Nebivolol

DEA Class;  Rx

Common Brand Names; Bystolic

• Headache (6-9%)
• Fatigue (2-5%)
• Dizziness (2-4%)
• Diarrhea (2-3%)
• Nausea (1-3%)
• Increased triglyceride levels and insulin resistance, decreased high-density lipoprotein (HDL) levels (1%)
• Insomnia (1%)
• Peripheral edema (1%)
• Weakness (1%)
• Bradycardia
• Chest pain
• Dyspnea

Anesthetics that cause myocardial depression, bradycardia, 1° heart block, ischemic heart disease, Prinzmetal angina, untreated congestive heart failure (CHF)

Patients with bronchospastic disease should not receive beta-blockers; patients with bronchospastic disease who do not respond to other therapies, initial low doses may be employed and used cautiously; monitor closely; patient should have immediate access to beta2-agonist

May mask hyperthyroidism, including tachycardia; abrupt withdrawal may exacerbate symptoms of hyperthyroidism or precipitate thyroid storm; if thyrotoxicosis suspected, carefully manage and treat

Severe renal impairment decreases clearance; adjust dose in severe renal failure

Moderate hepatic impairment decreases metabolism ; adjust dose in moderate hepatic impairment (Child-Pugh class B); contraindicated in severe hepatic impairment (Child-Pugh class C)

May potentiate hypoglycemia in patients with hypoglycemia and/or mask signs and symptoms

Sudden discontinuance can exacerbate angina and lead to MI; to discontinue therapy, taper gradually over 1-2 weeks to avoid acute tachycardia, ischemia, and/or hypertension; temporary but prompt resumption of beta-blocker therapy may be necessary if angina symptoms or acute coronary insufficiency symptoms worsen

Pregnancy category: C

Lactation: Not known whether drug is excreted into breast milk; use not recommended