3. General Cautions
The list below outlines some general cautions regarding beta-blockers.
1. Do not suddenly stop taking beta-blockers. Beta-blockers control the heart rate and oxygen requirement in just the same way as the reins that control a horse. If beta-blockers are stopped abruptly, it is similar to cutting the reins; the horse may gallop away. Therefore, the heart rate may increase from the accustomed 55–65 beats per minute to 80–90 beats per minute. It is relatively safe to miss one dose of a beta-blocker, or at the most two doses per week. It is unadvisable to miss any doses, but there are always unavoidable circum¬stances. No harm usually results from one missed dose; however, omitting the drug for two to three days consecutively may precipitate angina. Withdrawal should be gradual over weeks and under the guidance of your doctor.
2. Report shortness of breath or wheezing to your doctor as soon as possible.
3. Beta-blockers must not be used in combination with monoamine oxidase (MAO) inhibitors, which are drugs used to treat different types of severe depression.
4. Do not take decongestants or cold or cough remedies containing epinephrine (adrenaline), phenylephrine, or phenylpropanolamine. These drugs can cause an increase in blood pressure.

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