Bystolic - Use | Dosage | Side Effects

Bystolic is used with other medications for the treatment of mild to moderate chronic heart failure in patients aged 70 years or older. Bystolic is a cardiovascular medicine that belongs to the group of selective beta blockers (i.e., medicines which selectively act on the cardiovascular system). Prevents the tachycardia (a heart rate that exceeds the normal range) and control the force with which the heart pumps blood. Bystolic, also expanding the blood vessels, which also contributes to the reduction of blood pressure. It is used to treat high blood pressure (hypertension).

Warning and precautions

Do not take Bystolic if you have:

  • If you are allergic (hypersensitive) to the Bystolic or any other ingredient.
  • If you have one or more of the following disorders:
    • Low blood pressure.
    • Serious disturbances of circulation in hands and feet.
    • Very slow heart rate (less than 60 per minute).
    • Some other serious cardiac arrhythmias (eg, atrio-ventricular block second and third degree or heart conduction disorders).
    • Heart failure, which has just occurred or has recently worsened.
    • Asthma or wheezing (now or formerly).
    • Untreated pheochromocytoma, a tumor of the adrenal glands.
    • Disorders of liver function.
    • Metabolic disorders (metabolic acidosis), for example, diabetic ketoacidosis.

Be careful with Bystolic

Tell your doctor if you have or have had one of the following disorders:

  • An abnormally slow heart rate.
  • Kind of a pain in the chest due to spontaneous spasm of the coronary arteries, which is called Prinzmetal angina.
  • Untreated chronic heart failure.
  • First-degree heart block (mild types of cardiac conduction disturbances, that can affect the heart rhythm).
  • Poor circulation in the hands or feet; for example Raynaud's disease or syndrome, pain during the walking.
  • Long-term breathing problems.
  • Diabetes: This medication has no effect on blood sugar, but it may mask the warning signs of low blood sugar levels (eg, feeling palpitations, rapid pulse).
  • Over-active thyroid gland: this medicine may mask signs of abnormally rapid heart rate caused by these state.
  • Allergies: this medicine may enhance the reaction to pollen or other substances that you are allergic.
  • Psoriasis (a skin disease-pink spots that peel) or if you have ever had psoriasis.
  • If you have the surgery before anesthesia always tell the anesthesiologist that you are taking the Bystolic.
  • If you have severe kidney problems, do not take nebivolol and inform your doctor.

At the beginning of the treatment of chronic heart failure, you will be regularly monitored by experienced physician. The treatment must not be stopped abruptly unless your doctor said so.

Children and adolescents

It is not recommended use of Bystolic in children and adolescents due to a lack of data on the use of the medicine in these age groups.

Use with other medicines (Interaction)

Tell your doctor if you are taking or intend to use the medicine for lowering blood pressure, medicine to treat heart disease or medicine to treat diabetes. Also, tell your doctor or pharmacist if you have not long ago take any other medicines, including those obtained without a prescription. This is especially important if you are taking:

  • Medicines to lower blood pressure or medicines for cardiac diseases (e.g., amiodarone, amlodipine, cibenzolin, clonidine, digoxin, diltiazem, disopyramide, felodipine, flecainide, guanfacine, hydroquinidine, lacidipine, lidocaine, methyldopa, mexiletine, moxonidine, nicardipine, nifedipine, nimodipine, nitrendipine, propafenone, quinidine, rilmenidine, verapamil).
  • Sedative medications for the treatment of psychosis (mental disease), for example barbiturates (which are used ando treat epilepsy), a phenothiazines, (which is also used for nausea, and vomiting), and thioridazine.
  • Medication for depression, for example: amitriptyline, paroxetine, fluoxetine.
  • Medicines used during surgery for anesthesia.
  • Medicines for asthma, stuffy nose or certain eye disorders such as glaucoma (increased pressure in the eye ) or dilation (expansion) of the pupil (timolol, levobunolol).
  • Baclofen (anticonvulsant medicine used to treat epilepsy), amifostine (protective medicine used to treat cancer).

All of these medicines and Bystolic may affect blood pressure and/or heart function.

  • Medicines for the treatment of excessive gastric acid, or for the treatment of ulcers (antacids), for example: cimetidine: Bystolic should be taken during meals, and antacid between meals.

Taking food and drinks with Bystolic

Bystolic can be taken with food or on an empty stomach, but it is best to take the pill with glass of water.

Pregnancy and breast-feeding

Bystolic should not be taken during pregnancy unless it really is necessary. It is not recommended to take Bystolic while breastfeeding. Before taking any medication, consult your doctor.

Driving and operating machines

This medicine may cause dizziness and fatigue. If this apply to you, do not drive or operate machines.

