What beta blocker can you take with asthma

While cardioselective beta-blockers are available, your medical team will work with you to tailor your treatment to your specific needs—and you may need a prescription for a non-cardioselective beta-blocker.

Keep in mind that people react differently to different drugs, so it is important that you watch for any new respiratory symptoms, such as changes in your breathing pattern or any increases in the severity or frequency of your exacerbations.

Looking to start a diet to better manage your high blood pressure? Our nutrition guide can help. Ann Pharmacother. American Heart Association. Cardiac Medications. Updated July 31, Med Arch. Respiratory effects of beta-blocker therapy in heart failure.

Cardiovasc Drugs Ther. Beta-blockers in asthma: myth and reality. Expert Rev Respir Med. Your Privacy Rights.

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Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Patients continued their inhaled steroids and were also given tiotropium, presumably as a safety measure.

At trial's end, there were no significant differences between groups in airway hyperresponsiveness or asthma symptoms, although there was a 2. Beta blockers are a key component of care for people who have had previous heart attacks or who have systolic heart failure.

Three beta blockers have demonstrated a survival benefit in systolic heart failure: the cardioselective agents metoprolol XL and bisoprolol, and the noncardioselective carvedilol. It seems unlikely that the risks of worsening asthma or COPD outweigh the potential benefits of beta blocker use, in these patients. Beta blockers have not been proven beneficial in randomized trials for stable coronary artery disease primary prevention in people without a previous myocardial infarction or who have risk factors.

The theorized benefit among these patients drives the vast majority of beta-blocker prescriptions, but there is today no evidence-based imperative for this practice. What's more interesting is the question of whether chronic beta blocker use might actually improve asthma or COPD, as mounting observational evidence suggests. Enough safety data has accumulated that such prospective studies could be done ethically.

There are a few small studies listed on clinicaltrials. DOCX 20 kb. Sensitivity analyses for non-selective beta-blocker exposure and asthma exacerbations.

DOCX 17 kb. National Center for Biotechnology Information , U. BMC Med. Published online Jan Daniel R. Morales , 1 Brian J. Lipworth , 2 Peter T.

Donnan , 3 Cathy Jackson , 4 and Bruce Guthrie 1. Brian J. Peter T. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Aug 2; Accepted Jan 5. This article has been cited by other articles in PMC.

Methods Linked data from the UK Clinical Practice Research Datalink was used to perform nested case-control studies among people with asthma and CVD matched on age, sex and calendar time. Results The cohort consisted of 35, people identified with active asthma and CVD, of which Conclusions Cardioselective beta-blockers prescribed to people with asthma and CVD were not associated with a significantly increased risk of moderate or severe asthma exacerbations and potentially could be used more widely when strongly indicated.

Electronic supplementary material The online version of this article doi Background Cardiovascular disease CVD is an important comorbidity in people with asthma who are up to three times more likely to develop CVD than people without [ 1 ]. Study design and outcomes The primary analysis was a nested case-control design used to more efficiently account for time-varying confounders and drug exposure [ 18 ].

Control selection Up to 10 controls were randomly selected and matched to each case on age decile, gender and calendar year of cohort entry using incidence density sampling.

Exposures Exposure to beta-blockers used for the management of CVD was measured by prescriptions issued prior to the index date. Confounders In recognition of the stepwise approach to asthma management and to account for the severity of asthma, analyses were adjusted for current use of asthma medication defined as a prescription for either of SABA, ICS, LABA, leukotriene antagonists or methylxanthines issued within 90 days of the index date.

Data analysis Conditional logistic regression was used to calculate odds ratios for the association between asthma exacerbations and beta-blocker exposure. Sensitivity analyses and secondary self-controlled case series analysis Sensitivity analyses were performed for the primary analysis, namely modelling ICS by dose, excluding cases not originally matched on age, people hospitalised within the risk period assessing for potential immeasurable time bias [ 21 ], people over the age of 40 years who smoked assessing for potential misclassification with undiagnosed or unrecorded COPD , and using a complete case analysis and a and day risk window assessing whether risk attenuated over time and because the exact date patients started taking their medication was unknown.

Results The cohort consisted of 35, people with actively treated asthma and CVD mean age Table 1 Characteristics of cases and controls for severe and moderate asthma exacerbations. Severe asthma exacerbations Moderate asthma exacerbation Cases Controls Cases Controls Number of people 41, Female sex, no. Open in a separate window.

Cardioselective beta-blocker exposure Incidence rate ratios for moderate and severe asthma exacerbations associated with cardioselective beta-blocker exposure according to dose are presented in Table 2.

Table 2 Incidence rate ratios for the association between beta-blocker exposure and asthma exacerbations by dose. Table 3 Incidence rate ratios for the association between beta-blocker exposure and asthma exacerbations by dose and duration of exposure. Non-selective beta-blocker exposure High-dose non-selective beta-blocker exposure was associated with a significantly increased rate of moderate asthma exacerbations IRR 2. Sensitivity analyses and secondary self-controlled case series analysis Sensitivity analyses for the primary analysis were consistent with the main findings, showing no significantly increased risk of moderate or severe asthma exacerbations associated with cardioselective beta-blocker exposure, an increased risk of moderate asthma exacerbations associated with high-dose and acute low- to moderate-dose non-selective beta-blocker exposure, and an increased risk of severe asthma exacerbations associated with high-dose non-selective beta-blocker exposure Additional files 3 and 4.

Table 4 Risk of moderate and severe asthma exacerbations using a negative control with nitrate exposure. Discussion Although managing comorbidity is the norm in modern medicine, clinical uncertainty still exists around whether to prescribe cardioselective beta-blockers to people with asthma and CVD.

Conclusions In conclusion, this study suggests that the adverse respiratory response from beta-blockers in people with asthma and CVD varies according to cardioselectivity, dose and duration of exposure. Acknowledgments We are grateful to the GPs who contributed anonymised data allowing this study to be conducted. Competing interests Dr Lipworth has received research support from Chiesi, Teva, Pharmaxis, and Nycomed, has consultant arrangements with Gurnos, Chiesi, and Hexal, has received payment for lectures from Teva, and has received travel support from GlaxoSmithKline, Chiesi, and Pharmaxis.

Additional files Additional file 1: Table S1. References 1. Chronic disease co-morbidity of asthma and unscheduled asthma care among adults: results of the national telephone health interview survey German Health Update GEDA and Prim Care Respir J.

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