Nebivolol

Nebivolol is a prescription medication used to treat Hypertension. 

• Nebivolol is available under the following different brand names: Bystolic

Adult dosage

Tablet

• 2.5mg
• 5mg
• 10mg
• 20mg

Hypertension

Adult dosage

• 5 mg/day orally; may be increased every 2 weeks; not to exceed 40 mg/day

 

Dosage Considerations – Should be Given as Follows: 

See “Dosages”.

Common side effects of Nebivolol include:

• dizziness, 
• swelling in the legs, 
• slow heartbeats, 
• tiredness, and 
• headache

Serious side effects of Nebivolol include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• lightheadedness, 
• rapid weight gain, 
• shortness of breath, 
• slow or uneven heartbeats, and
• numbness or cold feeling in the hands and feet

Rare side effects of Nebivolol include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Nebivolol has severe interactions with no other drugs.
• Nebivolol has serious interactions with at least 29 other drugs.
• Nebivolol has moderate interactions with at least 200 other drugs. 
• Nebivolol has minor interactions with at least 29 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Hypersensitivity
• Severe hepatic impairment
• Cardiogenic shock
• Sick sinus syndrome (if no pacemaker)
• 2º/3º heart block (if no pacemaker)
• Bradycardia (HR less than 50 beats/minute)
• Decompensated heart failure
• Severe hepatic impairment (Child-Pugh Class C)

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Nebivolol?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Nebivolol?”

Cautions

• Anesthetics that cause myocardial depression, bradycardia, 1° heart block, ischemic heart disease, Prinzmetal angina, untreated congestive heart failure (CHF)
• Patients with bronchospastic disease should not receive beta-blockers; patients with bronchospastic disease who do not respond to other therapies, initial low doses may be employed and used cautiously; monitor closely; patient should have immediate access to beta2-agonist
• May mask hyperthyroidism, including tachycardia; abrupt withdrawal may exacerbate symptoms of hyperthyroidism or precipitate thyroid storm; if thyrotoxicosis suspected, carefully manage and treat
• Severe renal impairment decreases clearance; adjust dose in severe renal failure
• Moderate hepatic impairment decreases metabolism; adjust dose in moderate hepatic impairment (Child-Pugh class B); contraindicated in severe hepatic impairment (Child-Pugh class C)
• May potentiate hypoglycemia in patients with hypoglycemia and/or mask signs and symptoms
• Sudden discontinuance can exacerbate angina and lead to MI; to discontinue therapy, taper gradually over 1-2 weeks to avoid acute tachycardia, ischemia, and/or hypertension; temporary but prompt resumption of beta-blocker therapy may be necessary if angina symptoms or acute coronary insufficiency symptoms worsen
• Can precipitate or worsen symptoms of arterial insufficiency in patients with peripheral and Raynaud disease (intermittent claudication); use caution; monitor for progression of arterial obstruction
• Renal disease, cerebrovascular insufficiency, use in pheochromocytoma (alpha blocker should be started before beta blocker)
• Increased risk of stroke after surgery; routine withdrawal of chronic beta-blocker therapy not recommended prior to major surgery
• Use with caution in patients with myasthenia gravis
• Use with caution in patients taking calcium-channel blockers or cardiac glycosides or using inhaled anesthetics
• Drug loses receptor selectivity in poor metabolizers and in high doses (blocks both beta1 and beta2)
• Exacerbation or induction of psoriasis associated with psoriasis; use caution
• Not shown to reduce morbidity or mortality in heart failure population; bisoprolol, carvedilol, and extended release metoprolol only beta blockers proven to reduce mortality; use caution in patients with compensated heart failure and monitor for worsening of condition; temporarily discontinue or reduce dose if condition worsens; stabilize patients on heart failure regimen before initiating beta-blocker therapy; initiate therapy at very low doses; may require adjustment of other medications, including ACE inhibitors and/or diuretics
• May cause or exacerbate CNS depression; use caution in patient with psychiatric disorder

Pregnancy and Lactation

• Use with caution if benefits outweigh risks during pregnancy.
• Lactation: Not known whether drug is excreted into breast milk; use not recommended.