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Overview: Nebivolol is used to treat high blood pressure. It works by blocking receptors in your heart and relaxing your blood vessels, which helps lower your blood pressure. Common side effects include headache and feeling weak or tired. Call your health care provider right away if you have dizziness, confusion, trouble breathing, or wheezing. Nebivolol comes as an oral tablet.

Uses

What is nebivolol used for?

Nebivolol is commonly used to lower high blood pressure (hypertension).

Nebivolol may also be used for other conditions as determined by your health care provider.

How does nebivolol work (mechanism of action)?

Nebivolol blocks beta-1 receptors in your heart. These receptors normally bind to hormones called catecholamines. When catecholamines bind to these receptors, it causes your heart to beat harder and faster. Blocking these receptors helps your heart beat more slowly. Nebivolol also causes your blood vessels to relax. These effects can help lower blood pressure, and may reduce your risk for heart attack and stroke. 

How is nebivolol supplied (dosage forms)?

Brands and other names

  • Bystolic

Dosage forms and strengths

  • 2.5 mg oral tablets
  • 5 mg oral tablets
  • 10 mg oral tablets
  • 20 mg oral tablets

How should I store nebivolol?

Nebivolol should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place, in a tightly closed container. 

Side Effects

What are the most common side effects of nebivolol?

The most common side effects of nebivolol are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Headache
  • Feeling unusually weak or tired 

There may be other side effects of nebivolol that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of nebivolol?

While less common, the most serious side effects of nebivolol are described below, along with what to do if they happen.

Heart Rate Changes. Nebivolol can make your heart beat slower than normal (bradycardia). Call your health care provider right away if you have any of the following symptoms of bradycardia. 

  • Feeling lightheaded, dizziness, or fainting
  • Confusion
  • Feeling weak or easily tired 
  • Chest pain
  • Shortness of breath

Decreased Blood Pressure (Hypotension). Nebivolol may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your health care provider right away if you have any of the following symptoms of low blood pressure.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired

Peripheral Vascular Disease. Nebivolol can cause the heart to pump less blood to the rest of the body. This can make blood flow problems to the arms, legs and intestines worse. 

Breathing Problems. Nebivolol may cause the muscles around the airways to tighten (bronchospasm) instead of relaxing, which can be serious. Stop taking nebivolol and contact your health care provider right away if you have trouble breathing.

Severe Allergic Reactions. Nebivolol may cause allergic reactions, which can be serious. Stop taking nebivolol and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use nebivolol?

Allergies to Ingredients. People who are allergic to any of the following should not use nebivolol.

  • Bystolic
  • Nebivolol
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific nebivolol products they stock.

Bradycardia. Nebivolol should not be used if your heart is beating too slow (bradycardia).

Heart Block. Nebivolol should not be used if the electrical signals in your heart move too slow (heart block).

Severe or Worsening Heart Failure. Nebivolol should not be used if your heart failure is severe or getting worse, causing you to feel very tired, have trouble breathing, or swelling in your legs. 

Cardiogenic Shock. Nebivolol should not be used if you have a life-threatening condition called cardiogenic shock where your heart cannot pump enough blood to the rest of your body.

Liver Problems. Nebivolol should not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your health care provider may do tests to know if it is working well enough to take this medicine.

What should I know about nebivolol before using it?

Do not take nebivolol unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share nebivolol with other people, even if they have the same condition as you. It may harm them.

Keep nebivolol out of the reach of children.

Nebivolol can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how nebivolol affects you.

Stopping nebivolol suddenly may lead to chest pain, heart attack or dangerous heart rhythms in people with heart disease. Do not stop taking this medicine without talking to your health care provider first. 

What should I tell my health care provider before using nebivolol?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if nebivolol is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Heart or circulation problems
  • Breathing problems
  • Kidney problems
  • Liver problems
  • Pheochromocytoma
  • Thyroid problems

Diabetes. Nebivolol can decrease early signs of low blood sugar, such as fast heartbeat, and make it more likely for the low blood sugar to be serious, especially for people with diabetes.

Fasting. Tell your health care provider if you are not eating regularly or fasting for any reason. Fasting can lead to low blood sugar levels, and taking nebivolol can hide early signs of low blood sugar, such as fast heartbeat. This can make it more likely for the low blood sugar to become serious.

Pregnancy. It is not known if or how nebivolol could affect pregnancy or harm a fetus. Tell your health care provider if you are or plan to become pregnant.

Breastfeeding. Nebivolol passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop nebivolol.

Interactions

Does nebivolol interact with foods or drinks?

There are no known interactions between nebivolol and foods or drinks.

It is unknown if drinking alcohol will affect nebivolol. The risk of dizziness may be increased if you drink alcohol while taking nebivolol.

Does nebivolol interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking nebivolol.

  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Any medicine for irregular heart rate or rhythm
  • Any medicine for high blood pressure 
  • Any medicine for diabetes

Some other medicines may alter the blood levels of nebivolol. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with nebivolol. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much nebivolol?

If you or someone else has used too much nebivolol, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of nebivolol?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.