Two medicines, side by side
Metoprolol vs nebivolol
Metoprolol and nebivolol are both labeled for high blood pressure. Drugs@FDA records approvals of metoprolol since 1978 and of nebivolol since 2007. Pharmacies paid $0.085 per metoprolol succ ER 100 mg tablet and $0.141 per nebivolol 10 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Metoprolol's other strengths are brand-only: $1.20 per mL (Lopressor 10 mg/mL oral solution). How each works, in its label's words: Metoprolol, “Metoprolol is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent.”; Nebivolol, “The mechanism of action of the antihypertensive response of BYSTOLIC has not been definitively established.”
Check it at the source: the metoprolol FDA label on DailyMed (effective March 3, 2026); the nebivolol FDA label on DailyMed (effective August 1, 2024).
Highlights of the metoprolol record
Metoprolol (Lopressor) · label of March 3, 2026
Used for
From the label: indicationsTOPROL-XL, metoprolol succinate, is a beta-adrenergic blocker indicated for the treatment of: Hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. ( 1.1 ) Angina Pectoris. […]
On the market
- Earliest approval on file
- August 7, 1978
- Generic labelers
- 74 labelers
- Pharmacy cost
- $0.085 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 39
Highlights of the nebivolol record
Nebivolol (Bystolic) · label of August 1, 2024
Used for
From the label: indicationsINDICATIONS AND USAGE BYSTOLIC is a beta-adrenergic blocking agent indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. ( 1.1 ) 1.1 Hypertension BYSTOLIC is indicated for the treatment of hypertension, to lower blood pressure [see Clinical Studies ( 14.1 )]. […]
On the market
- Earliest approval on file
- December 17, 2007
- Generic labelers
- 23 labelers
- Pharmacy cost
- $0.141 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 5
Source: FDA drug labels via openFDA (Metoprolol label of March 3, 2026, Nebivolol label of August 1, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do metoprolol and nebivolol differ on the record?
How each works, in its label's words: Metoprolol, “Metoprolol is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent.”; Nebivolol, “The mechanism of action of the antihypertensive response of BYSTOLIC has not been definitively established.”
Both are in FDA's class beta-adrenergic blockers.
Half-life, in each label's words: Metoprolol, “Elimination Elimination is mainly by biotransformation in the liver, and the plasma half-life ranges from approximately …”; Nebivolol, “The active isomer (d-nebivolol) has an effective half-life of about 12 hours in CYP2D6 extensive metabolizers (most …”
Generics: metoprolol since 1993; nebivolol since 2015 (Drugs@FDA).
| Metoprolol | Nebivolol | |
|---|---|---|
| Labeled for | High blood pressure, Angina, Heart failure, Heart attack and coronary artery disease | High blood pressure |
| Pharmacologic class | beta-Adrenergic Blocker | beta-Adrenergic Blocker |
| How it works (label) | Metoprolol is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent. | The mechanism of action of the antihypertensive response of BYSTOLIC has not been definitively established. |
| Half-life (label) | Elimination Elimination is mainly by biotransformation in the liver, and the plasma half-life ranges from approximately 3 to 7 hours. | The active isomer (d-nebivolol) has an effective half-life of about 12 hours in CYP2D6 extensive metabolizers (most people), and 19 hours in poor metabolizers and exposure to d-nebivolol is substantially increased in … |
| Earliest approval on file (Drugs@FDA) | August 7, 1978 | December 17, 2007 |
| First generic approved | December 21, 1993 | April 16, 2015 |
| Generic labelers (NDC) | 74 labelers | 23 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.085 per tablet (Metoprolol succ ER 100 mg tablet) | $0.141 per tablet (Nebivolol 10 mg tablet) |
| 12-month price change | -8% | +0.8% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | A presentation being discontinued |
| Recalls recorded | 39 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 353,609 | 33,555 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to metoprolol
- every medicine labeled for the same conditions