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Beta-blockers are used by tens of millions of Americans to treat high blood pressure and other heart ailments. They are effective, life-saving medicines with more than 25 years of widespread and generally safe use.
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. Our report, which evaluates the effectiveness, safety, and cost of 15 beta-blockers in the treatment of high blood pressure, angina (the chest pain that occurs in people with coronary artery disease), heart attack and heart failure, 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.
- 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 or superior to other beta-blockers. Carvedilol has the strongest evidence of increasing survival in people with the most severe forms of heart failure. A new sustained-release, once-daily form of carvedilol called carvedilol phosphate (Coreg CR) is now available. It has the same active ingredient and, taken once a day, is expected to be as effective against severe heart failure as the immediate-release form, when taken twice daily. But Coreg CR is not yet available as a generic and it is substantially more expensive than the original form of carvedilol.
All beta-blockers are effective against high blood pressure. But because people with high blood pressure may respond to the various beta-blockers differently, you may have to try more than one before finding the drug that works best for you. Beta-blockers are considered “second step” treatment after diuretics (widely known as “water pills”) if you only have high blood pressure and no other heart condition. They are best used in combination with other blood pressure medicines in treating high blood pressure.
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 treatment for you. Note: As this report goes to print in June 2009, there is a shortage of generic metoprolol succinate, so if you are unable to obtain this drug, you may have to consider one of our other Best Buy beta-blockers. You should discuss this with your doctor.
This information was released and last updated in June 2009.
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 February 2009, rounded to the nearest dollar. Information derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite®. Wolters Kluwer Health is not involved in our analysis or recommendations.
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