Do Beta Blockers Make You Tired? Why It Happens and What Helps (UK)

Do beta blockers make you tired? What the NHS says

Yes. The NHS beta blockers page lists tiredness (fatigue) among the common side effects, with cold feet and hands, dizziness, insomnia, vivid dreams or nightmares and erection problems. The propranolol page lists “feeling tired, dizzy or weak” and the bisoprolol page “feeling tired (fatigue) and weak” as common side effects.

Common beta blockers in the UK include atenolol, bisoprolol, metoprolol, carvedilol, labetalol, propranolol and sotalol. They are used for high blood pressure, angina, atrial fibrillation, some types of heart failure and after a heart attack, and propranolol is also used for anxiety and migraine.

How likely is tiredness on beta blockers?

Less likely than many people think. A 2002 review of 15 placebo-controlled trials with more than 35,000 people found beta blockers added a small risk of reported fatigue: 18 extra reports per 1,000 people a year, or about 1 extra person for every 57 treated. There was no significant increase in depressive symptoms. The fatigue risk was higher with older, early-generation beta blockers than with newer ones.

So if you feel tired on a beta blocker, it may be the medicine, but the condition it treats, your sleep or another cause can play a part too. See why am I always tired? and still tired after 8 hours of sleep.

Why beta blockers make you tired

• A slower heart. Beta blockers work by slowing your heartbeat, which the NHS says is how they help the heart and blood vessels.
• Lower blood pressure. The NHS bisoprolol page says low blood pressure can make you feel dizzy and tired. See low blood pressure.
• Poorer sleep. Beta blockers suppress the body’s night-time melatonin, which researchers think may explain the insomnia some people get. Insomnia and vivid dreams are listed side effects. See vivid dreams and nightmares.
• Other medicines. If you also take a statin, that can cause tiredness too. See do statins make you tired? Weight-loss injections can as well: see Mounjaro and Wegovy.

Does tiredness from propranolol and bisoprolol go away?

Usually, yes. The NHS says feeling tired, dizzy or weak on propranolol should wear off as your body gets used to it, and that bisoprolol side effects usually happen when you first start or the dose goes up, and often get better over time. If you’re still tired after a few weeks, or it affects daily life, speak to your doctor or pharmacist.

iFor propranolol taken once a day, the NHS says your doctor may suggest the first dose at bedtime because it can make you dizzy. Alcohol makes the tiredness and dizziness worse, so it’s best avoided while you see how the medicine affects you.

Is there a beta blocker that doesn’t cause fatigue?

No beta blocker is guaranteed tiredness-free, but they aren’t all the same. In the 2002 review, older beta blockers carried a higher fatigue risk than newer ones. The NHS propranolol page says that if side effects bother you, your doctor may be able to prescribe a different medicine instead. Ask whether a different beta blocker, dose or timing would suit you better.

What helps tiredness on beta blockers

1. Don’t stop suddenly. The NHS warns that stopping propranolol suddenly can make your condition worse and cause an irregular heart rate, sweating and shaking. Your doctor will usually reduce the dose gradually over 1 to 2 weeks.
2. Protect your sleep. For sleep problems on propranolol the NHS suggests avoiding a big meal, smoking, alcohol, tea or coffee in the evening, no TV or phone before bed, and an hour to relax. See sleep hygiene habits.
3. If you feel dizzy, sit or lie down until it passes, and don’t drive or ride a bike until it stops, as the NHS advises.
4. Warm cold hands and feet under warm water, wear mittens and warm socks, and skip caffeine and smoking, which narrow blood vessels, as the NHS advises. See Raynaud’s and why am I always cold?
5. Ask about melatonin if sleep is the problem. In a small 2012 trial, 16 people on beta blockers slept 36 minutes longer on melatonin than placebo. Melatonin is prescription-only in the UK: see melatonin in the UK.
6. Ask about blood tests if tiredness lasts, to rule out other causes. See iron deficiency and underactive thyroid.

When to get advice or urgent help

The NHS says beta blockers may not be suitable if you have asthma or COPD, heart block or low blood pressure. You can report side effects through the MHRA Yellow Card scheme.

iPregnancy: the NHS says some beta blockers can be taken while pregnant or breastfeeding, so speak to your doctor about the best medicine for you. We don’t recommend our products during pregnancy or breastfeeding.

Supplements on beta blockers: check first

iNo supplement treats beta blocker side effects. The NHS asks you to tell your doctor about any herbal remedies, vitamins or supplements before taking bisoprolol, so check with your GP or pharmacist before adding anything. See magnesium side effects and heart palpitations.

Our pick

Magnesium Glycinate Sleep Complex

Magnesium Glycinate Sleep Complex is a berry drink powder with 290mg of magnesium (77% NRV) per 4.75g serving, from bisglycinate and citrate, plus glycine and L-theanine. Magnesium contributes to a reduction of tiredness and fatigue. It doesn’t override a medicine side effect. Check with your prescriber or pharmacist first.

Add Magnesium Glycinate Sleep Complex to bag See ingredients and reviews

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Prefer a warm drink earlier in the day? Our Reishi Mushroom Adaptogenic Complex is a reishi hot chocolate: per 8g serving, 0.5g reishi, 0.5g maca and 0.3g cinnamon with cacao. It contains a little natural caffeine, so have it before mid-afternoon.

iThinking about CBD? The FSA advises people taking any medication not to take CBD unless under medical direction, so speak to your doctor first. See can CBD interact with medication?

iIf you take any regular medicines, check with your GP or pharmacist first. We don’t recommend our products during pregnancy or breastfeeding. Both are vegan, made in the UK and for adults (18+) only.

For home readings and treatment targets by age, see normal blood pressure.