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Bystolic Side Effects

Generic Name: nebivolol

Note: This page contains information about the side effects of nebivolol. Some of the dosage forms included on this document may not apply to the brand name Bystolic.

In Summary

More frequent side effects include: fatigue. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to nebivolol: oral tablet

In addition to its needed effects, some unwanted effects may be caused by nebivolol (the active ingredient contained in Bystolic). In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking nebivolol:

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

Minor Side Effects

Some of the side effects that can occur with nebivolol may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

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

For Healthcare Professionals

Applies to nebivolol: oral tablet


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]


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]


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


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]


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


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


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


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


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


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


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


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


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


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


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


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.

Not all side effects for Bystolic may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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