systolic blood pressure <90 mm Hg, heart rate <55 beats per minute, fluid retention) have been associated with ISMN and NSBB combination therapies (Sharma, Kumar, Sharma, & Satin, 2009).
Carvedilol provides up to 20% HPVG reduction from baseline (Bosch, 2010), similar to the combination of ISMN and NSBB (Minano & Garcia-Tsao, 2010).
Also, because NSBBs increase bowel motility and reduce bacterial overgrowth, they decrease variceal bleeding triggers such as infection (Villanueva & Balanzo, 2008).
The NSBBs most commonly prescribed for primary prevention of variceal bleeding are propranolol hydrochloride (Inderal[R]) and nadolol (Corgard[R]).
NSBBs should be used cautiously in patients with diabetes because symptoms of hypoglycemia such as rapid heart rate may be masked.