Bystolic

The typical dosage of Bystolic for adults with hypertension is:

• Initial Dose: 5 mg taken orally once daily, with or without food.
• Maintenance Dose: The dose may be increased at 2-week intervals based on the patient’s response. The maximum recommended dose is 40 mg per day.

• Heart Failure: Dosing is individualized and depends on the severity, generally starting at a lower dose and gradually incrementing until the desired effect is achieved.

• Severe bradycardia (slow heart rate).
• Heart block greater than first degree unless a pacemaker is present.
• Cardiogenic shock.
• Decompensated cardiac failure.
• Severe hepatic impairment.
• Hypersensitivity to nebivolol or any of the excipients in Bystolic.

Patients using Bystolic should be advised to:

• Take the medication exactly as prescribed and do not skip doses, even if they feel well. High blood pressure often has no symptoms, so regular use is important for controlling the condition.
• Monitor their blood pressure regularly and report any significant changes to their healthcare provider.
• Avoid sudden discontinuation of Bystolic, as this can lead to a rapid increase in blood pressure (rebound hypertension) or other heart-related issues. Any changes to the dosing regimen should be done under medical supervision.
• Inform their healthcare provider about all medications they are taking, including over-the-counter drugs and supplements, as Bystolic can interact with other medications.
• Report any symptoms such as dizziness, shortness of breath, or unusual swelling, as these may indicate side effects that need medical attention.

• Headache
• Fatigue
• Dizziness
• Nausea
• Slow heart rate (bradycardia)
• Insomnia

Serious side effects can include:

• Severe Bradycardia: A very slow heart rate that may cause fainting or dizziness.
• Heart Failure: Symptoms such as swelling of the ankles/feet, severe fatigue, and shortness of breath should be reported immediately.
• Bronchospasm: Especially in patients with a history of asthma or other bronchospastic diseases.
• Allergic Reactions: Such as rash, itching, swelling, or difficulty breathing.

Rebound Hypertension: Sudden discontinuation of Bystolic can cause a rapid increase in blood pressure, which can be dangerous. Tapering off the medication should be done gradually under a healthcare provider’s supervision.

Bronchospasm: Although Bystolic is a selective beta-1 blocker, it can still cause bronchospasm in susceptible individuals, such as those with asthma.

Diabetes: Bystolic may mask some of the symptoms of hypoglycemia (low blood sugar), such as rapid heartbeat, in patients with diabetes. Blood sugar levels should be monitored closely.

Bystolic may interact with other medications, including:

• Other Antihypertensives: Such as ACE inhibitors, ARBs, and diuretics, which can enhance the blood pressure-lowering effect.
• Calcium Channel Blockers: Especially those like Verapamil HCl or dilTIAZem HCl, which can cause additive effects on heart rate and contractility.
• CYP2D6 Inhibitors: Such as Fluoxetine or PARoxetine HCl, which can increase the levels of Bystolic in the blood, potentially increasing the risk of side effects.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Which can reduce the effectiveness of Bystolic in lowering blood pressure.

Alternative treatments for hypertension include:

• Other Beta-Blockers: Such as metoprolol, Atenolol, or Propranolol HCl.
• ACE Inhibitors: Such as Lisinopril or enalapril.
• Angiotensin II Receptor Blockers (ARBs): Such as losartan or Valsartan.
• Calcium Channel Blockers: Such as amlodipine or dilTIAZem HCl.
• Diuretics: Such as hydroCHLOROthiazide or Chlorthalidone.

The choice of treatment depends on the individual’s overall health, the severity of their hypertension, and their response to previous treatments.