Updated on February 6, 2024
7 min read

Beta-Blockers Overdose: What You Need to Know

Key Takeaways

Beta-blockers are prescription medications that manage heart rate and blood pressure. They work by decreasing the activity of the heart and blood vessels.

While they offer beneficial effects, consuming too many beta-blockers can lead to serious side effects. In extreme cases, it leads to overdose and even death.

This post provides information on potential risks and signs of overdosing on beta-blockers. It also discusses treatment options available for those affected.

What Are Beta-Blockers?

Beta-blockers are cardiovascular drugs with multiple uses in preventing, treating, and alleviating symptoms in various heart-related conditions. These include:1

  • Arrhythmia (irregular heartbeat)
  • Chest pain
  • Heart attack
  • Heart failure
  • Migraine
  • A few types of tremors

Beta-blockers aren't usually the first choice to treat high blood pressure. Instead, they’re a secondary option if other medications like diuretics aren't effective. However, a beta-blocker can still be part of a comprehensive approach to lowering blood pressure.

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Symptoms of a Beta-Blocker Overdose

Overdosing on beta-blockers causes various symptoms, including:2

  • Shortness of breath
  • Blurred or double vision
  • Wheezing (for those with asthma or acute heart failure)
  • Low blood pressure
  • Weak or irregular heartbeat
  • Heart failure
  • Nausea and vomiting
  • Low blood pressure
  • Confusion
  • Loss of consciousness
  • Seizures
  • Profuse sweating
  • Drowsiness
  • Fever
  • Coma
  • Physical weakness

If you notice symptoms, such as low blood pressure, heart failure, or seizures, seek immediate medical attention or contact your local poison center.

How Soon After Ingestion Can Symptoms Appear?

When you take beta-blockers orally, your body quickly and effectively absorbs them. Peak absorption occurs within 1 to 4 hours. However, this doesn't apply to sustained-release preparations.

The symptoms of a beta-blocker overdose typically occur early, usually within 1 to 2 hours.3 However, when it comes to sotalol (a type of beta-blocker) toxicity, the most significant risk of toxicity can still present up to 20 hours later.

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How Is Beta-Blocker Overdose Treated?

If you believe someone has overdosed on a beta-blocker, seek immediate medical attention. Additionally, contacting local poison control centers can offer immediate guidance on the steps to take.

Treatment for an overdose typically involves reversing the effects of the medication and managing symptoms. According to the National Institutes of Health, medical professionals may do the following to reverse the effects of a beta-blocker overdose:

  • Administer intubation for proper airway management
  • Give Albuterol and oxygen for breathing difficulties
  • Use gastric suctioning to remove the medication from the body quickly (although rare today)
  • Administer activated charcoal to absorb the medication before it is metabolized for minor symptoms
  • Give Benzodiazepines or other anticonvulsants for seizures
  • Administer calcium salts, atropine, glucagon, or insulin for high blood pressure
  • Consider pacemaker insertion for slow heartbeats

Medical professionals may also use other treatments, depending on the individual’s needs. Pills break down and move into the small intestine within a very short time.

Medical professionals may sometimes induce vomiting if it's safe and appropriate. In such cases, they administer medications that make you vomit or manually stimulate your gag reflex. 

What Diagnostic Tools Are Employed in Suspected Cases?

Diagnosis of a beta-blocker overdose typically involves evaluation using toxicokinetics and other laboratory tests. 

Toxicokinetics helps identify the degree of toxicity. In contrast, laboratory tests help determine electrolyte balance, acid-base status, heart protein levels, and liver and kidney function.

There's no single test that diagnoses a beta-blocker overdose. Instead, medical professionals use a combination of tests and your medical history to assess toxicity and recommend appropriate treatments.

How Can a Beta-Blocker Overdose Be Prevented?

You can avoid too much beta-blocker exposure or overdose by being aware of the necessary safety and precautionary measures:

  • Take your medications as prescribed. Follow your doctor’s instructions on how and when to take the medication.
  • Do not ever take more than the prescribed dosage.
  • Monitor your response to the medication and report any changes to your doctor.
  • Do not mix beta-blockers with other medications, such as alcohol or illicit drugs. Alcohol and other drugs can increase the risk of side effects or toxicity, even in small amounts.
  • Don't stop taking the medication without consulting your doctor first. Suddenly stopping beta-blockers may lead to a rebound effect that increases your risk of a heart attack or stroke.
  • Be vigilant about potential interactions beta-blockers can have. Inform your doctor about other medications you take.
  • Tell your doctor about any allergies or medical conditions you have, such as diabetes and asthma. This information helps them make sure the medication is safe for you.
  • Drink enough water each day and take it with food if necessary.
  • Learn the signs of an overdose and seek medical help if they occur.

