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Bystolic is a medication used to treat hypertension. It comes in tablet form with dosages ranging from 2.5mg to 20mg. The typical starting dose for hypertension is 5 mg once daily, with adjustments based on kidney and liver function. Bystolic works by blocking chemicals that bind to heart receptors, slowing the heart rate, and relaxing blood vessels to lower blood pressure. Common side effects include headache, fatigue, and dizziness. It’s important to take Bystolic as prescribed and follow safety guidelines, including regular monitoring of blood pressure and heart rate.

Product Overview

Bystolic is a medication containing the active ingredient nebivolol, which is primarily used to treat hypertension (high blood pressure). Hypertension is a common condition where the force of the blood against the artery walls is too high, which results in heart disease, stroke, and other health problems if not managed properly. Nebivolol works by blocking certain receptors in the heart, slowing down the heart rate, and relaxing blood vessels, thereby reducing blood pressure.

Bystolic comes in tablet form with strengths of 2.5mg, 5mg, 10mg, and 20mg. It is typically taken once daily, with or without food, and the dosage may be adjusted based on the patient’s response and medical condition. It is suitable for adults and should be used cautiously in people with kidney or liver problems. The medication works by inhibiting the action of chemicals that stimulate the heart and blood vessels, leading to a decrease in heart rate and dilation of blood vessels.

Common side effects of Bystolic include headache, diarrhea, fatigue, dizziness, and nausea. Patients should be cautious about potential allergic reactions and heart-related issues. It is important to follow the prescribed dosage and not to stop taking the medication abruptly. If a dose is missed, it should be taken as soon as possible unless it is close to the time for the next dose. In case of overdose, immediate medical attention is required. Bystolic should be stored at room temperature, away from heat and moisture, and out of reach of children. Patients should inform their healthcare providers of all medications they are taking to avoid potential interactions.

Uses of Bystolic

  • Treats hypertension

How to Use Bystolic?


Strengths and Forms

  • Tablet: 2.5mg, 5mg, 10mg, 20mg

Recommended Dosage for Different Patients

For Hypertension (High Blood Pressure)

  • The typical starting dose is 5 mg taken orally once per day.
  • The dose may be increased every 2 weeks, but should not exceed 40 mg per day.

Dosing adjustments for people with kidney problems:

  • For those with a creatinine clearance (CrCl) between 30 and 80 mL/min: The manufacturer does not provide specific dosing adjustments.
  • For those with a CrCl below 30 mL/min: Start with a dose of 2.5 mg taken orally once per day, and increase the dose cautiously if needed.

For People with Renal problems

  • Mild liver impairment (Child-Pugh Class A): The manufacturer does not provide specific dose adjustment instructions.
  • Moderate liver impairment (Child-Pugh Class B): Start with 2.5 mg taken by mouth once daily. If the initial response is not adequate, the dose can be increased cautiously.
  • Severe liver impairment (Child-Pugh Class C): Bystolic should not be used in this case as it is contraindicated.

[Note: Remember these recommendations may vary depending on person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

  • Take Bystolic exactly as your doctor prescribes. Do not alter the dosage or duration of treatment without consulting your doctor.
  • Follow the instructions on your prescription label carefully.
  • Take this tablet at the same time each day, either without having a meal or after a meal.
  • Do not skip doses or stop taking Bystolic without your doctor’s approval. Abruptly stopping the medication can worsen your condition or lead to serious heart problems.
  • Your blood pressure should be monitored regularly. Make sure to visit your doctor for check-ups.
  • Inform your surgeon that you are taking Bystolic if you plan to undergo surgery.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Bystolic Work?

Bystolic (nebivolol) works by blocking certain chemicals that bind to receptors in the heart, which slows down the heart rate and allows the heart to relax between contractions. This action helps to lower blood pressure. Additionally, Bystolic uniquely relaxes blood vessels, further reducing blood pressure.

Important Safety Information

Side Effects

Common side effects may include:

  • Headache
  • Diarrhea
  • Fatigue or tiredness
  • Shortness of breath
  • Dizziness or lightheadedness
  • Nausea or upset stomach
  • Slow heartbeat (bradycardia)
  • Insomnia or trouble sleeping
  • Swelling of the legs or feet (edema)

Adverse/Serious side effects may include:

  • Severe allergic reactions: Symptoms can include rash, itching, swelling of the face, lips, tongue, or throat, and difficulty breathing.
  • Heart-related issues: Such as worsening heart failure, chest pain, or irregular heartbeat.
  • Severe dizziness or fainting: This can be a sign of extremely low blood pressure.
  • Breathing problems: Especially in people with asthma or other respiratory conditions.
  • Changes in blood sugar levels: Which can be problematic for people with diabetes.
  • Severe skin reactions: Including Stevens-Johnson syndrome or toxic epidermal necrolysis.
  • Swelling of the extremities: This can indicate heart or circulation problems.

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]


  • Maintain all medical and lab appointments while taking Bystolic to monitor its effectiveness in controlling high blood pressure and to check your heart rate.
  • Inform all healthcare providers and lab personnel that you are taking Bystolic.
  • Be aware that Bystolic can cause drowsiness and dizziness, which may vary among individuals. Avoid driving or operating heavy machinery until you know how it affects you.
  • Notify your healthcare professionals before undergoing any surgery, including dental procedures, that you are on Bystolic.
  • Contact your doctor for medical advice if you become pregnant while taking Bystolic. It is uncertain if Bystolic passes into breast milk, so avoid breastfeeding while on this medication.
  • Note that Bystolic may worsen allergic reactions to different substances, and your allergic symptoms may not respond as effectively to epinephrine while on Bystolic.


