Bystolic (Nebivolol)
Class and Category of Drug
Before you buy Bystolic (Nebivolol) online, read common information about the medication.
Chemical class: Beta-adrenergic blocker
Therapeutic class: Antihypertensive
Pregnancy category: C
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Drug Indications and Dosages
Before purchase Bystolic (Nebivolol) online , you must read how it works.
To treat hypertension
Tablets
Adults. Initial: 5 mg once daily, increased at 2-wk intervals, as needed. Maximum: 40 mg once daily.
Dosage Adjustment
For patients with moderate renal impairment (creatinine clearance less than 30 ml/min/1.73 m2) or moderate hepatic impairment (Child-Pugh Class B), initial dose reduced to 2.5 mg.
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Contraindications of Drug
Read contraindications if you want cheap Bystolic (Nebivolol) online.
Advanced atrioventricular block, cardiogenic shock, decompensated cardiac failure, hypersensitivity to nebivolol or its components, sick sinus syndrome (unless permanent pacemaker is in place), severe bradycardia, severe hepatic impairment
Generic Drug Interactions
Drugs
antiarrhythmias such as disopyramide, beta blockers, digoxin, diltiazem: Increased effect on atrioventricular conduction and myocardial depression; increased risk of bradycardia
fluoxetine, paroxetine, propafenone, quinidine: Increased hypertensive effect of nebivolol
guanethidine, reserpine: Possibly excessive reduction of sympathetic activity
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Drugs Adverse Reactions
Central Nervous System: Asthenia, dizziness, fatigue, headache, insomnia, paresthesia, somnolence, syncope, vertigo
Cardiovascular: Allergic vasculitis, atrioventricular block, bradycardia, chest pain, hypercholesterolemia, hyperuricemia, MI, peripheral edema, peripheral ischemia, Raynaud's phenomenon
Gastrointestinal: Abdominal pain, diarrhea, elevated liver enzymes, nausea, vomiting
Genitourinary: Acute renal failure, elevated BUN level, erectile dysfunction
Hematologic: Decreased platelet count, thrombo-cytopenia
Respiratory: Acute pulmonary edema, broncho-spasm, dyspnea
Skin: Pruritus, psoriasis, rash, urticaria
Other: Angioedema
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Nursing Considerations for Generic Drugs
• Know that patients with bronchospastiс disease usually shouldn't be treated with beta blocker therapy such as nebivolol.
• Use nebivolol cautiously in patients with impaired hepatic or renal function.
• Expect to administer an alpha blocker, as ordered, before starting nebivolol therapy in patients with pheochromocytoma.
• Monitor blood pressure and pulse rate often, especially at start of nebivolol therapy and during dosage adjustments. Also monitor fluid intake and output and daily weight, and watch for evidence of heart failure, such as dyspnea, edema, fatigue, and jugular vein distention. If heart failure occurs or worsens, expect drug to be discontinued.
• Be aware that drug shouldn't be stopped abruptly because MI, myocardial ischemia, severe hypertension, or ventricular arrhythmias may result.
• Expect to temporarily withhold nebivolol before surgery. If drug will be continued during perioperative period, monitor patient closely for protracted severe hypotension and difficulty restarting and keeping a heartbeat.
• Assess distal circulation and peripheral pulses in patient with peripheral vascular disease because drug can worsen it.
• Be aware that nebivolol may mask tachycardia from hyperthyroidism and that abrupt withdrawal can cause thyroid storm. Drug also can decrease blood glucose level, prolong or mask symptoms of hypoglycemia, and promote hyperglycemia in patient with diabetes mellitus; or worsen psoriasis.
• Monitor patient closely for hypersensitivity reactions that may occur with beta blockers, especially patients with a history of severe anaphylactic reactions who may not be responsive to usual doses of epinephrine used to treat allergic reactions.
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