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class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Pharmacology and biochemistry</span> </div> </a> <button aria-controls="toc-Pharmacology_and_biochemistry-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Pharmacology and biochemistry subsection</span> </button> <ul id="toc-Pharmacology_and_biochemistry-sublist" class="vector-toc-list"> <li id="toc-β1-selectivity" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#β1-selectivity"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>β1-selectivity</span> </div> </a> <ul id="toc-β1-selectivity-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Vasodilator_action" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Vasodilator_action"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> 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class="vector-toc-numb">3</span> <span>Contraindications</span> </div> </a> <ul id="toc-Contraindications-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Side_effects" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Side_effects"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Side effects</span> </div> </a> <ul id="toc-Side_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Controversies" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Controversies"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Controversies</span> </div> </a> <button aria-controls="toc-Controversies-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Controversies subsection</span> </button> <ul id="toc-Controversies-sublist" class="vector-toc-list"> <li id="toc-Pharmacology_of_side-effects" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pharmacology_of_side-effects"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>Pharmacology of side-effects</span> </div> </a> <ul id="toc-Pharmacology_of_side-effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-FDA_warning_letter_about_advertising_claims" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#FDA_warning_letter_about_advertising_claims"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.2</span> <span>FDA warning letter about advertising claims</span> </div> </a> <ul id="toc-FDA_warning_letter_about_advertising_claims-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Nebivolol</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox 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Available in 23 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-23" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">23 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%86%D9%8A%D8%A8%D9%8A%D9%81%D9%88%D9%84%D9%88%D9%84" title="نيبيفولول – Arabic" lang="ar" hreflang="ar" data-title="نيبيفولول" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Nebivolol" title="Nebivolol – Bosnian" lang="bs" hreflang="bs" data-title="Nebivolol" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Nebivolol" title="Nebivolol – German" lang="de" hreflang="de" data-title="Nebivolol" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%9D%CE%B5%CE%BC%CF%80%CE%B9%CE%B2%CE%BF%CE%BB%CF%8C%CE%BB%CE%B7" title="Νεμπιβολόλη – Greek" lang="el" hreflang="el" data-title="Νεμπιβολόλη" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Nebivolol" title="Nebivolol – Spanish" lang="es" hreflang="es" data-title="Nebivolol" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%86%D8%A8%DB%8C%D9%88%D9%88%D9%84%D9%88%D9%84" title="نبیوولول – Persian" lang="fa" hreflang="fa" data-title="نبیوولول" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/N%C3%A9bivolol" title="Nébivolol – French" lang="fr" hreflang="fr" data-title="Nébivolol" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Nebivololo" title="Nebivololo – Italian" lang="it" hreflang="it" data-title="Nebivololo" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Nebivolol" title="Nebivolol – Hungarian" lang="hu" hreflang="hu" data-title="Nebivolol" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%9D%D0%B5%D0%B1%D0%B8%D0%B2%D0%BE%D0%BB%D0%BE%D0%BB" title="Небиволол – Macedonian" lang="mk" hreflang="mk" data-title="Небиволол" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Nebivolol" title="Nebivolol – Dutch" lang="nl" hreflang="nl" data-title="Nebivolol" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%A8%E0%AD%87%E0%AC%AC%E0%AC%BF%E0%AC%AD%E0%AD%8B%E0%AC%B2%E0%AD%8B%E0%AC%B2" title="ନେବିଭୋଲୋଲ – Odia" lang="or" hreflang="or" data-title="ନେବିଭୋଲୋଲ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Nebiwolol" title="Nebiwolol – Polish" lang="pl" hreflang="pl" data-title="Nebiwolol" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Nebivolol" title="Nebivolol – Portuguese" lang="pt" hreflang="pt" data-title="Nebivolol" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Nebivolol" title="Nebivolol – Romanian" lang="ro" hreflang="ro" data-title="Nebivolol" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9D%D0%B5%D0%B1%D0%B8%D0%B2%D0%BE%D0%BB%D0%BE%D0%BB" title="Небиволол – Russian" lang="ru" hreflang="ru" data-title="Небиволол" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Nebivolol" title="Nebivolol – Slovenian" lang="sl" hreflang="sl" data-title="Nebivolol" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Nebivolol" title="Nebivolol – Serbian" lang="sr" hreflang="sr" data-title="Nebivolol" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Nebivolol" title="Nebivolol – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Nebivolol" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Nebivololi" title="Nebivololi – Finnish" lang="fi" hreflang="fi" data-title="Nebivololi" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Nebivolol" title="Nebivolol – Turkish" lang="tr" hreflang="tr" data-title="Nebivolol" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9D%D0%B5%D0%B1%D1%96%D0%B2%D0%BE%D0%BB%D0%BE%D0%BB" title="Небіволол – Ukrainian" lang="uk" hreflang="uk" data-title="Небіволол" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Nebivolol" title="Nebivolol – Vietnamese" lang="vi" hreflang="vi" data-title="Nebivolol" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q418130#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav aria-label="Namespaces"> <div id="p-associated-pages" class="vector-menu vector-menu-tabs mw-portlet mw-portlet-associated-pages" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="ca-nstab-main" class="selected vector-tab-noicon mw-list-item"><a href="/wiki/Nebivolol" 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class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Chemical compound</div> <p class="mw-empty-elt"> </p> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox" style="border-spacing:2px;"><caption class="infobox-title"><span title="International nonproprietary name (INN): Nebivolol">Nebivolol</span></caption><tbody><tr><td colspan="2" class="infobox-image notheme" style="background-color: #f8f9fa;"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Nebivolol.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2d/Nebivolol.svg/220px-Nebivolol.svg.png" decoding="async" width="220" height="67" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2d/Nebivolol.svg/330px-Nebivolol.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2d/Nebivolol.svg/440px-Nebivolol.svg.png 2x" data-file-width="2005" data-file-height="610" /></a></span></td></tr><tr><td colspan="2" class="infobox-image notheme" style="background-color: #f8f9fa;"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Nebivolol_ball-and-stick.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Nebivolol_ball-and-stick.png/220px-Nebivolol_ball-and-stick.png" decoding="async" width="220" height="156" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Nebivolol_ball-and-stick.png/330px-Nebivolol_ball-and-stick.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Nebivolol_ball-and-stick.png/440px-Nebivolol_ball-and-stick.png 2x" data-file-width="2000" data-file-height="1418" /></a></span></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Clinical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_nomenclature#Trade_names" title="Drug nomenclature">Trade names</a></th><td class="infobox-data">Nebilet, Bystolic, others</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">Other names</th><td class="infobox-data">Narbivolol, Nebivolol, Nebivololum<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/American_Society_of_Health-System_Pharmacists" title="American Society of Health-System Pharmacists">AHFS</a>/<a href="/wiki/Drugs.com" title="Drugs.com">Drugs.com</a></th><td class="infobox-data"><span title="www.drugs.com"><a rel="nofollow" class="external text" href="https://www.drugs.com/monograph/nebivolol-hydrochloride.html">Monograph</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span title="medlineplus.gov"><a rel="nofollow" class="external text" href="https://medlineplus.gov/druginfo/meds/a608029.html">a608029</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">License data</a></th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style><div class="plainlist"> <ul><li><small><abbr class="country-name" title="United States">US</abbr></small> <a href="/wiki/DailyMed" title="DailyMed">DailyMed</a>: <span title="dailymed.