Generic Name: nebivolol (ne-BIV-oh-lol)
Brand Name: Bystolic
Nebivolol is used for:
Treating high blood pressure. It may also be used for other conditions as determined by your doctor.
Nebivolol is a beta-blocker. It works by slowing down the heart and decreasing the amount of blood it pumps out. This helps to decrease blood pressure, helps the heart pump more efficiently, and reduces the workload on the heart.
Do NOT use nebivolol if:
- you are allergic to any ingredient in nebivolol
- you have moderate to severe heart block, sick sinus syndrome, or a very slow heartbeat and you do not have a permanent pacemaker
- you have uncontrolled heart failure, shock caused by serious heart problems, or very low blood pressure after a heart attack
- you have asthma or Raynaud syndrome
- you have severe liver problems
- the patient is a child with diabetes or heart failure
- you are taking mibefradil
Contact your doctor or health care provider right away if any of these apply to you.
Before using nebivolol:
Some medical conditions may interact with nebivolol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances, or are taking medicine for allergies
- if you have a history of other heart problems (eg, heart failure, slow heartbeat)
- if you have a history of liver or kidney problems, blood vessel disease, lung or breathing problems (eg, chronic bronchitis, chronic obstructive pulmonary disease [COPD], emphysema), diabetes, low blood sugar, overactive thyroid, or glaucoma
- if you have Wolff-Parkinson-White syndrome, Down syndrome, or an adrenal gland tumor (pheochromocytoma)
- if you smoke or drink alcohol
Some MEDICINES MAY INTERACT with nebivolol. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Mibefradil because the risk of serious heart side effects may be increased
- Many prescription and nonprescription medicines (eg, used for diabetes, depression, infections, inflammation, heart problems, irregular heartbeat, aches and pains, high blood pressure, high cholesterol, seizures, local anesthesia), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John's wort) may interact with nebivolol, increasing the risk of side effects
This may not be a complete list of all interactions that may occur. Ask your health care provider if nebivolol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use nebivolol:
Use nebivolol as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take nebivolol by mouth with or without food.
- Take nebivolol on a regular schedule to get the most benefit from it. Taking nebivolol at the same time each day will help you remember to take it.
- Continue to take nebivolol even if you fell well. Do not miss any doses.
- Do not suddenly stop taking nebivolol without first talking with your doctor. You may have an increased risk of side effects (eg, chest pain, irregular heartbeat). If you need to stop nebivolol or add a new medicine, your doctor may need to gradually lower your dose.
- If you miss a dose of nebivolol, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use nebivolol.
Important safety information:
- Nebivolol may cause drowsiness, dizziness, lightheadedness, or vision changes. These effects may be worse if you take it with alcohol or certain medicines. Use nebivolol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Check with your doctor before you drink alcohol while you are taking nebivolol; it may increase the risk of nebivolol's side effects.
- Do NOT take more than the recommended dose without checking with your doctor.
- Do not suddenly stop taking nebivolol. Sharp chest pain, irregular heartbeat, and sometimes heart attack may occur if you suddenly stop nebivolol. The risk may be greater if you have certain types of heart disease. Your doctor should slowly lower your dose over several weeks if you need to stop taking it. This should be done even if you only take nebivolol for high blood pressure. Heart disease is common and you may not know you have it. Limit physical activity while you are lowering your dose. If new or worsened chest pain or other heart problems occur, contact your doctor right away. You may need to start taking nebivolol again.
- Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
- Tell your doctor or dentist that you take nebivolol before you receive any medical or dental care, emergency care, or surgery.
- If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk for an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are using nebivolol.
- Nebivolol may lower your blood sugar levels. This is most likely to happen in infants and children, or in patients who have diabetes or kidney problems. It may also occur after prolonged physical activity or during fasting. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you hungrier. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens.
- Diabetes patients - Nebivolol may hide signs of low blood sugar, such as a rapid heartbeat. Be sure to watch for other signs of low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your vision change; give you a headache, chills, or tremors; or make you more hungry. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Nebivolol may interfere with certain lab tests, including dobutamine stress echocardiography. Be sure your doctor and lab personnel know you are taking nebivolol.
- Lab tests, including blood pressure, heart function and electrocardiogram (ECG), kidney function, and blood cholesterol levels, may be performed while you use nebivolol. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use nebivolol with caution in the ELDERLY; they may be more sensitive to its effects.
- Nebivolol should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using nebivolol while you are pregnant. It is not known if nebivolol is found in breast milk. Do not breast-feed while taking nebivolol.
Possible side effects of nebivolol:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Dizziness; fatigue; headache; nausea; stomach pain; trouble sleeping.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); chest pain or tightness; fainting; mental or mood changes; numbness or tingling of the hands; persistent or severe vision changes; red, swollen, blistered, or peeling skin; severe dizziness; shortness of breath or wheezing; sudden, unusual weight gain; swelling of the hands, ankles, or feet; unusual bruising or bleeding; unusual tiredness or weakness; unusually slow or irregular heartbeat; very cold or blue fingers or toes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include severe dizziness; shortness of breath; swelling of the hands, ankles, or feet; trouble breathing; very slow heart rate; wheezing.Proper storage of nebivolol:
Store nebivolol at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep nebivolol out of the reach of children and away from pets.
- If you have any questions about nebivolol, please talk with your doctor, pharmacist, or other health care provider.
- Nebivolol is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take nebivolol or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about nebivolol. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to nebivolol. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using nebivolol.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.