Q: What is the conversion (or equivalent) of propranolol to Nadolol in portal hypertension?
Answer: Decrease the dose to half and give once a day.
In portal hypertension treatment, Beta-blockers are noncardioselective and reduce portal and collateral blood flow by 2 methods
- Reduction in cardiac output (blockade of beta1-adrenoreceptors) occurs.
- Splanchnic vasoconstriction (blockade of vasodilatory adrenoreceptors of the splanchnic circulation).
Most commonly used noncardioselective B-blockers are propranolol and Nadolol.
Nadolol dosing is half the daily dose of propranolol, administered once a day.