nebivolol at a glance
Medicine class
Selective beta blocker with nitric-oxide-mediated vasodilating activity
Licensed uses
Essential hypertension; selected stable chronic heart failure in older adults
Food
The tablets may be taken with or without food
Stopping treatment
Do not stop suddenly without prescriber advice, particularly in heart failure or ischaemic heart disease
What is nebivolol used for?
The selected product is licensed for:
Treatment of essential hypertension.
Treatment of stable mild or moderate chronic heart failure, alongside standard therapies, in people aged 70 years or over.
How does nebivolol work?
Nebivolol selectively blocks beta-1 receptors, reducing sympathetic stimulation of the heart and lowering heart rate and blood pressure. It also promotes vasodilation through the L-arginine–nitric oxide pathway, reducing resistance in blood vessels.
nebivolol preparations and strengths
Tablet
Route: Oral
Strengths: 5 mg
How to take nebivolol
Take the tablets exactly as prescribed and swallow them with water. They may be taken with or without food. Do not stop treatment abruptly unless a clinician instructs you to do so.
The selected tablet is cross-scored and can be divided into equal halves.
Tell the anaesthetist or surgical team that you take nebivolol before an operation.
nebivolol side effects
Common or expected effects
- Headache, dizziness or tiredness
- Tingling or altered skin sensation
- Nausea, diarrhoea or constipation
- Shortness of breath
- Swelling of the hands, feet or ankles
Get urgent medical advice
- Sudden facial, lip, tongue or throat swelling, especially with breathing difficulty
- Severe wheezing or bronchospasm
- Fainting, a markedly slow heartbeat or symptoms of heart block
- New or worsening breathlessness, swelling or other signs of worsening heart failure
- Severe symptomatic low blood pressure
nebivolol in pregnancy
Nebivolol may be used in pregnancy when a doctor considers it necessary; do not stop it without review. Beta blockers have not been shown to cause birth defects, but fetal growth monitoring may be offered, and babies exposed near birth may need observation for effects such as a slow heartbeat or low blood glucose.
nebivolol while breastfeeding
The selected product information advises against breastfeeding because risk to the infant cannot be excluded. Specialist guidance says nebivolol may sometimes be used cautiously for a full-term, healthy infant with monitoring, although better-studied beta blockers are preferred where clinically appropriate. Specialist advice is important for premature or unwell infants.
nebivolol interactions
Check all prescribed, pharmacy and herbal products with a clinician or pharmacist. Important interactions include:
Verapamil or diltiazem
The combination can excessively reduce heart contraction, blood pressure and atrioventricular conduction; intravenous verapamil is particularly hazardous.
Antiarrhythmics such as flecainide, quinidine or amiodarone
Effects on cardiac conduction and contractility may be increased.
Clonidine and other centrally acting antihypertensives
The combination may worsen heart failure, while poorly coordinated withdrawal can cause rebound hypertension.
Common questions about nebivolol
Answers are fully visible for fast scanning and source review.
Can nebivolol be taken with food?
Yes. The selected tablets may be taken with or without food and swallowed with water.
Why should nebivolol not be stopped suddenly?
Sudden withdrawal can temporarily worsen heart failure or aggravate ischaemic heart symptoms. A prescriber should plan any discontinuation.
Can nebivolol make the heartbeat too slow?
Yes. Bradycardia is a recognised effect; dizziness, faintness, unusual fatigue or collapse may indicate that the pulse or blood pressure is too low.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.