Bystolic (Nebivolol) - Summary

BYSTOLIC SUMMARY

BYSTOLIC as tablets for oral administration contains nebivolol hydrochloride equivalent to 2.5, 5, and 10 mg of nebivolol base. Nebivolol is a β-adrenergic receptor blocking agent.

BYSTOLIC is indicated for the treatment of hypertension. BYSTOLIC may be used alone or in combination with other antihypertensive agents.

See all Bystolic indications & dosage >>

NEWS HIGHLIGHTS

Media Articles Related to Bystolic (Nebivolol)

ESH/ESC Publish Hypertension Guidelines
Source: Medscape Medical News Headlines [2013.06.15]
The new guidelines make <140 mm Hg the treatment target for all individuals, with a few minor exceptions, and say that all the drug classes have a role in reducing blood pressure. In addition, the ESH/ESC guidelines emphasize a role for ABPM and reiterate their emphasis on combination therapy.
Heartwire

Vitamin D Can Help Prevent Hypertension
Source: Health News from Medical News Today [2013.06.15]
The world's largest study to examine the link between vitamin D levels and hypertension has found that low levels of Vitamin D can be a major cause of hypertension. Researchers presented their findings at the annual conference of the European Society of Human Genetics (ESHG). Data were gathered from 35 studies, which included more than 155,000 participants from different parts of Europe and North America. Dr. Vimal Karani S, from the Institute of Child Health, University College London, London, UK, led the study...

Hypertension Risk Drops with Volunteer Work (CME/CE)
Source: MedPageToday.com - medical news plus CME for physicians [2013.06.14]
(MedPage Today) -- Older adults had a significantly lower risk of developing hypertension if they performed at least 200 hours of volunteer service in the previous year, a longitudinal survey showed.

Link Clarified Between Hypertension And Vitamin D Deficiency
Source: Hypertension News From Medical News Today [2013.06.12]
Low levels of vitamin D can trigger hypertension, according to the world's largest study to examine the causal association between the two. Although observational studies have already shown this link, a large-scale genetic study was necessary before the cause and effect could be proven, the annual conference of the European Society of Human Genetics (ESHG) heard. Dr...

Portal Hypertension
Source: MedicineNet Cirrhosis Specialty [2013.06.10]
Title: Portal Hypertension
Category: Diseases and Conditions
Created: 1/31/2005 8:20:00 AM
Last Editorial Review: 6/10/2013 12:00:00 AM

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Published Studies Related to Bystolic (Nebivolol)

beta-Blockers in patients with intermittent claudication and arterial hypertension: results from the nebivolol or metoprolol in arterial occlusive disease trial. [2011.08]
The use of beta-receptor blockers in peripheral arterial disease is controversial for their impact on vasomotor tone... In the direct comparison, there was no significant difference between nebivolol and metoprolol.

Effect of nebivolol vs. hydrochlorothiazide on the walking capacity in hypertensive patients with intermittent claudication. [2011.07]
CONCLUSION: The increases in ICD, ACD and ABI with nebivolol suggest that this medication does not have negative effects on hypertensive patients with symptomatic PAD, and can be used for treatment of hypertension in these patients at high cardiovascular risk without reducing the walking ability.

Comparison of antihypertensive efficacy of carvedilol and nebivolol in mild-to-moderate primary hypertension: a randomized trial. [2011.06]
OBJECTIVE: The aim of the present study is to compare the antihypertensive effects of carvedilol and nebivolol in mild-to-moderate hypertensive patients... CONCLUSION: Although both carvedilol and nebivolol effectively decreased blood pressure compared to placebo, they showed similar efficacy for lowering blood pressure.

Differential effects of nebivolol and metoprolol on central aortic pressure and left ventricular wall thickness. [2011.06]
The aim of this study was to investigate the effects of the vasodilating beta-blocker nebivolol and the cardioselective beta-blocker metoprolol succinate on aortic blood pressure and left ventricular wall thickness... This proof-of-principle study provides evidence to suggest that beta-blockers with vasodilating properties may offer advantages over conventional beta-blockers in antihypertensive therapy; however, this remains to be tested in a larger trial.

