Brand Name of Nebivolol
The brand name of nebivolol is Bystolic. 1
Nebivolol is a third-generation beta-blocker with unique properties that distinguish it from other beta-blockers in its class. It is FDA-approved for the treatment of hypertension in the United States under the brand name Bystolic 1, while it has been available in Europe for a longer period for treating both hypertension and heart failure.
Key Characteristics of Nebivolol
- Pharmacological classification: Nebivolol is a highly cardioselective beta1-blocker 2
- Unique mechanism: Unlike other beta-blockers, nebivolol has vasodilatory properties related to nitric oxide modulation 3
- Dosing: Typically administered once daily at doses of 5 mg (or 2.5 mg in patients over 65 years) 4
- Cardiovascular benefits: In the SENIORS trial, nebivolol significantly decreased all-cause mortality or cardiovascular hospital admissions in elderly heart failure patients 3
Clinical Applications
Nebivolol is one of four beta-blockers (along with carvedilol, metoprolol succinate, and bisoprolol) that have proven mortality benefits in heart failure patients 3. It is particularly useful in:
- Hypertension management: Provides comparable blood pressure reduction to other antihypertensive agents 1
- Heart failure treatment: Especially beneficial in elderly patients with heart failure 3
- Patients with metabolic concerns: Shows favorable metabolic profile with less impact on glucose and lipid metabolism compared to traditional beta-blockers 5, 4
Distinguishing Features
Nebivolol has several characteristics that set it apart from other beta-blockers:
- Nitric oxide-mediated vasodilation: Enhances nitric oxide bioavailability, which contributes to its antihypertensive effect 2
- Cardioselectivity: Higher beta1-selectivity than other agents in this class 2
- Tolerability: Better side effect profile compared to traditional beta-blockers like atenolol and metoprolol, particularly regarding fatigue and sexual dysfunction 1, 6
- Metabolic effects: May have favorable effects on glucose and lipid parameters 5, 4
Clinical Considerations
When prescribing nebivolol, be aware that:
- It is classified as a "cardioselective and vasodilatory" beta-blocker in clinical guidelines 3
- The usual dose range is 5-40 mg daily, administered once daily 3
- It induces nitric oxide-mediated vasodilation, which contributes to its antihypertensive effect 3
- Like other beta-blockers, abrupt cessation should be avoided 3
Nebivolol represents an important option in the beta-blocker class, particularly for patients who cannot tolerate traditional beta-blockers due to side effects or who have comorbid conditions like diabetes where metabolic neutrality is desirable.