Background

Beta-blockers are used by tens of millions of Americans to treat high blood pressure and other heart ailments. The cost of these drugs varies from less than $10 per month to more than $200, so your choice of medicine could mean a big difference in expense. This report gives you information that could save you up to $1,000 to $2,000 a year, if you take a generic beta-blocker instead of a brand-name one.

To help you and your doctor choose the right beta-blocker if you need one, Consumer Reports Best Buy Drugs has evaluated the drugs in this category based on their effectiveness, safety, and cost. This brief is a summary of a 20-page report you can access for free on the Internet at CRBestBuyDrugs.org. This Web site also has free reports about other drugs we’ve analyzed.

Our independent evaluations are based on scientific reviews conducted by the Oregon Health and Science University-based Drug Effectiveness Review Project. Grants from the Engelberg Foundation and the National Library of Medicine help fund Consumer Reports Best Buy Drugs. These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

Do You Need a Beta-Blocker?

If you only have high blood pressure and no other heart condition, diuretics (widely known as “water pills”) are a good first option. But if you’re already taking a diuretic and your blood pressure is still not low enough, adding another drug, including a beta-blocker, to your regimen can help.

In contrast, if you have angina, heart failure, or if you have had a heart attack—with or without high blood pressure—our Best Buy beta-blockers may well be a first step in your treatment. The table below gives you general guidance on blood pressure levels and treatment.

Our Recommendations

Beta-blockers are effective, life-saving medicines that are generally considered safe. They work by blocking the effects of normal amounts of adrenaline on the heart and blood vessels. Adrenaline speeds up the heart rate, makes the heart muscle contract more strongly, and constricts arteries throughout the body—which can raise blood pressure. Beta-blockers slow down the heart and reduce its workload, which helps to decrease blood pressure.

Choosing a beta-blocker, and its dosage, depends on what you need it for. Studies show that some beta-blockers are more effective and safer than others for certain conditions.

Taking effectiveness, safety, and cost into account, we have selected the following beta-blockers, at all appropriate doses, as Consumer Reports Best Buy Drugs:

• As a second drug for high blood pressure—atenolol, metoprolol tartrate, nadolol, and propranolol

• For angina—atenolol, metoprolol tartrate, nadolol, and propranolol

• After a heart attack—atenolol, metoprolol tartrate, and propranolol

• For mild heart failure—bisoprolol, carvedilol, and metoprolol succinate

• For severe heart failure—carvedilol

All of these medicines are available as low-cost generics. All have been proven to be either as effective as or superior to other beta-blockers.

This information was released and last updated in March 2011.

Blood Pressure Treatment Guidance

Blood Pressure Classification

Systolic Measure (mm Hg)

Diastolic Measure (mm Hg)

General Treatment Guidance

Normal

Below 120

Below 80

  • No treatment needed
  • Healthy lifestyle encouraged to maintain normal blood pressure

Prehypertensive

120–139

80–89

  • Lifestyle changes needed: weight loss, quitting smoking, low-salt and low-fat diet, curb excessive alcohol use, and increased exercise
  • Drug treatment not indicated except if you have diabetes or kidney or heart disease

Stage 1 High Blood Pressure

140–159

90–99

  • Lifestyle changes urged, same as above
  • Drug treatment needed. Doctor may start with one medicine (usually a diuretic) to see if it does the job

Stage 2 High Blood Pressure

160 or above

100 or above

  • Contact your doctor immediately
  • Drug treatment needed. Two or more medicines usually required to bring blood pressure down
  • Lifestyle changes, as described above, are a critical component of your treatment

Source: Chobanian AV, Bakris GL, Black HR, et al., “The seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure,” Journal of the American Medical Association, 2003; 289(19):2560-2572

