Two medicines, side by side
Nebivolol vs propranolol
Nebivolol and propranolol are both labeled for high blood pressure. Drugs@FDA records approvals of nebivolol since 2007 and of propranolol since 1967. Pharmacies paid $0.141 per nebivolol 10 mg tablet and $0.0493 per propranolol 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. How each works, in its label's words: Nebivolol, “The mechanism of action of the antihypertensive response of BYSTOLIC has not been definitively established.”; Propranolol, “Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established.”
Check it at the source: the nebivolol FDA label on DailyMed (effective August 1, 2024); the propranolol FDA label on DailyMed (effective January 15, 2026).
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
Highlights of the propranolol record
Propranolol (Inderal) · label of January 15, 2026
Used for
From the label: indicationsHypertension Propranolol hydrochloride tablets are indicated in the management of hypertension. It may be used alone or used in combination with other antihypertensive agents, particularly a thiazide diuretic. Propranolol hydrochloride tablets are not indicated in the management of hypertensive emergencies. […]
On the market
- Earliest approval on file
- November 13, 1967
- Generic labelers
- 42 labelers
- Pharmacy cost
- $0.0493 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 4
Source: FDA drug labels via openFDA (Nebivolol label of August 1, 2024, Propranolol label of January 15, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do nebivolol and propranolol differ on the record?
How each works, in its label's words: Nebivolol, “The mechanism of action of the antihypertensive response of BYSTOLIC has not been definitively established.”; Propranolol, “Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established.”
Both are in FDA's class beta-adrenergic blockers.
Half-life, in each label's words: Nebivolol, “The active isomer (d-nebivolol) has an effective half-life of about 12 hours in CYP2D6 extensive metabolizers (most …”; Propranolol, “The plasma half-life of propranolol is from 3 to 6 hours.”
Generics: nebivolol since 2015; propranolol since 1985 (Drugs@FDA).
| Nebivolol | Propranolol | |
|---|---|---|
| Labeled for | High blood pressure | High blood pressure, Angina, Atrial fibrillation, Migraine |
| Pharmacologic class | beta-Adrenergic Blocker | beta-Adrenergic Blocker |
| How it works (label) | The mechanism of action of the antihypertensive response of BYSTOLIC has not been definitively established. | Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established. |
| Half-life (label) | 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 … | The plasma half-life of propranolol is from 3 to 6 hours. |
| Earliest approval on file (Drugs@FDA) | December 17, 2007 | November 13, 1967 |
| First generic approved | April 16, 2015 | July 30, 1985 |
| Generic labelers (NDC) | 23 labelers | 42 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.141 per tablet (Nebivolol 10 mg tablet) | $0.0493 per tablet (Propranolol 20 mg tablet) |
| 12-month price change | +0.8% | -17% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | In shortage |
| Recalls recorded | 5 | 4 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 33,555 | 71,660 |
| 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 nebivolol
- every medicine labeled for the same conditions