  • Allergies: Inform your doctor or pharmacist if you are allergic to nebivolol or have any other allergies. The medication may contain inactive ingredients that can cause allergic reactions.
  • Medical History: Share your medical history with your doctor, especially if you have:
    • Heart failure
    • Kidney disease
    • Liver disease
    • Heart rhythm problems (e.g., slow heartbeat, second- or third-degree atrioventricular block)
    • Blood circulation issues (e.g., Raynaud’s disease, peripheral vascular disease)
    • Mental/mood disorders (e.g., depression)
    • Myasthenia gravis (a muscle disease)
    • Overactive thyroid (hyperthyroidism)
    • Breathing problems (e.g., asthma, chronic bronchitis, emphysema)
    • Serious allergic reactions, including those requiring epinephrine treatment
  • Dizziness: Nebivolol may cause dizziness. Avoid driving or operating machinery until you know how the medication affects you. Alcohol and marijuana can increase dizziness, so limit their use.
  • Surgery: Inform your doctor or dentist about all the medications you use before undergoing surgery.
  • Blood Sugar Levels: Nebivolol may mask the rapid heartbeat associated with low blood sugar (hypoglycemia). If you have diabetes, monitor your blood sugar levels closely and inform your doctor if you experience symptoms of high blood sugar, such as increased thirst or urination. Your doctor may suggest some adjustments in your diabetes medication, exercise program, or diet.
  • Children: Children may be more susceptible to low blood sugar while using nebivolol. Ensure they eat regularly, and inform the doctor if they cannot eat, are vomiting, or show symptoms of low blood sugar.
  • Pregnancy: Use nebivolol during pregnancy only if clearly needed. Discuss the risks and benefits with your doctor. Babies born to mothers taking this medication may need monitoring for issues like low birth weight, low blood pressure, decreased heartbeat, lowered blood sugar, and shallow breathing.
  • Breastfeeding: It is unknown if nebivolol passes into breast milk. Consult your doctor before breastfeeding.

Bystolic Contraindications

Do not take medication if you have had a series of allergic reactions to nebivolol. 

Avoid Bystolic if you have serious problems in the liver, lung (such as asthma or emphysema), or certain heart issues. Ask your doctor what these heart problems are.

Missed Dose

  • If you forget to take a dose, take it as soon as you remember. 
  • If it’s almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. 
  • Do not take a double dose to make up for the missed one.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]


Symptoms of an overdose may include a slow heart rate, dizziness, vomiting, difficulty breathing, or a sensation of being close to fainting.

[Note: If you consumed more than recommended dose, get medical help right away, or call the Poison Help line at 1-800-222-1222.]


  • Store the medicine in a sealed container at room temperature, away from heat, moisture, and direct sunlight. Avoid freezing.
  • Keep it out of children’s reach.
  • Dispose of any expired or unneeded medicine.
  • Consult your healthcare professional for proper disposal of unused medicine.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Bystolic Interactions

  • Amlodipine
  • Aspirin
  • Aspirin Low Strength (aspirin)
  • Atorvastatin
  • Clonidine
  • Crestor (rosuvastatin)
  • Furosemide
  • Gabapentin
  • Hydrochlorothiazide
  • Levothyroxine
  • Meloxicam
  • Prednisone
  • Trazodone
  • Xanax (alprazolam)

[Note: This isn’t a complete list, and there could be other drugs that interact with Bystolic. Make sure to tell your doctor any prescription, over-the-counter medicines, and herbal products you’re taking.]

Bystolic Alternatives

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

How effective is Bystolic in reducing blood pressure?

In a study, individuals who took Bystolic alone experienced a reduction of approximately 15 mmHg in both systolic and diastolic blood pressures. In another study involving patients already on other blood pressure medications, adding Bystolic lowered their systolic blood pressure by about 4 mmHg to 6 mmHg and diastolic blood pressure by about 3 mmHg to 5 mmHg. The extent of blood pressure reduction can vary depending on factors such as the dosage of the medication.

How fast does Bystolic start to lower blood pressure?

Bystolic can begin to reduce blood pressure within the first two weeks of treatment. However, the onset of its effects can vary among individuals. This variation is partly because your healthcare provider may gradually increase your dosage every few weeks when you initially start the medication to determine the most effective dose for you.

Can Bystolic be used to prevent migraine headaches?

Some beta-blockers, like propranolol, are approved for migraine prevention. Although the FDA hasn’t approved Bystolic for this, some studies have found that nebivolol could be helpful for preventing migraines. However, treatment guidelines haven’t quite recommended using it for migraines. If you struggle with migraine headaches, consult with your medical professional about the best options for you.

Is Bystolic an effective beta-blocker?

Yes, Bystolic is an effective beta-blocker that specifically targets the heart, resulting in fewer side effects compared to other beta-blockers. However, it is important to note that Bystolic, as a brand-name medication, can be costly. Additionally, skipping doses may elevate your blood pressure and increase the risk of chest pain, heart attack, and irregular heart rhythm.

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