Cardiac disorders: Uncommon: AV-conduction disturbances, worsening of pre-existing heart failure; bradycardia.
Nervous system disorders: Common: dizziness*, headache*. Rare: syncope.
Eye disorders: Rare: reduced tear flow (to be considered if the patient uses contact lenses). Very rare: conjunctivitis.
Ear and labyrinth disorders: Rare: hearing disorders.
Respiratory, thoracic and mediastinal disorders: Uncommon: bronchospasm in patients with bronchial asthma or a history of obstructive airways disease. Rare: allergic rhinitis.
Gastrointestinal disorders: Common: gastrointestinal complaints such as nausea, vomiting, diarrhea, constipation.
Skin and subcutaneous tissue disorders: Rare: hypersensitivity reactions (pruritus, flush, rash). Very rare: alopecia. β-blockers may provoke or worsen psoriasis or induce psoriasis-like rash.
Musculoskeletal and connective tissue disorders: Uncommon: muscle weakness, muscle cramps.
Vascular disorders: Common: feeling of coldness or numbness in the extremities, hypotension.
General disorders: Common: fatigue. Uncommon: asthenia.
Hepatobiliary disorders: Rare: hepatitis.
Reproductive system and breast disorders: Rare: erectile dysfunction.
Psychiatric disorders: Uncommon: depression, sleep disorder. Rare: nightmare, hallucination.
*These symptoms especially occur at the beginning of the therapy. They are generally mild and usually disappear within 1-2 weeks.
An increased level of antinuclear antibodies (ANA) have been noticed, but the clinical relevance of this is not clear.
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