Cost Comparison

Beta-Blocker Name, Dosage Strength, and Form1

Product Name

Daily Dosage Frequency

Total Daily Dosage

Average Monthly Cost3

Best Buy Indication

Acebutolol 200 mg capsule

Generic2

One

200 mg

$20

Acebutolol 200 mg capsule

Sectral

One

200 mg

$102

Atenolol 25 mg tablet

Generic

One

25 mg

$6*

Angina, heart attack, 2nd drug for high blood pressure

Atenolol 25 mg tablet

Tenormin

One

25 mg

$62

Atenolol 50 mg tablet

Generic

One

50 mg

$8*

Angina, heart attack, 2nd drug for high blood pressure

Atenolol 50 mg tablet

Tenormin

One

50 mg

$61

Betaxolol 10 mg tablet

Generic

One

10 mg

$35

Bisoprolol 5 mg tablet

Generic

One

5 mg

$36*

Mild heart failure

Bisoprolol 5 mg tablet

Zebeta

One

5 mg

$114

Bisoprolol 10 mg tablet

Generic

One

10 mg

$36

Mild heart failure

Bisoprolol 10 mg tablet

Zebeta

One

10 mg

$112

Carvedilol 3.125 mg tablet

Generic

Two

6.25 mg

$45*

Mild and severe heart failure

Carvedilol 3.125 mg tablet

Coreg

Two

6.25 mg

$167

Carvedilol 6.25 mg tablet

Generic

Two

12.5 mg

$49*

Mild and severe heart failure

Carvedilol 6.25 mg tablet

Coreg

Two

12.5 mg

$161

Carvedilol 12.5 mg tablet

Generic

Two

25 mg

$47*

Mild and severe heart failure

Carvedilol 12.5 mg tablet

Coreg

Two

25 mg

$169

Metoprolol succinate 25 mg sustained-release tablet

Generic

One

25 mg

$31*

Mild heart failure

Metoprolol succinate 25 mg sustained-release tablet

Toprol XL

One

25 mg

$46

Metoprolol succinate 50 mg sustained-release tablet

Generic

One

50 mg

$32*

Mild heart failure

Metoprolol succinate 50 mg sustained-release tablet

Toprol XL

One

50 mg

$47

Metoprolol succinate 100 mg sustained-release tablet

Generic

One

100 mg

$46*

Mild heart failure

Metoprolol succinate 100 mg sustained-release tablet

Toprol XL

One

100 mg

$66

Metoprolol tartrate 25 mg or 50 mg tablet

Generic

One

25 or 50 mg

$3–4*

Angina, heart attack, 2nd drug for high blood pressure

Nadolol 20 mg tablet

Generic

One

20 mg

$11*

Angina, 2nd drug for high blood pressure

Nadolol 20 mg tablet

Corgard

One

20 mg

$94

Nadolol 40 mg tablet

Generic

One

40 mg

$10

Angina, 2nd drug for high blood pressure

Propranolol 10 mg tablet

Generic

Two

20 mg

$8

Angina, heart attack, 2nd drug for high blood pressure

Propranolol 20 mg tablet

Generic

Two

40 mg

$8

Angina, heart attack, 2nd drug for high blood pressure

Propranolol 40 mg tablet

Generic

Two

80 mg

$60

Angina, heart attack, 2nd drug for high blood pressure

*Indicates the dose of that drug may be available for a low monthly cost through programs offered by chain stores. For example, Kroger, Sam’s Club, Target, and Walmart offer a month’s supply of selected generic drugs for $4 or a three-month supply for $10. Other stores, such as Costco, CVS, Kmart, and Walgreens, offer similar programs. Some programs have restrictions or membership fees, so check the details carefully for restrictions and to make sure your drug is covered.

1. Selected drugs and dosages only. For a complete price list of beta-blockers, go to CRBestBuyDrugs.org to download the free, full 20-page report.

2. “Generic” indicates that this drug is sold by its generic name. For example, in this table, for the first drug listed, acebutolol is the generic or chemical name, and Sectral is the brand name. Both are available, and they have the same active ingredient. In column 2, when the word “generic” appears, the price given is for the generic version. Note that the generic will almost always cost much less than the brand-name version.

3. Prices reflect nationwide retail average for January 2011, rounded to the nearest dollar. Information derived by Consumer Reports Best Buy Drugs from data provided by Symphony Health Solutions, which is not involved in our analysis or recommendations.

NOTE: The information contained in the Consumer Reports Best Buy Drugs™ reports is for general informational purposes and is not intended to replace consultation with a physician or other health-care professional. Consumers Union is not liable for any loss or injury related to your use of the reports. The reports are intended solely for individual, noncommercial use and may not be used in advertising, promotion, or for any other commercial purpose.


Copyright 2010, Consumers Union of United States, Inc

Beta-Blockers is a sample topic from the Consumer Reports Health.

To view other topics, please or purchase a subscription.

Learn more.

Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case