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DrugsBystolic (nebivilol)

September 2008

Therapeutic area - Cardiovascular


Indicated only for the treatment of hypertension, used alone or in combination with other antihypertensive agents.


Nebivolol is a β-adrenergic receptor blocking agent. At doses ≤10 mg, nebivolol is preferentially β1 selective in most of the population (extensive metabolizers). At higher doses and in poor metabolizers, nebivolol inhibits both β1- and β2 - adrenergic receptors.


For most patients, the recommended starting dose is 5 mg once daily. The dose can be increased at 2-week intervals up to 40 mg.


Patient has a diagnosis of hypertension and -unless contraindicated- has tried drugs from at least three of the following classes alone or in combination with a result of intolerable effects or ineffectiveness:

Diuretics (Examples) Beta Blockers (Examples) ACE inhibitors (Examples) ARB (Examples)
hydrochlorothiazide acebutolol (Sectral) benazepril candesartan (Atacand)
chlorothiazide atenolol (Tenormin) captopril eprosartan (Teveten)
furosemide carvedilol (Coreg) enalapril irbesartan (Avapro)
bumetanide bisoprolol (Zebeta) fosinopril losartan (Cozaar)
triamterene labetalol (Trandate) lisinopril olmesartan (Benicar)
metoprolol (Toprol) moexipril telmisartan (Micardis)
nadolol (Corgard) perindopril valsartan (Diovan)
pindolol (Visken) quinapril
propranolol (Inderal) ramipril
timolol (Blocadren)
In general, patients with bronchospastic diseases should not receive beta blockers.

Thiazide-type diuretics should be used as initial therapy for most patients with hypertension, either alone or in combination with one of the other classes. (JNC 7)


MHCP Provider Call Center 651-431-2700 or 800-366-5411

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