The Medical Letter on Drugs and Therapeutics
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Byvalson - A Beta Blocker/ARB Combination for Hypertension

The FDA has approved Byvalson (Allergan), a fixed-dose combination of the beta blocker nebivolol (Bystolic) and the angiotensin receptor blocker (ARB) valsartan (Diovan, and generics), for treatment of hypertension. It is the only combination product that contains nebivolol, and the first to combine a beta blocker with an ARB.

STANDARD TREATMENT — Most recent guidelines recommend a thiazide-type diuretic (chlorthalidone is preferred), a calcium channel blocker, an angiotensin-converting enzyme (ACE) inhibitor, or an ARB as initial therapy for hypertension in non-black patients. A thiazide-type diuretic or a calcium channel blocker is preferred for initial treatment of black patients, except those with chronic kidney disease or heart failure, who should receive an ACE inhibitor or an ARB. Beta blockers generally are no longer recommended as initial therapy, except in patients with a ... more      

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