The effect of nebivolol versus metoprolol succinate extended release on asymmetric dimethylarginine in hypertension. [2011.05]
This study sought to determine if metoprolol succinate ER (MET), and nebivolol (NEB), a beta1-AR with increased bioavailability of nitric oxide (NO), would have differing effects on plasma asymmetric dimethylarginine concentration in hypertensives. It was hypothesized that NEB, a beta1-AR antagonist and beta3-AR agonist with NO-releasing properties, and MET, only a beta1-AR antagonist, would have different effects on plasma asymmetric dimethylarginine (ADMA) concentration...

more studies >>

Clinical Trials Related to Bystolic (Nebivolol)

The Effect of Nebivolol on Endothelial Dysfunction in African Americans With Hypertension [Recruiting]
High blood pressure (hypertension) is called the "silent killer" because many people do not know they have it, and do not know when it is well controlled. Unfortunately, over time uncontrolled hypertension can cause irreversible organ damage that can lead to heart attack, stroke, heart failure, and kidney failure. If a person cannot control their blood pressure with diet and exercise, doctors often prescribe medications to help control the blood pressure. Nebivolol is a medication that has been recently approved by the FDA for the treatment of hypertension. Our study will investigate whether treatment with nebivolol, as compared to another medication called metoprolol, in African Americans with hypertension will be more effective in protecting blood vessels against the harmful effects of high blood pressure.

Over time high blood pressure causes hardening of the arteries (atherosclerosis) which leads to narrowing of the blood vessels and reduces blood flow to our organs. Arteries also relax and contract naturally, which further changes the blood supply. When arteries are narrowed, exercise can bring on a condition in which the blood supply is inadequate, and this might result in the sensation of pain.

Cells lining our blood vessels produce a variety of substances that normally cause arteries to relax. Two of these substances are called nitric oxide (NO) and endothelium-derived hyperpolarizing factor (EDHF). We are trying to determine the nature of these substances in African Americans with high blood pressure and how it is affected by nebivolol and metoprolol. One way to determine this is to inject drugs such as L-NMMA (N(G)-monomethyl-L-arginine) or TEA (tetraethylammonium chloride), which block the production of NO and EDHF respectively, and then study what happens to the blood flow at rest and during exercise. It is our thought that nebivolol, in comparison to metoprolol, will increase the substances that naturally cause arteries to relax and improve blood supply.

Comparative Effects of Nebivolol and Metoprolol on Femal Sexual Function [Recruiting]
Beta-blockers (BB) are an important treatment for high blood pressure and heart disease. However beta-blockers can cause sexual dysfunction (SD) and this common side effect limits successful use of this class of medications. Sexual side effects often result in drug discontinuation, compromising therapy goals. The investigators are conducting the study to determine if nebivolol, a newer beta blocker that is selective for receptors in the heart and causes vasodilation in the body causes fewer sexual side effects, or even improves sexual function, compared with metoprolol succinate.

Comparative Effects of Nebivolol Versus Placebo on Sodium Sensitivity of Blood Pressure in Hispanic Postmenopausal Women With Hypertension [Not yet recruiting]
2. 1 Research objectives:

The objective of this randomized, placebo-controlled, 2 period crossover clinical trial is to determine the effects of nebivolol versus placebo on ambulatory blood pressure, the blood pressure response to dietary sodium loading, and renal handling of an acute sodium load in postmenopausal women with hypertension.

2. 1.1 Hypothesis:

Nebivolol will result in a blunted response of blood pressure to oral sodium administration and improved handling of an intravenous sodium load in comparison with placebo in hypertensive postmenopausal women.

2. 2 Research plan:

2. 2.1 Study design

The study will consist of a randomized crossover trial of the effects on salt sensitivity of nebivolol. All study procedures will be carried out under the direct supervision of the Principal Investigator in the outpatient and inpatient research unit of the University of Miami Division of Clinical Pharmacology.

2. 2.2 Primary endpoints:

1. Change and percentage change in systolic, diastolic and mean blood pressure by ABPM from final day of low sodium to the final day of high sodium in nebivolol versus placebo

2. Differences in renal sodium excretion in response to an acute sodium load during treatment with either nebivolol or placebo.

2. 2.3 Secondary endpoints

1. Change in clinic blood pressure following 4 weeks of outpatient nebivolol versus placebo

2. Change in weight from final day of low sodium to the final day of high sodium in nebivolol versus placebo

3. Change in 24-hour sodium and potassium excretion from last day of low sodium to last day of high sodium

4. Asymmetrical dimethylarginine (ADMA)

Effects of Nebivolol on Skeletal Muscle During Exercise in Hypertensive Patients [Recruiting]
The purpose of this study is to determine if Nebivolol improves microvascular perfusion in skeletal muscle during exercise in hypertensive patients and whether this improvement is accompanied by reduction in vascular oxidative stress or increased endothelial nitric oxide synthase (eNOS) expression in humans.

Nebivolol in the Supine Hypertension of Autonomic Failure [Recruiting]
The purpose of this study is to evaluate the effect of the antihypertensive drug, nebivolol (Bystolic), compared to metoprolol (Lopressor) and sildenafil (Viagra) on blood pressure in patients with autonomic failure and supine hypertension.

more trials >>

Reports of Suspected Bystolic (Nebivolol) Side Effects

Dyspnoea (18),  Fatigue (17),  Blood Pressure Increased (17),  Loss of Consciousness (15),  Palpitations (14),  Heart Rate Decreased (13),  Depression (12),  Headache (11),  Dizziness (11),  Abdominal Distension (10), more >>

PATIENT REVIEWS / RATINGS / COMMENTS

Bystolic review by 36 year old female patient
		Rating
Overall rating:
Effectiveness:		Highly Effective
Side effects:		Mild Side Effects
		Treatment Info
Condition / reason:		heart palpitations
Dosage & duration:		2.5mg taken 1x/day for the period of 6months
Other conditions:		none
Other drugs taken:		Loestrin-24
		Reported Results
Benefits:		I have had SVT's all my life. It was only when I turned 24 that I sought treatment for them as they usually were linked with a syncope episode. I was originally put on the grandfather of beta/alpha blockers inderal. While this drug was effective at treating my migraines, it was not particularly effective at controlling my palpitations and it tended to lower my blood pressure too much. I always felt tired and had little energy on this drug. At 24 years of age I was not happy to have the energy of a 65 year-old. Next came atenolol and labatolol (when I was pregnant). I also had break-through palpitations with these drugs as well as low-enegy side effects. With labetolol I could barely jog down my street without becoming significantly winded and according to my cardiologist I fell into the 94th percentile for "in-shape" people my age. Finally, when bystolic hit the market I was thrilled. First of all I didn't need a large dose of it to be effective. Second, it was effective. I experience no break-through palpitations, and last but not least there were very few to no side effects. I had energy again and I could get throught my cardiovascular exercise without becoming winded.
Side effects:		The beta blocker controls and regulates your heart beat so it beats on time when it's supposed to. It also however, controls your heart rate and doesn't allow it to race out of control. So when exercising, many people have a hard time being able to get their heart rate up to pump enough blood to the lungs which is why you feel winded while exercising even mildly. With Bystolic there is very little of this type of side effect. Sometimes I don't notice it at all.
Comments:		I take 2.5mg of Bystolic one time per day to control palpitations. This drug is commonly prescribed for hypertension but I do not take it for that. At this dose it does not lower my already low blood pressure very much but it is effective against the palpitations.