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Nebivolol">Nebivolol</a></span></li></ul></div> </td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Pregnancy_category" title="Pregnancy category">Pregnancy<br />category</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><small><abbr class="country-name" title="Australia">AU</abbr>:</small> C</li> <li class="mw-empty-elt"></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Route_of_administration" title="Route of administration">Routes of<br />administration</a></th><td class="infobox-data"><a href="/wiki/Oral_administration" title="Oral administration">By mouth</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Anatomical_Therapeutic_Chemical_Classification_System" title="Anatomical Therapeutic Chemical Classification System">ATC code</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><a href="/wiki/ATC_code_C07" title="ATC code C07">C07AB12</a> (<span title="www.whocc.no"><a rel="nofollow" class="external text" href="https://www.whocc.no/atc_ddd_index/?code=C07AB12">WHO</a></span>) </li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Legal status</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">Legal status</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><small><abbr class="country-name" title="United Kingdom">UK</abbr>:</small> <a href="/wiki/Prescription_drug" title="Prescription drug">POM</a> (Prescription only)</li> <li><small><abbr class="country-name" title="United States">US</abbr>:</small> <a href="/wiki/Prescription_drug" title="Prescription drug">℞-only</a></li></ul></div> </td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd"><a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">Pharmacokinetic</a> data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Plasma_protein_binding" title="Plasma protein binding">Protein binding</a></th><td class="infobox-data">98%</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_metabolism" title="Drug metabolism">Metabolism</a></th><td class="infobox-data"><a href="/wiki/Liver" title="Liver">Liver</a> (<a href="/wiki/CYP2D6" title="CYP2D6">CYP2D6</a>-mediated)</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Biological_half-life" title="Biological half-life">Elimination <span class="nowrap">half-life</span></a></th><td class="infobox-data">12-19 hours<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Excretion" title="Excretion">Excretion</a></th><td class="infobox-data"><a href="/wiki/Kidney" title="Kidney">Kidney</a> and fecal</td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Identifiers</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/CAS_Registry_Number" title="CAS Registry Number">CAS Number</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="commonchemistry.cas.org"><a rel="nofollow" class="external text" href="https://commonchemistry.cas.org/detail?cas_rn=118457-14-0">118457-14-0</a></span><sup> <span typeof="mw:File"><span><img alt="☒" src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/7px-X_mark.svg.png" decoding="async" width="7" height="8" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/11px-X_mark.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/14px-X_mark.svg.png 2x" data-file-width="525" data-file-height="600" /></span></span><span style="display:none">N</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/PubChem#CID" title="PubChem">PubChem</a> <span style="font-weight:normal"><abbr title="Compound ID">CID</abbr></span></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="pubchem.ncbi.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://pubchem.ncbi.nlm.nih.gov/compound/71301">71301</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Guide_to_Pharmacology" title="Guide to Pharmacology">IUPHAR/BPS</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.guidetopharmacology.org"><a rel="nofollow" class="external text" href="https://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=7246">7246</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/DrugBank" title="DrugBank">DrugBank</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.drugbank.ca"><a rel="nofollow" class="external text" href="https://www.drugbank.ca/drugs/DB04861">DB04861</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChemSpider" title="ChemSpider">ChemSpider</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.chemspider.com"><a rel="nofollow" class="external text" href="https://www.chemspider.com/Chemical-Structure.64421.html">64421</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Unique_Ingredient_Identifier" title="Unique Ingredient Identifier">UNII</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="precision.fda.gov"><a rel="nofollow" class="external text" href="https://precision.fda.gov/uniisearch/srs/unii/030Y90569U">030Y90569U</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/KEGG" title="KEGG">KEGG</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.kegg.jp"><a rel="nofollow" class="external text" href="https://www.kegg.jp/entry/D05127">D05127</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li><li>as