BYSTOLIC

Bystolic Generic Name & Formulations

Legal Class

General Description

Nebivolol (as HCl) 2.5mg, 5mg, 10mg, 20mg; tabs.

Pharmacological Class

Cardioselective beta-blocker.

How Supplied

Tabs—30, 100

Manufacturer

AbbVie

Bystolic Indications

Indications

Hypertension.

Bystolic Dosage and Administration

Adult

≥18yrs: initially 5mg once daily. Individualize; may increase at 2-week intervals; max 40mg/day. Severe renal or moderate hepatic impairment: initially 2.5mg once daily.

Children

<18yrs: not recommended.

Bystolic Contraindications

Contraindications

Severe hepatic impairment (Child-Pugh >B). Severe bradycardia. 2^nd- or 3^rd-degree AV block. Cardiogenic shock. Overt heart failure. Sick sinus syndrome (unless paced).

Bystolic Boxed Warnings

Not Applicable

Bystolic Warnings/Precautions

Warnings/Precautions

CHF. Angina. Recent MI. Bronchospastic disease. Diabetes. Hyperthyroidism. Severe renal impairment. Moderate hepatic impairment. Avoid abrupt cessation (taper over 1–2 weeks). Surgery. Peripheral vascular disease. Pheochromocytoma. Pregnancy (Cat.C). Nursing mothers: not recommended.

Bystolic Pharmacokinetics

Metabolism

Hepatic.

Elimination

Renal (38%); fecal (44%). Half-life: ~12hrs.

Bystolic Interactions

Interactions

Caution with phenylalkylamine and benzothiazepine calcium channel blockers (eg, verapamil, diltiazem), antiarrhythmics (eg, disopyramide), digoxin, reserpine, guanethidine; monitor. May be potentiated by CYP2D6 inhibitors (eg, quinidine, propafenone, paroxetine, fluoxetine); may need to reduce dose. If on both nebivolol and clonidine, discontinue nebivolol before tapering clonidine. May block epinephrine.

Bystolic Adverse Reactions

Adverse Reactions

Headache, fatigue, dizziness, GI upset.

Bystolic Clinical Trials

See Literature

Bystolic Note