Drugs - Bystolic (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) |
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)
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