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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