Nebivolol
Pronunciation: (neh-BIV-oh-lol).
- Generic name
- Nebivolol
- Brand names
- Bystolic, Nebivolol, Nebivolol Sandoz, Nebistar, Nebivolol Teva, Nebivolol Accord
- Drug class
- Beta-blocker (selective β1-adrenergic receptor antagonist)
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What Nebivolol is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Nebivolol works
Nebivolol is a highly selective beta-1 adrenergic receptor antagonist with vasodilating properties. It reduces heart rate, myocardial contractility, and cardiac output. Additionally, nebivolol increases nitric oxide (NO) bioavailability, leading to vasodilation and further reduction in peripheral vascular resistance. (2)
What Nebivolol is used for
Hypertension (high blood pressure)
The FDA-approved indication for Bystolic (nebivolol) is treatment of hypertension, to lower blood pressure, alone or in combination with other antihypertensive agents. (2)
Before taking Nebivolol
Do not take / not appropriate for
- severe hepatic impairment, severe bradycardia, heart block greater than first degree, cardiogenic shock, decompensated heart failure, and hypersensitivity to nebivolol. Use with caution in patients with bronchospastic diseases, diabetes (may mask hypoglycemia), peripheral vascular disease, and thyroid disorders. (Contraindication) (2)
Tell your clinician about
(2)How to take Nebivolol
- General Instructions: Take nebivolol exactly as prescribed by your doctor, usually once daily, with or without food. Take it at the same time each day.. Adult Dosing: The typical starting dose for adults is 5 mg once daily. Your doctor may adjust the dose up to 40 mg daily based on your response and condition.. Pediatric Dosing: Safety and effectiveness in children have not been established. Nebivolol is generally not recommended for pediatric use.. Administration: Swallow the tablet whole with water. Do not crush or chew the tablet.. When To Stop: Do not stop taking nebivolol suddenly, as this can worsen your condition. Always consult your doctor before discontinuing.. Storage: Store at room temperature, away from moisture and heat. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
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. Do not take two doses at the same time.
Overdose
Symptoms of overdose may include severe dizziness, fainting, slow or irregular heartbeat, or difficulty breathing. Seek emergency medical attention or call your local poison control center immediately. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Headache
Incidence: Reported in clinical trials of Bystolic (nebivolol)
Fatigue/tiredness
Incidence: Reported in clinical trials of Bystolic (nebivolol)
Dizziness
Incidence: Reported in clinical trials of Bystolic (nebivolol)
Diarrhea
Incidence: Reported in clinical trials of Bystolic (nebivolol)
Nausea
Incidence: Reported in clinical trials of Bystolic (nebivolol)
Insomnia (trouble sleeping)
Incidence: Reported in clinical trials of Bystolic (nebivolol)
Slow heart rate (bradycardia)
Incidence: Reported in clinical trials of Bystolic (nebivolol)
Swelling of the legs/ankles (peripheral edema)
Incidence: Reported in clinical trials of Bystolic (nebivolol)
Signs of worsening heart failure: shortness of breath, sudden weight gain, or increasing swelling of the legs/ankles
(1)Very slow or irregular heartbeat, severe dizziness, fainting, or chest pain
(2)Signs of an allergic reaction (rash, itching, swelling of the face/lips/tongue/throat, difficulty breathing)
(2)Serious warnings
May mask symptoms of low blood sugar in diabetics — serious
Symptoms: May mask symptoms of low blood sugar in diabetics. Use with caution in patients with asthma or other bronchospastic diseases. Monitor for signs of worsening heart failure. May interact with other blood pressure or heart medications. Not recommended during pregnancy unless clearly needed.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindications include severe hepatic impairment, severe bradycardia, heart block greater than first degree, cardiogenic shock, decompensated heart failure, and hypersensitivity to nebivolol. Use with caution in patients with bronchospastic diseases, diabetes (may mask hypoglycemia), peripheral vascular disease, and thyroid disorders.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Nebivolol may interact with other medications that lower blood pressure, antiarrhythmics, calcium channel blockers, certain antidepressants, and drugs affecting liver enzymes. Always inform your healthcare provider of all medicines, supplements, and herbal products you are taking to avoid potential interactions. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Data on nebivolol use in human pregnancy are limited. As a class, beta-blockers used late in pregnancy can cause neonatal effects such as low blood pressure, low blood sugar, and a slow heart rate; use during pregnancy only if the potential benefit justifies the potential risk, and discuss this with your obstetric provider before starting or continuing nebivolol while pregnant. (2)
Breastfeeding
The FDA label for Bystolic (nebivolol) does not recommend use while breastfeeding. Discuss feeding options and any need for continued blood-pressure treatment with your doctor before breastfeeding while taking nebivolol. (2)
Children
Frequency: Not applicable. Weight Based: Not recommended for pediatric use. Max Daily Dose: Not applicable. Max Single Dose: Not applicable. Age Restrictions: Safety not established in children (2)
Renal_impairment
FDA label guidance: renal clearance of nebivolol is decreased in patients with severe renal impairment, and Bystolic has not been studied in patients on dialysis — use with caution and individualized dosing in severe renal impairment. Metabolism of nebivolol is decreased in patients with moderate hepatic impairment, and Bystolic has not been studied in severe hepatic impairment, which is a contraindication recorded in the clinician database — dosing in moderate hepatic impairment should be individualized and cautious, starting at the lowest dose. (2)
Hepatic_impairment
FDA label guidance: renal clearance of nebivolol is decreased in patients with severe renal impairment, and Bystolic has not been studied in patients on dialysis — use with caution and individualized dosing in severe renal impairment. Metabolism of nebivolol is decreased in patients with moderate hepatic impairment, and Bystolic has not been studied in severe hepatic impairment, which is a contraindication recorded in the clinician database — dosing in moderate hepatic impairment should be individualized and cautious, starting at the lowest dose. (2)
Monitoring
(2)Storage
Store Bystolic (nebivolol) tablets at room temperature (approximately 20-25°C/68-77°F), away from excess heat and moisture, in the original container, and out of reach of children.