What Role Do Medical Professionals Play in Prevention?

Medical professionals should educate users on the safe use of these medications and monitor a person’s vital signs and response to the drug.  They adjust medications or dosages when necessary to ensure optimal results.

Healthcare providers should also be aware of potential interactions with existing conditions or other drugs and alert users about risks. Finally, they must know personal risk factors and observe people closely, especially those with heart or breathing problems.

How Do Beta-Blockers Work in the Body?

Beta-blockers work by blocking beta-adrenergic receptors in the body. Once in effect, they lower the heart's activity and reduce the amount of stress hormones in the bloodstream.

It also relaxes the blood vessels for improved circulation and lowers blood pressure. When you take it appropriately, beta-blockers are highly effective in treating various conditions. 

How Is Beta-Blocker Toxicity Manifested?

Toxicity from beta-blockers typically occurs due to an overdose of the medication. Sometimes, it can also happen when you take a large dose over a short period.

Beta-blocker toxicity is most commonly observed in people with asthma or other breathing problems. When they take it in high doses, these medications may worsen symptoms and lead to additional breathing problems. 

Beta-blocker overdose can cause a slow heart rate and low blood pressure. People with beta-blocker poisoning may also have low blood sugar and act differently than usual.2 Such poisoning can look like calcium channel blocker poisoning.

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Common Questions on Beta-Blocker Overdose

Can a single extra dose lead to an overdose?

Yes, taking an extra beta-blocker dose can lead to an overdose and cause various central nervous system symptoms. 

Beta-blockers with high lipid affinity can quickly enter the brain, leading to a range of central nervous system effects. These are common with an overdose. However, they can also occur with water-soluble beta-blockers like atenolol, causing tiredness and fatigue.3

Are there any long-term effects of a beta-blocker overdose?

A beta-blocker overdose can lead to many long-term effects, including:

  • Bradycardia (slow heart rate)
  • Hypotension (low blood pressure)
  • Hypoglycemia (low blood sugar)
  • Erectile or sexual dysfunction4  

Additionally, an overdose can be fatal if left untreated. 

Do beta-blockers interact with other medications?

Beta-blockers can interact with other medications, including antipsychotics, mefloquine, clonidine, and antiarrhythmics. These interactions may increase the risk of adverse effects or an overdose.5

Are certain individuals more at risk of a beta-blocker overdose?

Yes, people with asthma and diabetes and those at higher risk for low blood sugar should exercise caution when considering beta-blockers.1 

People who frequently drink alcohol should avoid beta-blockers, as the combination can increase the risk of an overdose.6 

Elderly patients may also be at a higher risk due to their increased sensitivity to medications. 

Can beta-blockers cause heart failure?

Yes, beta-blockers can cause heart failure in certain people. This is more likely to occur if you already have a weak or damaged heart. 

People with an underlying condition should be cautious when considering these medications and consult their healthcare provider before starting them. 

People should never start taking prescription medications, including beta-blockers, without discussing them first with their doctor and getting a prescription for the correct medication and dose.

Summary

Beta-blockers are essential medications for treating many health problems. However, an overdose can have fatal consequences.

To avoid it, you should take precautions and follow your doctor's instructions when taking these medications. Likewise, medical professionals should promote safe use, monitor users closely, and adjust dosages as necessary.

Always consult your healthcare provider before taking this medication to ensure safety. If an overdose occurs, seek medical attention immediately. Prompt treatment is vital to a successful recovery.

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Updated on February 6, 2024
6 sources cited
Updated on February 6, 2024
  1. Mayo Foundation for Medical Education and Research. “Beta blockers.” Mayo Clinic, 2023.
  2. Beta-blockers overdose.” University of Florida Health, 2023.
  3. Khalid et al. “Beta-Blocker Toxicity.” StatPearls Publishing, 2023.
  4. Farzam, K., and Jan, A. “Beta Blockers.” StatPearls Publishing, 2023.
  5. Beta-blockers.” U.K. National Health Service, 2022.
  6. Boysan, A. “Everything You Need To Know About Propranolol and Alcohol.” The Independent Pharmacy, 2022.

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