Bystolic (Nebivolol)

Bystolic (nebivolol) is a once-a-day pill that has been used for over 13 years to treat adults with high blood pressure (hypertension). You can take it by itself or with other medications.

Clinical trials have proven that Bystolic can significantly lower blood pressure for a wide range of people.

The drug is thought to lower blood pressure by relaxing the muscle surrounding the blood vessels, allowing blood to flow more freely, reducing heart rate, and lowering the production of chemicals in your kidneys that cause an increase in blood pressure.

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What is Bystolic (nebivolol)?

Bystolic is a selective beta-blocker taken to treat mild to moderate hypertension. It may also be combined with water pills or angiotensin-converting enzyme (ACE) inhibitors to lower blood pressure.

Nebivolol is available as a generic medication.

What is Bystolic used to treat?

Bystolic is prescribed to treat or prevent high blood pressure and may be used alone or combined with other hypertension medications. Lowering blood pressure decreases the risk of serious or fatal cardiovascular complications, including strokes and heart attacks.

It works by blocking certain natural compounds from binding to receptors on the heart, stopping them from causing arrhythmias. It helps slow your heart rate so your heart doesn't have to work as hard.

Bystolic is different from other beta-blockers, as it also works on an extra pathway¹ to help open up blood vessels and lower blood pressure.

How do you take Bystolic?

Take medication as prescribed by your doctor, usually once daily with or without food, either alone or in combination with other drugs. Your doctor will prescribe you a dose based on your medical condition and response to treatment. To help you remember to take your medication, take it at the exact same time each day.

Bystolic comes in 2.5mg, 5mg, 10mg, and 20mg strengths.² Your doctor may start you off with a low dose of Bystolic and see how effective it is.

Seeing results 

Bystolic takes up to four hours to start working, and it may take several weeks before you see results. Keep taking this medicine for as long as your prescription lasts. Don’t stop taking it without the approval of your doctor.

Most people with high blood pressure don't feel any symptoms, but you should keep taking Bystolic even if you feel okay.

Potential side effects of Bystolic

Bystolic may cause side effects. The most common Bystolic side effects are:

  • Headache

  • Fatigue

  • Dizziness

  • Diarrhea

  • Nausea

  • Slow heartbeat

  • Stomach pain

  • Trouble sleeping (insomnia)

Rarely, Bystolic can cause more serious side effects, including:

  • Bradycardia (slow heartbeat)

  • Heart block (when electrical signals in the heart don’t work properly)

  • Congestive heart failure (CHF)

  • Acute renal (kidney) failure

  • Bronchospasm (spasm in the airways)

  • Lupus erythematosus

  • Raynaud phenomenon (decreased blood flow to fingers)

Speak to your doctor if you have any side effects when taking Bystolic, and seek urgent medical help if you develop a more serious side effect.

Long-term use of Bystolic

Bystolic is safe for long-term use, but taking the drug for a long time may cause the following side effects:

  • Disorientation

  • Short-term memory loss

  • Rapid or extreme mood changes

  • Trouble concentrating or thinking clearly

Missed doses

Take a missed dose of Bystolic as soon as possible unless it’s nearly time to take your next dose. Don’t take two doses at the same time to make up for a missed dose, as this could cause an overdose.


It’s possible to take an overdose of Bystolic, and doing so can result in serious complications.

The most common signs of a Bystolic overdose³ include:

  • Bradycardia

  • Hypotension (low blood pressure)

  • Hypokalemia (low potassium levels in your blood)

  • Heart failure

  • Vomiting

  • Dizziness

  • Fatigue

Get emergency medical help as soon as possible if you think you or someone else has taken too much Bystolic.

What to discuss with your doctor before taking Bystolic

Your doctor will decide if Bystolic is the right medication for you. This decision will depend on your condition, other medications you’re currently taking, and whether you have allergies or other medical conditions.

Before taking Bystolic, tell your doctor if:

  • You are allergic to nebivolol.

  • You had an allergic reaction to nebivolol or its ingredients in the past.

  • You are allergic to another medication.

  • You are taking prescription and nonprescription medications, vitamins, nutritional supplements, or herbal products. Tell your doctor if you plan to start taking them while undergoing Bystolic treatment.

