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nebivolol

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Brand names: Bystolic

Beta-1 Selective Blocker Rx

Nebivolol is a medicine that lowers high blood pressure. Lowering blood pressure helps prevent strokes and heart attacks.

Drug Pricing (NADAC)

Brand Price

$5.84/unit

Generic Price

$0.13/unit

Generic Savings

98%

Generic Available

Yes (13 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Nebivolol treats high blood pressure.

Common side effects

Headache, Tiredness, Dizziness

Key warnings

Do not stop taking nebivolol suddenly if you have heart disease.

How It Works

Nebivolol is a beta-blocker that mainly affects the heart. It works by relaxing blood vessels and slowing down your heart rate. This makes it easier for your heart to pump blood and lowers blood pressure.

How to Take It

Take nebivolol once a day, with or without food. Your doctor may start you on 5 mg per day. The dose can be increased every 2 weeks up to 40 mg per day, as needed. Follow your doctor's instructions carefully.

Pregnancy & Breastfeeding

Talk to your doctor if you are pregnant or plan to become pregnant. Nebivolol may cause problems for the baby, such as low blood pressure or slow heart rate. Breastfeeding is not recommended while taking nebivolol.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.

Storage

Store nebivolol at room temperature, away from light and moisture.

Side Effects (from patient reports)

Based on 6,432 FDA adverse event reports.

Sudden kidney damage
922
Difficulty breathing
773
Diarrhea
724
Interaction with another medicine
616
Low blood pressure
610
Low red blood cell count
598
Feeling sick to your stomach
573
Medicine not working
553
Using the medicine for something it is not approved for
544
Tiredness
519

FDA Adverse Event Report Analysis

Detailed analysis of 14,997 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

14,997

Death-Related Reports

1,464

Hospitalization Reports

8,438

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 6,870 (49%)
Male 6,998 (50%)

Age Distribution

0–17 104
18–44 685
45–64 3,463
65–74 3,676
75+ 4,405

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 ACUTE KIDNEY INJURY 922
2 DYSPNOEA 773
3 DIARRHOEA 724
4 DRUG INTERACTION 616
5 HYPOTENSION 611
6 ANAEMIA 598
7 NAUSEA 573
8 DRUG INEFFECTIVE 553
9 OFF LABEL USE 544
10 FATIGUE 519
11 FALL 513
12 DIZZINESS 477
13 ASTHENIA 472
14 HEADACHE 449
15 VOMITING 419

Reactions in Death Reports

DEATH 184
ACUTE KIDNEY INJURY 165
COMPLETED SUICIDE 123
GENERAL PHYSICAL HEALTH DETERIORATION 91
PNEUMONIA 88
DYSPNOEA 75
ANAEMIA 72
CARDIAC FAILURE 72
DIARRHOEA 67
CARDIAC ARREST 60

Reactions in Hospitalization Reports

ACUTE KIDNEY INJURY 710
DYSPNOEA 494
ANAEMIA 469
DIARRHOEA 441
HYPOTENSION 423
FALL 417
DRUG INTERACTION 358
GENERAL PHYSICAL HEALTH DETERIORATION 343
OFF LABEL USE 310
NAUSEA 304

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Do not stop taking nebivolol suddenly if you have heart disease. This can make chest pain worse or cause a heart attack. Talk to your doctor before stopping nebivolol. They will likely lower your dose slowly over 1 to 2 weeks.

Known Drug Interactions

moderate fluoxetine

( 7.4 ) 7.1 CYP2D6 Inhibitors Use caution when nebivolol is co-administered with CYP2D6 inhibitors (quinidine, propafenone, fluoxetine, paroxetine, etc.) [ see Clinical Pharmacology ( 12.5 ) ].

Mechanism: Fluoxetine blocks the liver protein responsible for breaking down nebivolol, which can lead to higher levels of the drug in your blood.

What to do: Use this combination with caution and follow your doctor's instructions for monitoring.

moderate propafenone

( 7.4 ) 7.1 CYP2D6 Inhibitors Use caution when nebivolol is co-administered with CYP2D6 inhibitors (quinidine, propafenone, fluoxetine, paroxetine, etc.) [ see Clinical Pharmacology ( 12.5 ) ].

Mechanism: Propafenone slows down the body's ability to process nebivolol, which could cause the medication to build up to higher levels.

What to do: Use caution when taking these drugs together and consult your doctor about potential dose adjustments.

7 DRUG INTERACTIONS CYP2D6 enzyme inhibitors may increase nebivolol levels ( 7.1 ) Reserpine or clonidine may produce excessive reduction of sympathetic activity. In patients who are receiving nebivolol and clonidine, discontinue nebivolol tablets for several days before the gradual tapering of clonidine.