HCl: <span title="www.kegg.jp"><a rel="nofollow" class="external text" href="https://www.kegg.jp/entry/D06622">D06622</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChEMBL" title="ChEMBL">ChEMBL</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.ebi.ac.uk"><a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/chembldb/index.php/compound/inspect/ChEMBL434394">ChEMBL434394</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/CompTox_Chemicals_Dashboard" title="CompTox Chemicals Dashboard">CompTox Dashboard</a> <span style="font-weight:normal">(<abbr title="U.S. Environmental Protection Agency">EPA</abbr>)</span></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="comptox.epa.gov"><a rel="nofollow" class="external text" href="https://comptox.epa.gov/dashboard/chemical/details/DTXSID9040556">DTXSID9040556</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q418130#P3117" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Chemical and physical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Chemical_formula" title="Chemical formula">Formula</a></th><td class="infobox-data"><span title="Carbon">C</span><sub>22</sub><span title="Hydrogen">H</span><sub>25</sub><span title="Fluorine">F</span><sub>2</sub><span title="Nitrogen">N</span><span title="Oxygen">O</span><sub>4</sub></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Molar_mass" title="Molar mass">Molar mass</a></th><td class="infobox-data"><span class="nowrap"><span data-sort-value="7002405442000000000♠"></span>405.442</span> g·mol<sup>−1</sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">3D model (<a href="/wiki/JSmol" class="mw-redirect" title="JSmol">JSmol</a>)</th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="chemapps.stolaf.edu (3D interactive model)"><a rel="nofollow" class="external text" href="https://chemapps.stolaf.edu/jmol/jmol.php?model=Fc4cc1c%28OC%28CC1%29C%28O%29CNCC%28O%29C3Oc2ccc%28F%29cc2CC3%29cc4">Interactive image</a></span></li></ul></div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/Simplified_molecular-input_line-entry_system" class="mw-redirect" title="Simplified molecular-input line-entry system">SMILES</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">Fc4cc1c(OC(CC1)C(O)CNCC(O)C3Oc2ccc(F)cc2CC3)cc4</div></li></ul> </div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/International_Chemical_Identifier" title="International Chemical Identifier">InChI</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">InChI=1S/C22H25F2NO4/c23-15-3-7-19-13(9-15)1-5-21(28-19)17(26)11-25-12-18(27)22-6-2-14-10-16(24)4-8-20(14)29-22/h3-4,7-10,17-18,21-22,25-27H,1-2,5-6,11-12H2<sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></div></li><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">Key:KOHIRBRYDXPAMZ-UHFFFAOYSA-N<sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></div></li></ul> </div></td></tr><tr><td colspan="2" class="infobox-below"><style data-mw-deduplicate="TemplateStyles:r886047488">.mw-parser-output .nobold{font-weight:normal}</style><span class="nobold"> <sup><span typeof="mw:File"><span><img alt="☒" src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/7px-X_mark.svg.png" decoding="async" width="7" height="8" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/11px-X_mark.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a2/X_mark.svg/14px-X_mark.svg.png 2x" data-file-width="525" data-file-height="600" /></span></span><span style="display:none">N</span><span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup> <a href="/wiki/Wikipedia:WikiProject_Chemicals/Chembox_validation" title="Wikipedia:WikiProject Chemicals/Chembox validation">(what is this?)</a></span><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r886047488"><span class="nobold">  <span class="reflink plainlinks nourlexpansion"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Special:ComparePages&rev1=462258880&page2=Nebivolol">(verify)</a></span></span></td></tr></tbody></table> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Ebivol.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/Ebivol.jpg/220px-Ebivol.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/Ebivol.jpg/330px-Ebivol.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a2/Ebivol.jpg/440px-Ebivol.jpg 2x" data-file-width="3968" data-file-height="2976" /></a><figcaption>Ebivol (Nebivolol) tablets</figcaption></figure> <p><b>Nebivolol</b> is a <a href="/wiki/Beta_blocker" title="Beta blocker">beta blocker</a> used to treat <a href="/wiki/Hypertension" title="Hypertension">high blood pressure</a> and <a href="/wiki/Heart_failure" title="Heart failure">heart failure</a>.