Study the drug class: Beta blockers
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Hypertension
Dose summary: Most patients start at 5 mg orally once daily; the dose may be increased at 2-week intervals up to a maximum of 40 mg once daily, based on response.
Renal context: FDA label: renal clearance of nebivolol is decreased in patients with severe renal impairment. Bystolic has not been studied in patients receiving dialysis. No specific numeric renal dose-reduction schedule is published; use with caution and individualize dosing (typically starting at the lowest dose) in severe renal impairment. (2)
Hepatic guidance
FDA label: metabolism of nebivolol is decreased in patients with moderate hepatic impairment. Bystolic has not been studied in patients with severe hepatic impairment, and the clinician-authored database record lists severe hepatic impairment as a contraindication. Start at the lowest dose (5 mg) and individualize titration in moderate hepatic impairment; avoid use in severe hepatic impairment unless specifically directed by the prescriber.
Frequently asked questions
What is nebivolol used for?
Nebivolol is primarily used to treat high blood pressure (hypertension) and may also be prescribed for certain heart conditions such as heart failure.
How does nebivolol work?
Nebivolol works by blocking beta-1 receptors in the heart, slowing the heart rate and relaxing blood vessels, which helps lower blood pressure.
Can I stop taking nebivolol suddenly?
No, do not stop taking nebivolol suddenly without consulting your doctor, as this can worsen your heart condition or cause serious side effects.
What should I do if I miss a dose?
Take the missed dose as soon as you remember, unless it is almost time for your next dose. Do not double up on doses.
Are there any foods or drinks I should avoid?
Avoid alcohol, as it may increase side effects. Maintain a healthy diet and follow your doctor's advice regarding salt and fluid intake.
Is nebivolol safe during pregnancy or breastfeeding?
Nebivolol should only be used during pregnancy or breastfeeding if clearly needed and prescribed by your doctor. Discuss risks and benefits with your healthcare provider.
Can nebivolol interact with other medications?
Yes, nebivolol can interact with other blood pressure medicines, heart drugs, antidepressants, and more. Always inform your healthcare provider about all medications you take.
What happens if I take too much Nebivolol?
Taking too much Nebivolol can lead to severe bradycardia (slow heart rate), hypotension (low blood pressure), dizziness, and fainting. In some cases, it may cause difficulty breathing or even heart failure. If you suspect an overdose, seek immediate emergency medical attention or contact poison control. Do not attempt to self-treat.
Can I drink alcohol while taking Nebivolol?
It is generally advisable to limit or avoid alcohol consumption while taking Nebivolol. Alcohol can exacerbate some side effects of beta-blockers, such as dizziness, lightheadedness, and drowsiness, by further lowering blood pressure. This combination can increase the risk of falls or impaired coordination. Always consult your healthcare provider for personalized advice.
Is Nebivolol safe during pregnancy?
Nebivolol's safety during pregnancy is not definitively established, and it is generally categorized as a Pregnancy Category C medication. This means animal studies have shown an adverse effect on the fetus, but there are no adequate and well-controlled studies in humans. It is crucial to consult your doctor to discuss the potential risks and benefits if you are pregnant or planning to become pregnant.
What is the mechanism of action of Nebivolol?
Nebivolol is a highly selective beta-1 adrenergic receptor antagonist with vasodilating properties. It reduces heart rate, myocardial contractility, and cardiac output. Additionally, nebivolol increases nitric oxide (NO) bioavailability, leading to vasodilation and further reduction in peripheral vascular resistance. (2)
What is the generic name of Nebivolol?
The generic name is Nebivolol. It is sold under brand names including Bystolic, Nebivolol, Nebivolol Sandoz, Nebistar, Nebivolol Teva, Nebivolol Accord.
What class of drug is Nebivolol?
Nebivolol is classed as: Beta-blocker (selective β1-adrenergic receptor antagonist).
References
- Clinician-authored medicine record for Nebivolol (MedGuideGlobal medicines database)MedGuideGlobal clinician-authored medicine record · null · accessed 2026-08-06 · source 1
- DailyMed — BYSTOLIC (nebivolol hydrochloride) tablet, FDA-approved labelingU.S. Food and Drug Administration (via DailyMed) · United States · accessed 2026-08-07 · source 2
- NEBIVOLOL TABLET [MAJOR PHARMACEUTICALS] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Nebivolol — FDA approval record (Drugs@FDA ANDA208717)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- Nebivolol — RxNorm normalized drug concept (RXCUI 236883)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient Nebivolol names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Bystolic2.5 mg, 10 mg, 5 mg, 20 mg · allergan, inc.
Canada
- BYSTOLIC