The Medical Letter on Drugs and Therapeutics
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1281
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Nebivolol (Bystolic) for Hypertension

Nebivolol (Bystolic – Forest) is a new beta-blocker that has been approved by the FDA for treatment of hypertension. It has been marketed in Europe since 1999 for treatment of hypertension and heart failure.

PHARMACOLOGY — Like carvedilol and labetalol, nebivolol has vasodilating as well as beta-blocking effects, but unlike the other two drugs, which have alpha-blocking properties, nebivolol has nitric oxidemediated vasodilatory effects.1 At doses of up to 10 mg, nebivolol selectively antagonizes beta1-adrenergic receptors, causing a decrease in heart rate, myocardial contractility and renin activity. At higher doses, it antagonizes beta2 receptors and could cause bronchospasm and other symptoms as well. It has no intrinsic sympathomimetic activity. Nebivolol is highly lipophilic. Unlike some other beta-blockers, it apparently does not increase insulin ... more      

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