<sup id="cite_ref-BNF76_5-0" class="reference"><a href="#cite_note-BNF76-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> As with other β-blockers, it is generally a less preferred treatment for high blood pressure.<sup id="cite_ref-AHFS2019_6-0" class="reference"><a href="#cite_note-AHFS2019-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> It may be used by itself or with other <a href="/wiki/Blood_pressure" title="Blood pressure">blood pressure</a> medication.<sup id="cite_ref-AHFS2019_6-1" class="reference"><a href="#cite_note-AHFS2019-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> It is taken by mouth.<sup id="cite_ref-AHFS2019_6-2" class="reference"><a href="#cite_note-AHFS2019-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p><p>Common side effects include dizziness, feeling tired, nausea, and headaches.<sup id="cite_ref-AHFS2019_6-3" class="reference"><a href="#cite_note-AHFS2019-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Serious side effects may include heart failure and <a href="/wiki/Bronchospasm" title="Bronchospasm">bronchospasm</a>.<sup id="cite_ref-AHFS2019_6-4" class="reference"><a href="#cite_note-AHFS2019-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Its use in <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a> and <a href="/wiki/Breastfeeding" title="Breastfeeding">breastfeeding</a> is not recommended.<sup id="cite_ref-BNF76_5-1" class="reference"><a href="#cite_note-BNF76-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Preg2019_7-0" class="reference"><a href="#cite_note-Preg2019-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> It works by blocking <a href="/wiki/%CE%921-adrenergic_receptors" class="mw-redirect" title="Β1-adrenergic receptors">β1-adrenergic receptors</a> in the <a href="/wiki/Heart" title="Heart">heart</a> and dilating blood vessels.<sup id="cite_ref-AHFS2019_6-5" class="reference"><a href="#cite_note-AHFS2019-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-De2007_8-0" class="reference"><a href="#cite_note-De2007-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>Nebivolol was patented in 1983 and came into medical use in 1997.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> It is available as a <a href="/wiki/Generic_drug" title="Generic drug">generic medication</a> in the United Kingdom.<sup id="cite_ref-BNF76_5-2" class="reference"><a href="#cite_note-BNF76-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> In 2022, it was the 173rd most commonly prescribed medication in the United States, with more than 3<span class="nowrap"> </span>million prescriptions.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Medical_uses">Medical uses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=1" title="Edit section: Medical uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>It is used to treat <a href="/wiki/Hypertension" title="Hypertension">high blood pressure</a> and <a href="/wiki/Heart_failure" title="Heart failure">heart failure</a>.<sup id="cite_ref-BNF76_5-3" class="reference"><a href="#cite_note-BNF76-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Nebivolol is used in the treatment of angina, to decrease the heart rate and contractile force. This is relevant in patients who need to decrease the oxygen demand of the heart so that the blood supplied from stenosed or constricted arteries is adequate. </p><p><a href="/wiki/ACE_inhibitors" class="mw-redirect" title="ACE inhibitors">ACE inhibitors</a>, <a href="/wiki/Angiotensin_II_receptor_antagonists" class="mw-redirect" title="Angiotensin II receptor antagonists">angiotensin II receptor antagonists</a>, <a href="/wiki/Calcium-channel_blockers" class="mw-redirect" title="Calcium-channel blockers">calcium-channel blockers</a>, and <a href="/wiki/Thiazide_diuretics" class="mw-redirect" title="Thiazide diuretics">thiazide diuretics</a> are generally preferred over beta blockers for the treatment of primary hypertension in the absence of co-morbidities.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Pharmacology_and_biochemistry">Pharmacology and biochemistry</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=2" title="Edit section: Pharmacology and biochemistry"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="β1-selectivity"><span id=".CE.B21-selectivity"></span>β1-selectivity</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=3" title="Edit section: β1-selectivity"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Beta_blocker" title="Beta blocker">Beta blockers</a> help patients with cardiovascular disease by blocking β1 receptors, while many of the side-effects of these medications are caused by their blockade of β2 receptors.