Nebivolol

Nebivolol is a prescription medicine that is used to treat high blood pressure. Nebivolol is in a class of medications called beta blockers and works by relaxing blood vessels and slowing heart rate to decrease blood pressure. 

Nebivolol is a prescription medicine that is used to treat high blood pressure. It can be used alone or in combination with other medications.

Nebivolol may be found in some form under the following brand names:

• Bystolic

Common side effects of nebivolol include:

• Low blood pressure and feeling dizzy. If you feel dizzy, sit or lie down and tell your doctor right away.
• Tiredness
• Slow heartbeat
• Headache
• Leg swelling due to fluid retention (edema). Tell your doctor if you gain weight or have trouble breathing while taking nebivolol.

Tell your doctor if you have any side effects that bother you or don't go away.

This is not a complete list of nebivolol side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects.  You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.  Especially tell your doctor if you take:

• amiodarone (Cordarone, Pacerone)
• beta blockers such as acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), carvedilol (Coreg), and metoprolol (Lopressor)
• bupropion (Wellbutrin)
• calcium channel-blockers such as diltiazem (Cardizem) and verapamil (Isoptin)
• chlorpheniramine (in many allergy and cold medications)
• cimetidine (Tagamet)
• clomipramine (Anafranil)
• clonidine (Catapres)
• digoxin (Digitek, Lanoxin)
• disopyramide (Norpace)
• duloxetine (Cymbalta)
• fluoxetine (Prozac)
• haloperidol (Haldol)
• insulin and other diabetes medications
• methadone (Dolophine)
• paroxetine (Paxil)
• propafenone (Rythmol)
• quinidine (Quinaglute)
• reserpine 
• ritonavir (Norvir)
• sildenafil (Viagra)

This is not a complete list of nebivolol drug interactions. Ask your doctor or pharmacist for more information.

Do not take nebivolol if you:

• Have heart failure and are in the ICU or need medicines to keep up your blood circulation
• Have a slow heartbeat or your heart skips beats (irregular heartbeat)
• Have severe liver damage
• Are allergic to any ingredient in nebivolol.

Medicines can interact with certain foods.  In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of nebivolol, there are no specific foods that you must exclude from your diet when receiving nebivolol.

Tell your doctor about all of your medical problems, including if you:

• Have asthma or other lung problems (such as bronchitis or emphysema)
• Have problems with blood flow in your feet and legs (peripheral vascular disease). Nebivolol can make symptoms of blood flow problems worse.
• Have diabetes and take medicine to control blood sugar
• Have thyroid problems
• Have liver or kidney problems
• Had allergic reactions to medications or have allergies
• Have a condition called pheochromocytoma
• Are pregnant or trying to become pregnant. It is not known if nebivolol is safe for your unborn baby. Talk with your doctor about the best way to treat high blood pressure while you are pregnant.
• Are breastfeeding. It is not known if nebivolol passes into your breast milk. You should not breastfeed while using nebivolol.
• Are scheduled for surgery and will be given anesthetic agents

Tell your doctor about all the medicines you take. Include prescription and non-prescription medicines, vitamins, and herbal products. Nebivolol and certain other medicines can affect each other and cause serious side effects.

Keep a list of all the medicines you take. Show this list to your doctor and pharmacist before you start a new medicine.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Nebivolol falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

It is not known if nebivolol crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using nebivolol.

• Do not suddenly stop taking nebivolol. You could have chest pain or a heart attack. If your doctor decides to stop nebivolol, your doctor may slowly lower your dose over time before stopping it completely.
• Take nebivolol every day exactly as your doctor tells you. Your doctor will tell you how much nebivolol to take and how often. Your doctor may start with a low dose and raise it over time.
• Do not stop taking nebivolol or change your dose without talking with your doctor.
• Take nebivolol with or without food.
• If you miss a dose, take your dose as soon as you remember, unless it is close to the time to take your next dose. Do not take 2 doses at the same time. Take your next dose at the usual time.

For most people, the recommended starting dose is 5 mg once daily, with or without food, alone or in combination with other medicines. If necessary, the dose can be increased at 2-week intervals up to 40 mg. 

If you take too much nebivolol, call your doctor or poison control center right away or seek emergency medical attention.

• Store nebivolol between 68° to 77°F (20° - 25°C).
• Safely throw away nebivolol that is out of date or no longer needed.
• Keep nebivolol and all medicines out of the reach of children.