II. Indications

III. Contraindications

  1. Severe Liver Impairment

IV. Mechanism

  1. Third generation Beta Blocker (Beta-1 Selective) with vasodilatory properties (nitric oxide release)
  2. Unique vasodilator mechanism with nitric oxide release via Beta-3 Agonist activity
    1. Relaxes vascular Smooth Muscle resulting in vasodilation
    2. Contrast with Labetalol and Carvedilol which exert vasodilation via alpha-1 activity

V. Dosing

  1. Start: 5 mg orally daily
    1. Start at 2.5 mg in hepatic Impairment or CrCl <30 ml/min
  2. Maximum: 40 mg/day

VI. Adverse Effects

VII. Safety

  1. Pregnancy Category C
  2. Avoid in Lactation

IX. References

  1. (2019) Presc Lett, Resource #350503, Comparison of Oral Beta Blockers
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 66-7
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Related Studies

Cost: Medications

nebivolol (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
NEBIVOLOL 10 MG TABLET Generic $0.25 each
NEBIVOLOL 2.5 MG TABLET Generic $0.19 each
NEBIVOLOL 20 MG TABLET Generic $0.28 each
NEBIVOLOL 5 MG TABLET Generic $0.24 each
bystolic (on 1/14/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
BYSTOLIC 10 MG TABLET Generic $0.25 each
BYSTOLIC 2.5 MG TABLET Generic $0.19 each
BYSTOLIC 20 MG TABLET Generic $0.28 each
BYSTOLIC 5 MG TABLET Generic $0.24 each

Ontology: nebivolol (C0068475)

Definition (NCI) A beta-1 adrenergic receptor antagonist with antihypertensive and vasodilatory activity. Nebivolol binds to and blocks the beta-1 adrenergic receptors in the heart, thereby decreasing cardiac contractility and rate. This leads to a reduction in cardiac output and lowers blood pressure. In addition, nebivolol potentiates nitric oxide (NO), thereby relaxing vascular smooth muscle and exerting a vasodilatory effect.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C052753
SnomedCT 318638009, 395808005
English nebivolol, alpha,alpha'-(iminobis(methylene))bis(6-fluoro-3,4-dihydro)-2H-1-benzopyran-2-methanol, nebivolol [Chemical/Ingredient], NEBIVOLOL, Nebivolol (product), Nebivolol (substance), Nebivolol
Spanish nebivolol (producto), nebivolol (sustancia), nebivolol

Ontology: Bystolic (C1995642)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
English Bystolic