<sup id="cite_ref-pmid10453968_16-0" class="reference"><a href="#cite_note-pmid10453968-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> For this reason, beta blockers that selectively block β1 <a href="/wiki/Adrenergic_receptor" title="Adrenergic receptor">adrenergic receptors</a> (termed cardioselective or β1-selective beta blockers) produce fewer adverse effects (for instance, bronchoconstriction) than those drugs that non-selectively block both β1 and β2 receptors. </p><p>In a laboratory experiment conducted on biopsied heart tissue, nebivolol proved to be the most β1-selective of the <a href="/wiki/Beta_blockers" class="mw-redirect" title="Beta blockers">β-blockers</a> tested, being approximately 3.5 times more β1-selective than <a href="/wiki/Bisoprolol" title="Bisoprolol">bisoprolol</a>.<sup id="cite_ref-pmid12535855_17-0" class="reference"><a href="#cite_note-pmid12535855-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> However, the drug's receptor selectivity in humans is more complex and depends on the drug dose and the genetic profile of the patient taking the medication.<sup id="cite_ref-PI_18-0" class="reference"><a href="#cite_note-PI-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> The drug is highly cardioselective at 5 mg.<sup id="cite_ref-pmid12795776_19-0" class="reference"><a href="#cite_note-pmid12795776-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> In addition, at doses above 10 mg, nebivolol loses its cardioselectivity and blocks both β1 and β2 receptors,<sup id="cite_ref-PI_18-1" class="reference"><a href="#cite_note-PI-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> while the recommended starting dose of nebivolol is 5 mg, sufficient control of blood pressure may require doses up to 40 mg.<sup id="cite_ref-PI_18-2" class="reference"><a href="#cite_note-PI-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Furthermore, nebivolol is also not cardioselective when taken by patients with a genetic makeup that makes them "poor metabolizers" of nebivolol (and other drugs) or with CYP2D6 inhibitors.<sup id="cite_ref-PI_18-3" class="reference"><a href="#cite_note-PI-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> As many as 1 in 10 Caucasian people and even more black people are <a href="/wiki/CYP2D6#Ethnic_factors_in_variability" title="CYP2D6">poor CYP2D6 metabolizers</a> and therefore might benefit less from nebivolol's cardioselectivity although currently there are no directly comparable studies.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (October 2009)">citation needed</span></a></i>]</sup> </p><p>Nebivolol<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> while selectively blocking beta(1) receptor acts as a <a href="/wiki/Beta-3_adrenergic_receptor" title="Beta-3 adrenergic receptor">beta(3)-agonist</a>. β<sub>3</sub> receptors are found in the <a href="/wiki/Gallbladder" title="Gallbladder">gallbladder</a>, <a href="/wiki/Urinary_bladder" class="mw-redirect" title="Urinary bladder">urinary bladder</a>, and in <a href="/wiki/Brown_adipose_tissue" title="Brown adipose tissue">brown adipose tissue</a>. Their role in gallbladder physiology is unknown, but they are thought to play a role in lipolysis and thermogenesis in brown fat. In the urinary bladder it is thought to cause relaxation of the bladder and prevention of urination.<sup id="cite_ref-pmid16457637_21-0" class="reference"><a href="#cite_note-pmid16457637-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid15935402_22-0" class="reference"><a href="#cite_note-pmid15935402-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Rang163_23-0" class="reference"><a href="#cite_note-Rang163-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p><p>Due to enzymatic inhibition, <a href="/wiki/Fluvoxamine" title="Fluvoxamine">fluvoxamine</a> increases the exposure to nebivolol and its active hydroxylated metabolite (4-OH-nebivolol) in healthy volunteers.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Vasodilator_action">Vasodilator action</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=4" title="Edit section: Vasodilator action"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Nebivolol is unique as a beta-blocker.<sup id="cite_ref-pmid17521213_25-0" class="reference"><a href="#cite_note-pmid17521213-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Unlike <a href="/wiki/Carvedilol" title="Carvedilol">carvedilol</a>, it has a <a href="/wiki/Nitric_oxide" title="Nitric oxide">nitric oxide</a> (NO)-potentiating, vasodilatory effect via stimulation of β3 receptors.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid17326335_27-0" class="reference"><a href="#cite_note-pmid17326335-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid19454898_28-0" class="reference"><a href="#cite_note-pmid19454898-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p><p>Nebivolol induces vasodilation by stimulating the production of nitric oxide, a natural blood vessel relaxant. This effect is achieved by activating the endothelial isoform of <a href="/wiki/Nitric_oxide_synthase" title="Nitric oxide synthase">NO synthase</a> (eNOS) in the cells lining the blood vessels. Unlike traditional β-blockers, nebivolol's unique mechanism of action improves arterial flexibility and reduces <a href="/wiki/Peripheral_resistance" class="mw-redirect" title="Peripheral resistance">peripheral resistance</a>, making it beneficial for hypertensive patients with <a href="/wiki/Endothelial_dysfunction" title="Endothelial dysfunction">endothelial dysfunction</a>. The drug's ability to increase NO production persists even after <a href="/wiki/Metabolism" title="Metabolism">metabolism</a>, offering long-lasting benefits. Nebivolol's distinct approach to promoting NO release has shown promising results in improving endothelial function and managing hypertension in clinical trials.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p><p>Along with <a href="/wiki/Labetalol" title="Labetalol">labetalol</a>, <a href="/wiki/Celiprolol" title="Celiprolol">celiprolol</a> and <a href="/wiki/Carvedilol" title="Carvedilol">carvedilol</a>, it is one of four beta blockers to cause dilation of blood vessels in addition to effects on the heart.<sup id="cite_ref-pmid19454898_28-1" class="reference"><a href="#cite_note-pmid19454898-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Antihypertensive_effect">Antihypertensive effect</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=5" title="Edit section: Antihypertensive effect"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Nebivolol lowers blood pressure (BP) by reducing <a href="/wiki/Peripheral_vascular_resistance" class="mw-redirect" title="Peripheral vascular resistance">peripheral vascular resistance</a>, and significantly increases <a href="/wiki/Stroke_volume" title="Stroke volume">stroke volume</a> with preservation of cardiac output.<sup id="cite_ref-pmid12888152_30-0" class="reference"><a href="#cite_note-pmid12888152-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> The net hemodynamic effect of nebivolol is the result of a balance between the depressant effects of beta-blockade and an action that maintains cardiac output.<sup id="cite_ref-pmid16961165_31-0" class="reference"><a href="#cite_note-pmid16961165-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> Antihypertensive responses were significantly higher with nebivolol than with placebo in trials enrolling patient groups considered representative of the U.S. hypertensive population, in black people, and in those receiving concurrent treatment with other antihypertensive drugs.<sup id="cite_ref-Baldwin_2009_32-0" class="reference"><a href="#cite_note-Baldwin_2009-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Pharmacokinetics">Pharmacokinetics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=6" title="Edit section: Pharmacokinetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Nebivolol plasma protein binding is approximately 98%, mostly to <a href="/wiki/Albumin" title="Albumin">albumin</a> and its half-life of low doses is 12 hours in extensive <a href="/wiki/CYP2D6" title="CYP2D6">CYP2D6</a> metabolizers and 19 hours in poor metabolizers.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Contraindications">Contraindications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=7" title="Edit section: Contraindications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>Severe bradycardia</li> <li>Heart block greater than first degree</li> <li>Patients with cardiogenic shock</li> <li>Decompensated cardiac failure</li> <li>Sick sinus syndrome (unless a permanent pacemaker is in place)</li> <li>Patients with severe hepatic impairment (Child-Pugh class B)</li> <li>Patients who are hypersensitive to any component of this product.</li></ul> <div class="mw-heading mw-heading2"><h2 id="Side_effects">Side effects</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=8" title="Edit section: Side effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Side effects might include headache, tiredness, dizziness, lightheadedness, <a href="/wiki/Raynaud_syndrome" title="Raynaud syndrome">reduced blood flow to extremities</a>, bradycardia.<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Controversies">Controversies</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=9" title="Edit section: Controversies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Pharmacology_of_side-effects">Pharmacology of side-effects</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=10" title="Edit section: Pharmacology of side-effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div><p> Several studies have suggested that nebivolol has reduced typical beta-blocker-related side effects, such as <a href="/wiki/Fatigue_(medical)" class="mw-redirect" title="Fatigue (medical)">fatigue</a>, <a href="/wiki/Clinical_depression" class="mw-redirect" title="Clinical depression">clinical depression</a>, <a href="/wiki/Bradycardia" title="Bradycardia">bradycardia</a>, or <a href="/wiki/Impotence" class="mw-redirect" title="Impotence">impotence</a>.