ, Donnan PT, Guthrie B.Adverse respiratory effect of acute β-blocker exposure in asthma: a systematic review and meta-analysis of randomized controlled trials.Chest. 2014;145(4):779-786. doi:10.1378/chest.13-1235Texas Heart.Beta-Blockers.Huang KY, Tseng PT, Wu YC, et al.Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials.Scientific Reports. 2021;11(1). doi:10.1038/s41598-020-79837-3Finks SW, Rumbak MJ, Self TH.Treating Hypertension in Chronic Obstructive Pulmonary Disease.N Engl J Med. 2020;382(4):353-363. doi:10.1056/NEJMra1805377
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mersfelder TL, Shiltz DL.β-Blockers and the Rate of Chronic Obstructive Pulmonary Disease Exacerbations.Ann Pharmacother.2019;53(12):1249-1258. doi:10.1177/1060028019862322American Heart Association.Cardiac Medications. Updated July 31, 2015.Zvizdic F, Begic E, Mujakovic A, et al.Beta-blocker Use in Moderate and Severe Chronic Obstructive Pulmonary Disease.Med Arch. 2019;73(2):72–75. doi:10.5455/medarh.2019.73.72-75Du Q, Sun Y, Ding N, Lu L, Chen Y.Beta-blockers reduced the risk of mortality and exacerbation in patients with COPD: a meta-analysis of observational studies.PLoS One. 2014;9(11):e113048. Published 2014 Nov 26. doi:10.1371/journal.pone.0113048Agostoni P, Palermo P, Contini M.Respiratory effects of beta-blocker therapy in heart failure.Cardiovasc Drugs Ther.2009;23(5):377-84. doi:10.1007/s10557-009-6195-2Morales DR, Lipworth BJ, Donnan PT, Jackson C, Guthrie B.Respiratory effect of beta-blockers in people with asthma and cardiovascular disease: population-based nested case control study.BMC Med. 2017;15(1):18. Published 2017 Jan 27. doi:10.1186/s12916-017-0781-0Tiotiu A, Novakova P, Kowal K, et al.Beta-blockers in asthma: myth and reality.Expert Rev Respir Med.2019;13(9):815-822. doi:10.1080/17476348.2019.1649147National Library of Medicine.Metoprolol.Morales DR, Jackson C, Lipworth BJ, Donnan PT, Guthrie B.Adverse respiratory effect of acute β-blocker exposure in asthma: a systematic review and meta-analysis of randomized controlled trials.Chest. 2014;145(4):779-786. doi:10.1378/chest.13-1235Texas Heart.Beta-Blockers.Huang KY, Tseng PT, Wu YC, et al.Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials.Scientific Reports. 2021;11(1). doi:10.1038/s41598-020-79837-3Finks SW, Rumbak MJ, Self TH.Treating Hypertension in Chronic Obstructive Pulmonary Disease.N Engl J Med. 2020;382(4):353-363. doi:10.1056/NEJMra1805377
Mersfelder TL, Shiltz DL.β-Blockers and the Rate of Chronic Obstructive Pulmonary Disease Exacerbations.Ann Pharmacother.2019;53(12):1249-1258. doi:10.1177/1060028019862322
American Heart Association.Cardiac Medications. Updated July 31, 2015.
Zvizdic F, Begic E, Mujakovic A, et al.Beta-blocker Use in Moderate and Severe Chronic Obstructive Pulmonary Disease.Med Arch. 2019;73(2):72–75. doi:10.5455/medarh.2019.73.72-75
Du Q, Sun Y, Ding N, Lu L, Chen Y.Beta-blockers reduced the risk of mortality and exacerbation in patients with COPD: a meta-analysis of observational studies.PLoS One. 2014;9(11):e113048. Published 2014 Nov 26. doi:10.1371/journal.pone.0113048
Agostoni P, Palermo P, Contini M.Respiratory effects of beta-blocker therapy in heart failure.Cardiovasc Drugs Ther.2009;23(5):377-84. doi:10.1007/s10557-009-6195-2
Morales DR, Lipworth BJ, Donnan PT, Jackson C, Guthrie B.Respiratory effect of beta-blockers in people with asthma and cardiovascular disease: population-based nested case control study.BMC Med. 2017;15(1):18. Published 2017 Jan 27. doi:10.1186/s12916-017-0781-0
Tiotiu A, Novakova P, Kowal K, et al.Beta-blockers in asthma: myth and reality.Expert Rev Respir Med.2019;13(9):815-822. doi:10.1080/17476348.2019.1649147
National Library of Medicine.Metoprolol.
Morales DR, Jackson C, Lipworth BJ, Donnan PT, Guthrie B.Adverse respiratory effect of acute β-blocker exposure in asthma: a systematic review and meta-analysis of randomized controlled trials.Chest. 2014;145(4):779-786. doi:10.1378/chest.13-1235
Texas Heart.Beta-Blockers.
Huang KY, Tseng PT, Wu YC, et al.Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials.Scientific Reports. 2021;11(1). doi:10.1038/s41598-020-79837-3
Finks SW, Rumbak MJ, Self TH.Treating Hypertension in Chronic Obstructive Pulmonary Disease.N Engl J Med. 2020;382(4):353-363. doi:10.1056/NEJMra1805377
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