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Oct 4, 2022

Blood Pressure

Heart Health

HypertensionBeta Blocker

Bystolic (Nebivolol): A Novel Beta Blocker for High Blood Pressure

What is Bystolic?

Bystolic is a beta blocker, meaning it blocks certain substances in your body, like epinephrine, from affecting the heart and blood. Bystolic treats high blood pressure, which lowers your risk of developing serious medical complications such as heart failure.

As this medication helps to slow the heart rate, Bystolic, and some other beta blockers, can be used for anxiety. However, this is considered “Off-Label” use as this medication has not been approved by the FDA for this use. The thought is that a small dose can help reduce your number of panic attacks and treat generalized anxiety disorder.

Bystolic is the brand name for this medication. As of 2022, this medication has a generic version called nebivolol, therefore you may hear your medication referred to as such as well.

When Should Bystolic Be Taken?

Nebivolol can be taken with or without food. It can be taken at any time of day; however, studies have shown that there are additional benefits to taking your dose in the evening as it has the added benefit of reducing prewaking systolic BP.1 Take your dose of Bystolic as directed by your healthcare provider.


Typically, your healthcare provider will start you on 5 mg of nebivolol and increase it depending on how you respond. Bystolic maximum dose is 40 mg per day. It is available in 2.5 mg, 5 mg, 10 mg, and 20 mg tablets.

Side Effects

Some common side effects of nebivolol are:

  • Headaches
  • Dizziness
  • Fatigue
  • Nausea
  • Slow heartrate
  • Trouble sleeping

These side effects are usually only temporary as your body adjusts to the medication. However, if any of these symptoms persist longer than a few days or bother you speak to your pharmacist or healthcare provider.

Some rare, yet serious side effects of this medicine are:

  • Blue fingers/toes
  • Fainting
  • Very slow heartrate
  • Shortness of breath
  • Swelling ankles/feet
  • Sudden weight gain
  • Sudden mood changes

If you experience any of these symptoms, it could indicate a serious health condition. Speak to your healthcare provider as soon as possible.

Stopping nebivolol suddenly can be dangerous. Some Bystolic withdrawal symptoms are:

  • Chest pains
  • Heart attacks
  • Abnormal heartbeats

If you want to stop taking nebivolol for any reason, speak to your healthcare provider before altering or stopping your dose.


There are several medications that can affect the efficacy of nebivolol or lead to increased risk of side effects. Check with your healthcare provider if any medication you are currently taking interacts with Bystolic. Some medications that interact with Bystolic are:

  • Mental health medications (e.g., fluoxetine, paroxetine)
  • Heart medications (e.g., digoxin, verapamil, diltiazem, disopyramide)
  • Other high blood pressure medications (e.g., other beta-blockers, alpha blockers, catecholamine-depleting drugs, clonidine)
  • Sildenafil (Viagra)

Bystolic and Alcohol

Alcohol can interact with nebivolol to increase drowsiness and affect reflexes and judgement. You may feel as if your tolerance for alcohol has lowered. Alcohol also affects your blood pressure and heavy drinking can lead to hypertension. If you choose to drink, be sure to not exceed the daily recommended limit of 1 unit/day for women and 2 units/day for men.


The average retail price for Bystolic 20 mg 30 tablets is around $200. Even with a Bystolic coupon, prices are still above $150.

Get Bystolic at Marley Drug and Save

Marley Drug offers nebivolol (generic Bystolic) for affordable, consistent prices. One month of 20 mg tablets at Marley Drug is only $41.10 which is 80% cheaper than the average pharmacy. Increase your savings with 6-month and 12-month prescriptions. With free delivery straight to your door, you can get Bystolic for as low as $14.43/month. That is a saving of up to 95%!

If you have any questions about your medication or Marley Drug, contact us at 1 800-810-7790 and speak to our pharmacy team today!


1) National Library of Medicine

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