How to use Bystolic

Always take Bystolic exactly as your doctor has prescribed. If you are not sure,check with your doctor or pharmacist. Bystolic can be taken before, during or after a meal, and can be taken independently of meals. It is the best to take a pill with some water.

Treatment of high blood pressure (hypertension)

  • The usual dose is 5 mg per day (one tablet). The dose should preferably be taken every day in at the same time.
  • Older patients and those with kidney disorders usually will start with ½ (half) of tablet (2,5 mg) per day.
  • The effect of the blood pressure reduction was evident after 1-2 weeks of treatment. Sometimes the optimum effect achieve only after 4 weeks.

Treatment of chronic heart failure

  • Treatment will start under close supervision of an experienced physician.
  • Your doctor will initially prescribe ¼ (quarter) of tablet (1,25 mg) per day. After 1-2 weeks the doctor may increase the dose to ½ (half) of the tablet (2,5 mg) per day, and then at 1 tablet (5 mg) per day, and finally the 2 tablets per day until it is reached a dose which is suitable for you. Your doctor will in each phase prescribe the dose that is most suitable for you and you need to strictly adhere to his instructions.
  • The maximum recommended dose is 2 tablets (10 mg) per day.
  • At the beginning of treatment and every time the dose is increased you will need over 2 hours be under the supervision of an experienced physician.
  • If it is necessary, your doctor may reduce your dose.
  • The treatment must not be stopped abruptly, as this may cause a worsening of heart failure.

Patients with severe renal difficulties should not take this medicine.

  • Take the medicine once a day, preferably at the same time.

If your doctor has told you to take ¼ (quarter:1,25 mg) or ½ (half: 2,5 mg) tablet daily, read the instructions to divide Bystolic 5 mg tablet with cross dividing notch. Place the tablet on a flat, hard surface (such as a table or desktop) with a separation notches tablets facing up. Break over the tablet pressing the cut surface with both thumbs. A quarter of tablet you will get if you break half of the tablets in the same way. Sharing Bystolic tablets 5 mg with cross recess dividing in half.

Your doctor may decide to combine Bystolic with other medicines to treat your condition.

  • Medicine should not be given to children and adolescents.


If you accidentally take too much of this medicine, tell your doctor or pharmacist. The most common symptoms and signs of Bystolic overdose is very slow heart rate (bradycardia), low blood pressure and possible fainting, shortness of breath as asthma (bronchospasm) and acute heart failure. Until the arrival of the doctor, you can take activated charcoal (available at medicine store).

If you stop taking Bystolic

Be sure to consult with your doctor before you stop taking Bystolic without regardless if you are taking it for high blood pressure or chronic heart failure. You should not suddenly stop treatment with Bystolic, because it can temporarily worsen heart failure. If it is necessary to interrupt the treatment of chronic heart failure with Bystolic, the daily dose should be gradually reduced, so that the intervals of one week to reduce half of the previous dose.

Side effects

Possible side effects while taking Bystolic for the treatment of high blood pressure:

Common side effects (more than one in every 100 but less than one out of 10 treated persons)

  • Headache;
  • dizziness;
  • fatigue;
  • unusual itching or burning sensation;
  • diarrhea;
  • constipation;
  • nausea;
  • shortness of breath;
  • swelling of the hands or feet.

Uncommon side effects (in more than one in every 1,000, but less than one in every 100 persons treated)

  • Slow heartbeat or other heart problems;
  • low blood pressure;
  • pain while you are walking;
  • abnormal vision;
  • impotence;
  • feelings of depression;
  • indigestion (dyspepsia), gas in the stomach or intestines, vomiting;
  • skin rash, itching;
  • shortness of breath as asthma, due to sudden spasms of the muscles that surround the airways (bronchospasm);
  • nightmares.

Very rare (less than one in every 10,000 persons treated)

  • Fainting;
  • worsening of psoriasis (a skin disease-a pink spots that peel).

The following side effects have been reported in isolated cases during the treatment with Bystolic:

  • Allergic reactions all over the body, with generalized skin changes (hypersensitivity reactions).
  • Sudden swelling, especially around the lips, eyes or tongue with possible sudden harsh breathing (angioedema).

Adverse reactions observed in clinical trials of chronic heart failure:

Very common side effects (in more than one out of 10 treated person)

  • Slow heartbeat;
  • dizziness.

Common side effects (more than one in every 100 but less than one out of 10 treated persons)

  • Worsening of heart failure;
  • low blood pressure (eg feeling faint when getting up sharply);
  • the impossibility of filing of this medicine
  • AV block first grade;
  • swelling of the feet (such as swollen ankles).

If you notice any side effects please tell your doctor or pharmacist.

Information on this website are provided for educational purposes only and are not intended for medical advice, diagnosis or treatment.

If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional.