From the Guidelines
Pindolol is specifically indicated for the treatment of hypertension and angina pectoris, particularly in patients who require beta-blockade but are at risk for bradycardia or bronchospasm due to its intrinsic sympathomimetic activity. Pindolol is a non-selective beta-blocker, meaning it blocks both beta-1 and beta-2 adrenergic receptors, but its partial agonist activity helps maintain resting heart rate and cardiac output, making it a safer option in certain patient populations 1. The typical starting dose of pindolol is 10 mg per day, which can be increased gradually to 15-60 mg per day in divided doses, as indicated in the guidelines for the management of high blood pressure in adults 1.
Some key points to consider when prescribing pindolol include:
- Its use in patients with hypertension, either as monotherapy or in combination with other antihypertensive medications
- Its potential benefits in patients with angina pectoris
- The importance of gradual dose titration to minimize side effects
- The need to monitor patients for signs of bradycardia, bronchospasm, or other adverse effects
- The potential for pindolol to be used off-label as an augmentation strategy in treatment-resistant depression, although this is not a primary indication 1.
Overall, pindolol is a valuable option for the treatment of hypertension and angina pectoris, particularly in patients who require beta-blockade but are at risk for certain adverse effects. Its use should be guided by the most recent clinical guidelines and patient-specific factors, with careful monitoring for potential side effects.
From the FDA Drug Label
Pindolol has been shown in controlled, double-blind clinical studies to be an effective antihypertensive agent when used as monotherapy, or when added to therapy with thiazide-type diuretics. As monotherapy, pindolol is as effective as propranolol, α-methyldopa, hydrochlorothiazide, and chlorthalidone in reducing systolic and diastolic blood pressure.
Pindolol is specifically indicated for the treatment of hypertension. It can be used as monotherapy or in combination with other antihypertensive agents, such as thiazide-type diuretics. 2
From the Research
Indications for Pindolol
Pindolol is specifically indicated for the treatment of:
- Mild to moderate hypertension, either alone or in combination with a thiazide diuretic 3
- Angina pectoris, with variable but generally beneficial results reported in investigations 3, 4
Comparison with Other Beta-Blockers
Pindolol has been compared to other beta-blockers in several studies, including:
- Propranolol, with similar effectiveness in hypertension but more frequent central nervous system side effects 3
- Metoprolol, atenolol, and other cardioselective beta-blockers, with similar blood pressure reductions but less slowing of resting heart rate 5
- Oxprenolol, another nonselective beta-blocker with intrinsic sympathomimetic activity, with similar effectiveness in angina pectoris 4
Specific Patient Populations
Pindolol may be particularly useful in: