Non-selective β-blocker (with intrinsic sympathomimetic activity) Pregnancy: US Pregnancy Category B — studies in rats and rabbits at over 100 times the maximum recommended human doses revealed no embryotoxicity or teratogenicity; there are no adequate and well controlled studies in pregnant women, so pindolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Pindolol

Brand names: Visken

Pindolol is a non-selective beta-blocker with intrinsic sympathomimetic (partial agonist) activity, used in hypertension and angina.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Hypertension: recommended initial dose 5 mg, alone or in combination with other antihypertensive agents

Route: Oral

Frequency: Twice daily (b.i.d.)

Max: 60 mg/day

The dosage should be individualised. An antihypertensive response usually occurs within the first week of treatment, although maximal response may take as long as, or occasionally longer than, 2 weeks. If a satisfactory reduction in blood pressure does not occur within 3 to 4 weeks, the dose may be adjusted in increments of 10 mg/day at these intervals, up to a maximum of 60 mg/day. Paediatric: safety and effectiveness in paediatric patients have not been established. No renal or hepatic dose adjustment is stated in the fetched label sections.

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Bronchial asthma
Overt cardiac failure
Cardiogenic shock
Second- and third-degree heart block
Severe bradycardia

Side effects

Insomnia (10%) and muscle pain (10%)
Dizziness (9%) and fatigue (8%)
Joint pain (7%) and nervousness (7%)
Oedema (6%) and dyspnoea (5%)
Nausea (5%), bizarre or many dreams (5%), abdominal discomfort (4%), weakness (4%)

Interactions

Catecholamine-depleting drugs (e.g. reserpine) — additive effect with beta-blockers; observe closely for hypotension and/or marked bradycardia which may produce vertigo, syncope or postural hypotension
Thioridazine — pindolol increases serum thioridazine levels, and pindolol levels may also be increased by the combination
Pindolol has been used with hydrochlorothiazide, hydralazine and guanethidine without unexpected adverse interactions
Patients with a history of severe anaphylactic reaction may be more reactive to repeated allergen challenge while on beta-blockers and may be unresponsive to the usual doses of epinephrine used to treat allergic reactions

Clinical monograph

How it works

It blocks beta-adrenoceptors while exerting partial agonist activity, reducing heart rate and blood pressure with relatively less resting bradycardia than agents without intrinsic sympathomimetic activity.

Prescribing in practice

Avoid abrupt withdrawal, which can precipitate rebound angina, hypertension or arrhythmia; taper gradually.
Use with caution in asthma and other obstructive airways disease because of the risk of bronchospasm.
Caution in combination with other rate-limiting agents such as verapamil or diltiazem owing to additive negative chronotropic effects.

Monitoring

Monitor heart rate and blood pressure, and review for signs of heart failure or bronchospasm.

Counselling the patient

Do not stop the medicine suddenly without medical advice.
Report wheeze, marked slow pulse, dizziness or cold extremities.
It may mask the warning signs of low blood sugar in people with diabetes.

Evidence & guidelines

Beta-blockers are long-established antihypertensive and antianginal agents; choice of agent should follow current UK guidance such as NICE.

Reference: NICE NG136; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways