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Nebivolol (By mouth)

Treats high blood pressure. This medicine is a beta-blocker.

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Nebivolol is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure… Read more
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What works? Research summarized

Evidence reviews

Tolerability of nebivolol in head-to-head clinical trials versus other cardioselective beta-blockers in the treatment of hypertension: a meta-analysis

Bibliographic details: Ambrosioni E, Borghi C.  Tolerability of nebivolol in head-to-head clinical trials versus other cardioselective beta-blockers in the treatment of hypertension: a meta-analysis. High Blood Pressure and Cardiovascular Prevention 2005; 12(1): 27-35

Meta-analysis of carvedilol versus beta 1 selective beta-blockers (atenolol, bisoprolol, metoprolol, and nebivolol).

Because carvedilol is a unique vasodilating β blocker (BB) exerting antioxidant activity and pleiotropic effects, it was theorized that it may confer more potent beneficial effects on cardiovascular mortality and morbidity in acute myocardial infarction (AMI) and heart failure (HF) settings. A systematic review and meta-analysis was performed of randomized, controlled, direct-comparison trials that included adults receiving atenolol, bisoprolol, metoprolol, nebivolol, or carvedilol to evaluate the effects of carvedilol compared to other BBs on mortality, cardiovascular events, and hospital readmissions in the setting of AMI or systolic HF. Compared to β(1)-selective BBs used in HF (8 trials, n = 4,563), carvedilol significantly reduced all-cause mortality (risk ratio 0.85, 95% confidence interval 0.78 to 0.93, p = 0.0006). In 3 trials of patients with AMI (n = 644), carvedilol significantly reduced all-cause mortality by 45% (fixed-effects model: risk ratio 0.55, 95% confidence interval 0.32 to 0.94, p = 0.03, random-effects model: risk ratio 0.56, 95% confidence interval 0.26 to 1.12, p = 0.10), with no reduction in non-fatal MI (risk ratio 0.61, 95% confidence interval 0.31 to 1.22, p = 0.16). In conclusion, carvedilol, as compared against atenolol, bisoprolol, metoprolol and nebivolol in randomized direct comparison trials, significantly reduced all-cause mortality in systolic HF patients. Additionally, carvedilol significantly reduced all-cause mortality compared with β(1)-selective BBs in AMI patients using the fixed-effects model but not using the random-effects model.

Efficacy and tolerability of nebivolol compared with other antihypertensive drugs: a meta-analysis

The authors concluded that nebivolol 5 mg may have benefits in hypertensive patients compared to existing antihypertensives and may have a role in the first-line treatment of hypertension. Evidence appeared to support the authors’ conclusions, but the limited search and inadequate validity assessment made it difficult to comment on the strength of the evidence underpinning the authors’ conclusions.

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Summaries for consumers

Comparing Beta Blockers

How do beta blockers compare in hypertension?

Treatment of high blood pressure for people with peripheral arterial disease

When blood pressure is consistently high it can lead to complications such as a heart attack (myocardial infarction) or stroke. Both peripheral arterial disease (PAD), a condition that affects the blood vessels (arteries) carrying the blood to the legs, arms, and stomach area, and high blood pressure (hypertension) are associated with atherosclerosis. This is hardening of the arteries which is caused by deposits of fat, cholesterol and other substances inside the blood vessels. PAD is diagnosed when the blood supply to the legs is restricted causing pain and cramping that limits walking (intermittent claudication). It is measured by the walking distance (on a treadmill) before onset of pain (claudication distance) or ankle brachial index (ABI), the ratio of the blood pressure in the arms to the blood pressure in the legs. If the blood pressure is lower in the legs compared to the arms (ABI of less than 1.0) this indicates blocked arteries in the legs (or PAD). PAD can progress to pain at rest and critical limb ischaemia (sudden lack of blood flow to a limb caused by a blood clot or fatty deposit blockage) that requires revascularisation (restoring the blood flow by opening up the blocked blood vessel) or amputation. Treatment of hypertension to reduce cardiovascular events (heart attack or stroke) and death needs careful consideration in people with PAD. Anti‐hypertensive medications may worsen the PAD symptoms by further reducing blood flow and supply of oxygen to the limbs, and may have long‐term effects on disease progression. The evidence from randomised controlled trials (RCTs) examining the risks and benefits of various anti‐hypertensive drugs on measures of PAD is lacking.

Beta‐1 selective blockers for treatment of high blood pressure

Beta‐1 selective blockers are a subclass of beta blockers that are commonly used to treat high blood pressure. Drugs in this class include atenolol (Tenormin), metoprolol (Lopressor), nebivolol (Bystolic) and bisoprolol (Zebeta, Monocor). We developed a comprehensive methodology to examine how different doses and drugs in this class of drugs lower blood pressure.

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