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Nebivolol Side Effects

In Summary

More frequently reported side effects include: fatigue and bradycardia. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to nebivolol: oral tablet

As well as its needed effects, nebivolol may cause unwanted side effects that require medical attention.

Severity: Major

If any of the following side effects occur while taking nebivolol, check with your doctor immediately:

Less common:
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • chest pain or discomfort
  • difficult or labored breathing
  • lightheadedness, dizziness, or fainting
  • rapid weight gain
  • shortness of breath
  • slow or irregular heartbeat
  • tightness in the chest
  • tingling of the hands or feet
  • unusual tiredness or weakness
  • unusual weight gain or loss
  • wheezing

If any of the following symptoms of overdose occur while taking nebivolol, get emergency help immediately:

Symptoms of overdose:
  • Absence of or decrease in body movement
  • anxiety
  • blue lips, fingernails, or skin
  • blurred vision
  • chills
  • cold sweats
  • coma
  • confusion
  • cool, pale skin
  • cough
  • decreased urine output
  • depression
  • dilated neck veins
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • dry mouth
  • extreme fatigue
  • fast heartbeat
  • headache
  • increased hunger
  • increased sweating
  • increased thirst
  • irregular, fast or slow, or shallow breathing
  • loss of appetite
  • mood changes
  • muscle pain or cramps
  • nausea or vomiting
  • nervousness
  • nightmares
  • noisy breathing
  • numbness in the hands, feet, or lips
  • seizures
  • shakiness
  • slurred speech
  • troubled breathing
  • vomiting
  • weight gain

Severity: Minor

Some nebivolol side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • Mild headache
Less common:
  • Diarrhea
  • rash
  • sleeplessness
  • trouble sleeping
  • unable to sleep

For Healthcare Professionals

Applies to nebivolol: oral tablet

General

The more frequently reported side effects in patients treated for hypertension were headache, dizziness, and fatigue; additionally, bradycardia was frequently reported in patients treated for chronic heart failure.[Ref]

Cardiovascular

Very common (10% or more): Bradycardia (up to 11%)
Common (1% to 10%): Cardiac failure aggravation, edema, postural hypotension, first degree atrioventricular (AV) block, atrial fibrillation, hypertension, angina pectoris, chest pain
Uncommon (0.1% to 1%): Heart failure, slowed AV conduction, AV block (both second and third degree), hypotension, increased intermittent claudication, edema of the lower limbs,
Postmarketing reports: Raynaud's phenomenon, myocardial infarction, peripheral ischemia[Ref]

Bradycardia was a dose-related effect in hypertensive patients. Bradycardia occurred more frequently in chronic heart failure patients (11%) than hypertensive patients (1%) at doses of 20 to 40 mg.

Aggravation of cardiac failure occurred in 19% of patients with chronic heart failure compared to 21.3% of placebo-treated patients in the SENIORS (Study on the Effects of Nebivolol Interventions on Outcomes and Rehospitalizations in Seniors with heart failure; n = 2128; median age = 75.2 years). Heart failure occurred in 0.1% to 1% of hypertensive patients.[Ref]

Nervous system

Very common (10% or more): Dizziness (up to 11%)
Common (1% to 10%): Headache, paresthesia, somnolence, hypoesthesia
Uncommon (0.1% to 1%): Vertigo
Very rare (less than 0.01%): Syncope[Ref]

Respiratory

Common (1% to 10%): Dyspnea, exacerbated dyspnea, common cold, coughing, bronchitis, pharyngitis
Uncommon (0.1% to 1%): Bronchospasm
Postmarketing reports: Acute pulmonary edema[Ref]

Dermatologic

Common (1% to 10%): Increased sweating
Uncommon (0.1% to 1%): Pruritus, erythematous rash
Very rare (less than 0.01%): Psoriasis aggravated
Frequency not reported: Angioneurotic edema, urticaria
Postmarketing reports: Rash, skin disorders[Ref]

Musculoskeletal

Common (1% to 10%): Myalgia, arthrosis, back pain[Ref]

Gastrointestinal

Common (1% to 10%): Constipation, diarrhea, nausea
Uncommon (0.1% to 1%): Dyspepsia, flatulence, vomiting
Frequency not reported: Abdominal pain[Ref]

Other

Common (1% to 10%): Tiredness, drug intolerance, pain, injury, fatigue
Frequency not reported: Asthenia[Ref]

Psychiatric

Common (1% to 10%): Nervousness
Uncommon (0.1% to 1%): Nightmares, depression, insomnia, anxiety[Ref]

Genitourinary

Uncommon (0.1% to 1%): Impotence[Ref]

Ocular

Uncommon (0.1% to 1%): Impaired vision[Ref]

Hematologic

Frequency not reported: Decreased platelet count
Postmarketing reports: Thrombocytopenia[Ref]

Renal

Frequency not reported: Increased BUN
Postmarketing reports: Acute renal failure[Ref]

Metabolic

Frequency not reported: Hypercholesterolemia, hyperuricemia, increased uric acid, increased triglycerides, decreased HDL cholesterol[Ref]

Hepatic

Postmarketing reports: Abnormal hepatic function (e.g., increased AST, ALT, and bilirubin)[Ref]

Hypersensitivity

Postmarketing reports: Hypersensitivity (e.g., allergic vasculitis, angioedema, urticaria)[Ref]

References

1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals, St. Louis, MO.

It is possible that some side effects of nebivolol may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

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