Beta-Blockers: What Are They? And Why Might I Need Them in Chronic Liver Disease?

If you live with chronic liver disease, you may be taking a class of medication called beta-blockers. Beta-blockers are most commonly used to lower blood pressure, lower your risk of heart attack, slow and decrease the pressure of your heartbeat, and/or prevent your heart from beating out of rhythm. In liver disease, they play have a similar job (lowering pressure), but in different areas of the body.¹

In cirrhosis, beta-blockers are used to lower the pressure in vessels that are under too much strain from a scarred liver. That includes the portal vein (the vessel sending blood to the liver) and veins in the esophagus (esophageal varices). Beta-blockers can lower the risk of bleeding (especially in the digestive tract) from these high-pressure areas. By decreasing the pressure in the portal vein, beta-blockers can also lower chances of other complications, such as ascites (fluid buildup in the belly) and more.²

With that in mind, here are a few simple highlights about beta-blockers:

Common beta-blockers

There are a number of different beta-blockers. However, there are only about two to three used for the treatment of the liver cirrhosis complications I mentioned above. Those medications are propranolol, nadolol, and carvedilol. These are preferred because they have a stronger impact on your blood vessels than they do on your heart. And in liver disease, that’s where your body needs the help.²

Cost

The first beta-blocker was developed in the 1960s. That means many of these medications have been around long enough to be available as generic. Take, for example, propranolol. According to GoodRX, cash price for a month’s supply is around $9 to $12.³

Timing

Compared to other medications, beta-blockers are fairly easy to fit into a daily routine. You don’t need to worry about timing your pill with food (it can be taken with or without food). You also don’t need to take it at a certain time of the day (morning vs night). You can choose what time of the day works best for you, as long as you stick to the same time every day.³

Side effects

Common side effects may be tiredness, cold hands and feet, and a small amount of weight gain.¹

Other considerations

Beta-blockers may have to be used more carefully if you have refractory ascites. In the medical world, refractory means despite medications and/or treatment, the “problem” that’s trying to get fixed doesn’t go away. In this case, refractory ascites means fluid buildup in the belly is a problem which isn’t getting better with treatment.²

Beta-blockers can play an important role in decreasing complications related to liver scarring. Your important role is to ask your doctor how and when to take your medications, why they’re part of your treatment plan, and when to communicate concerns to your medical team.