  • You have any heart or liver diseases, or heart failure.

  • You have or have ever had asthma (or other lung diseases), diabetes, hyperthyroidism, blood circulation problems, kidney disease, severe allergies, or pheochromocytoma (a tumor that develops on a gland near the kidneys and may cause high blood pressure and fast heart rate).

  • You are pregnant, planning to get pregnant, or breastfeeding.

Before undergoing surgery, including dental procedures, tell the surgeon or dentist that you’re taking Bystolic.

Be aware that Bystolic can make you sleepy, so don’t drive a vehicle or operate machinery until you know how the medication affects you.

If you’re allergic to other substances, your allergic reaction may be worse while taking Bystolic. Be aware that Bystolic can reduce the efficacy of epinephrine.

Don’t take Bystolic if you:

  • Have heart failure and need medicines to keep your blood circulating

  • If you have a slow heartbeat or your heart skips beats

  • You have severe liver damage

Stopping Bystolic

Don’t stop taking your medication without talking to your doctor first. Your condition may get worse if you suddenly stop taking Bystolic.

If your doctor tells you to stop taking Bystolic, they may gradually taper off your dose over the course of one to four weeks.

As you gradually stop taking this medication, limit physical activity to prevent stress on your heart. Get medical help right away if you develop chest pain, tightness, pressure, unusual sweating, trouble breathing, or a fast or irregular heartbeat.

Stopping Bystolic suddenly may cause serious complications, including angina exacerbation (chest pain) or a heart attack.

Bystolic and pregnancy

You must tell your doctor if you’re pregnant, planning to get pregnant, or breastfeeding before taking Bystolic. It is not known if Bystolic is harmful to unborn or nursing babies, or if the drug passes into human breast milk.

Your doctor may prescribe Bystolic if you need to control your blood pressure during pregnancy, but you may need to be closely monitored.

Interactions with other drugs

Some drugs interact with Bystolic, including:

  • Albuterol

  • Bupropion

  • Ceritinib

  • Cinacalcet

  • Clonidine

  • Crizotinib

  • Diltiazem

  • Doxepin

Your doctor may recommend changing your dose or stopping your treatment if another drug you’re taking interacts with Bystolic.

Bystolic may also interact with:

  • Cimetidine

  • Clonidine

  • Digitalis

  • Isoniazid

  • Methimazole

  • Reserpine

  • Ropinirole

  • Ticlopidine

  • Other beta-blockers

  • Antibiotics

  • Antidepressants

  • Malaria medications

  • Heart or blood pressure medicines

  • Heart rhythm medication

  • HIV or AIDS medication

  • Medication to treat psychiatric disorders

Your doctor or pharmacist must be aware that you are taking any of these medications.

Allergy information

Beta-blockers are not usually associated with allergic reactions,⁴ but they can increase the risk of anaphylactic shock from other causes.

Clinical trial history

The FDA approved nebivolol to treat high blood pressure based on findings from three randomized, placebo-controlled, dose-ranging studies in adults with high blood pressure (2007,⁵ 2007,⁶ 2010).⁷

These studies concluded that nebivolol was safe and well-tolerated by patients.

Tips and advice for taking Bystolic

Keep these tips in mind when taking Bystolic to keep you safe and improve your experience:

  • Follow your doctor’s advice and instructions carefully.

  • Don’t take more or less of this medication than your doctor recommends.

  • Tell your doctor if you develop any side effects while taking this medicine.

  • Seek emergency medical help if you have any symptoms of an allergic reaction.

  • You should disclose information about other medications and health conditions before you start treatment to ensure Bystolic is safe for you.

  • Tell your doctor if you’re pregnant, breastfeeding, or planning to become pregnant before taking Bystolic.

  • Don’t stop taking this medicine without checking with your doctor first. Your doctor may suggest you slowly reduce your dose before stopping treatment completely. Stopping the medicine suddenly can be dangerous.

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Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.

However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.

It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.

Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.

Curious about clinical trials?

Access the latest treatments and medications. unavailable elsewhere - entirely free of charge. We make it easy to take part.