Bystolic

Bystolic is the brand name for nebivolol, a prescription beta-blocker used to treat hypertension.

Nebivolol is a cardioselective beta-1 blocker with additional vasodilatory properties produced by nitric oxide release.

Mechanism: It lowers heart rate, reduces contractility, and decreases renin release, lowering blood pressure. The NO-mediated vasodilation also reduces peripheral resistance.

Uses: Approved for hypertension. It may be chosen when a beta-blocker is indicated with vasodilatory benefit.

Dosing: Administered orally once daily. Typical starting dose is 5 mg, adjustable after 1–2 weeks to 10 mg; maximum 40 mg daily, based on response and tolerability.

Safety and side effects: Common adverse effects include dizziness, fatigue, headache, bradycardia, and hypotension. Nausea and cold extremities may occur. Because of beta-1 selectivity, bronchospasm is less likely than with nonselective blockers, but caution in asthma or COPD. It can mask signs of hypoglycemia; use with caution in diabetes. Do not use in severe bradycardia, AV block, or uncompensated heart failure.

Pregnancy and lactation: Not well studied; use only if benefits outweigh risks.

Availability: Nebivolol is available as a generic; Bystolic remains the branded version marketed in many markets.