Mechanism: Both drugs work to slow down the body's nervous system activity. Taking them together can cause an safely large drop in this activity.

What to do: If you need to stop these medicines, your doctor should have you stop nebivolol several days before slowly lowering your clonidine dose.

( 7.3 ) Verapamil- or diltiazem-type calcium channel blockers may cause excessive reductions in heart rate, blood pressure, and cardiac contractility. 7.4 Calcium Channel Blockers Nebivolol can exacerbate the effects of myocardial depressants or inhibitors of AV conduction, such as certain calcium antagonists (particularly of the phenylalkylamine [verapamil] and benzothiazepine [diltiazem] classes), or antiarrhythmic agents, such as disopyramide.

Mechanism: Both of these medicines slow the heart rate and lower blood pressure. Using them together can cause your heart to beat too slowly or weaken its pumping strength.

What to do: Your doctor should closely monitor your heart rate and blood pressure while you are taking this combination.

( 7.3 ) Verapamil- or diltiazem-type calcium channel blockers may cause excessive reductions in heart rate, blood pressure, and cardiac contractility. 7.4 Calcium Channel Blockers Nebivolol can exacerbate the effects of myocardial depressants or inhibitors of AV conduction, such as certain calcium antagonists (particularly of the phenylalkylamine [verapamil] and benzothiazepine [diltiazem] classes), or antiarrhythmic agents, such as disopyramide.

Mechanism: These drugs both act on the heart to slow it down and lower blood pressure. Combining them can cause your heart rate or blood pressure to drop to levels that are too low.

What to do: Monitor your heart rate regularly and report any symptoms like dizziness or extreme tiredness to your healthcare provider.

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Common Questions

Can I drink alcohol while taking nebivolol?
Talk to your doctor about drinking alcohol while taking nebivolol.
Will nebivolol cure my high blood pressure?
Nebivolol helps control high blood pressure, but it is usually not a cure. You may need to take it for the rest of your life.
Can I take nebivolol if I have asthma?
Talk to your doctor before taking nebivolol if you have asthma or other lung problems. Beta-blockers may make breathing problems worse.
What should I do if I feel dizzy after taking nebivolol?
Lie down until the dizziness passes. Avoid driving or operating machinery until you know how nebivolol affects you.
Can nebivolol affect my blood sugar?
Nebivolol can hide the symptoms of low blood sugar. If you have diabetes, monitor your blood sugar carefully.
Does nebivolol interact with other medications?
Yes, nebivolol can interact with other medications. Tell your doctor about all the medicines you take, including over-the-counter drugs and supplements.
How long does it take for nebivolol to start working?
It may take a few weeks for nebivolol to fully lower your blood pressure.
Can I exercise while taking nebivolol?
Yes, but talk to your doctor about the best exercise plan for you.
What if I need surgery?
Tell your doctor you are taking nebivolol before any surgery.
Can nebivolol cause weight gain?
Weight gain is not a common side effect of nebivolol, but it is possible.
What are the common side effects of nebivolol?
The most commonly reported side effects of nebivolol include Headache, Tiredness, Dizziness, Diarrhea, Nausea. Based on 6,432 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does nebivolol interact with other medications?
Yes, nebivolol has 7 known drug interactions. Notable interactions include fluoxetine, propafenone, clonidine. Always inform your doctor about all medications you are taking.
What drug class is nebivolol?
nebivolol belongs to the Beta-1 Selective Blocker drug class. It requires a prescription (Rx). Nebivolol treats high blood pressure.
Is there a generic version of nebivolol?
Yes, generic nebivolol is available from 13 manufacturers. The generic costs $0.13 per unit compared to $5.84 for the brand version, saving approximately 98%. Pricing is based on NADAC (National Average Drug Acquisition Cost) data from CMS.
Is nebivolol safe during pregnancy?
Talk to your doctor if you are pregnant or plan to become pregnant. Nebivolol may cause problems for the baby, such as low blood pressure or slow heart rate. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for nebivolol

The FDA label for nebivolol (sold under brand names such as Bystolic) classifies it as a prescription-only medication in the Beta-1 Selective Blocker class. Nebivolol treats high blood pressure. Official labeling lists 6 commonly reported side effects, including Headache, Tiredness, Dizziness.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 6,432 voluntary reports. The database also lists 7 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.13 versus $5.84 for the brand — a 98% generic savings.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: October 31, 2024

All federal data sources used on this page