Nebivolol(nah bev’ ah loll)
Bystolic
PREGNANCY CATEGORY C
Drug Classes
Antihypertensive
Beta-adrenergic blocker
Therapeutic Actions
Highly selective beta-1 adrenergic blocker. Decreases heart rate and contractility, suppresses renin release, and vasodilates and decreases peripheral vascular resistance, all leading to decreased blood pressure and decreased cardiac output and oxygen consumption.
Indications
Treatment of hypertension, as monotherapy or with other antihypertensives
Contraindications and Cautions
Contraindicated with hypersensitivity to any component of the drug, severe bradycardia, heart block, cardiogenic shock, decompensated HF, sick sinus syndrome (unless a pacemaker is in place), severe hepatic impairment (Child-Pugh greater than grade B), lactation.
Use cautiously with bronchospastic diseases, surgery, diabetes, hypoglycemia, thyroid dysfunction, renal impairment, hepatic impairment, history of anaphylactic reactions, pheochromocytoma, pregnancy.
Available Forms
Tablets—2.5, 5, 10, 20 mg
Dosages
Adults
Starting dose: 5 mg/day PO; may be increased at 2-wk intervals to a maximum of 40 mg/day PO based on patient response.
Pediatric patients
Safety and efficacy not established.
Patients with severe renal impairment
If CrCl is less than 30 mL/min, starting dose 2.5 mg/day PO; titrate slowly and monitor patient closely.
Patients with hepatic impairment
In moderate impairment, starting dose of 2.5 mg/day PO; titrate slowly and monitor patient closely. In severe impairment, drug not recommended.
Pharmacokinetics
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