<sup id="cite_ref-pmid11811391_35-0" class="reference"><a href="#cite_note-pmid11811391-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid16373195_36-0" class="reference"><a href="#cite_note-pmid16373195-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid11518851_37-0" class="reference"><a href="#cite_note-pmid11518851-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> However, according to the <a href="/wiki/Food_and_Drug_Administration_(United_States)" class="mw-redirect" title="Food and Drug Administration (United States)">FDA</a><sup id="cite_ref-Thomas_Abrams_2008_38-0" class="reference"><a href="#cite_note-Thomas_Abrams_2008-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup></p><blockquote><p>Bystolic is associated with a number of serious risks. Bystolic is contraindicated in patients with severe bradycardia, heart block greater than first degree, cardiogenic shock, decompensated cardiac failure, sick sinus syndrome (unless a permanent pacemaker is in place), severe hepatic impairment (Child-Pugh > B) and in patients who are hypersensitive to any component of the product. Bystolic therapy is also associated with warnings regarding abrupt cessation of therapy, cardiac failure, angina and acute myocardial infarction, bronchospastic diseases, anesthesia and major surgery, diabetes and hypoglycemia, thyrotoxicosis, peripheral vascular disease, non-dihydropyridine calcium channel blockers use, as well as precautions regarding use with CYP2D6 inhibitors, impaired renal and hepatic function, and anaphylactic reactions. Finally, Bystolic is associated with other risks as described in the Adverse Reactions section of its PI. For example, a number of treatment-emergent adverse events with an incidence greater than or equal to 1 percent in Bystolic-treated patients and at a higher frequency than placebo-treated patients were identified in clinical studies, including headache, fatigue, and dizziness.</p></blockquote> <div class="mw-heading mw-heading3"><h3 id="FDA_warning_letter_about_advertising_claims">FDA warning letter about advertising claims</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=11" title="Edit section: FDA warning letter about advertising claims"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In August 2008, the FDA issued a <a href="/wiki/FDA_Warning_Letter" class="mw-redirect" title="FDA Warning Letter">Warning Letter</a> to Forest Laboratories citing exaggerated and misleading claims in their launch journal ad, in particular over claims of superiority and novelty of action.<sup id="cite_ref-Thomas_Abrams_2008_38-1" class="reference"><a href="#cite_note-Thomas_Abrams_2008-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=12" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Unreferenced_section plainlinks metadata ambox ambox-content ambox-Unreferenced" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><a href="/wiki/File:Question_book-new.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/50px-Question_book-new.svg.png" decoding="async" width="50" height="39" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/75px-Question_book-new.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/100px-Question_book-new.svg.png 2x" data-file-width="512" data-file-height="399" /></a></span></div></td><td class="mbox-text"><div class="mbox-text-span">This section <b>does not <a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources">cite</a> any <a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">sources</a></b>.<span class="hide-when-compact"> Please help <a href="/wiki/Special:EditPage/Nebivolol" title="Special:EditPage/Nebivolol">improve this section</a> by <a href="/wiki/Help:Referencing_for_beginners" title="Help:Referencing for beginners">adding citations to reliable sources</a>. Unsourced material may be challenged and <a href="/wiki/Wikipedia:Verifiability#Burden_of_evidence" title="Wikipedia:Verifiability">removed</a>.</span> <span class="date-container"><i>(<span class="date">June 2022</span>)</i></span><span class="hide-when-compact"><i> (<small><a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a></small>)</i></span></div></td></tr></tbody></table> <p>Mylan Laboratories licensed the US and Canadian rights to nebivolol from <a href="/wiki/Janssen_Pharmaceutica" class="mw-redirect" title="Janssen Pharmaceutica">Janssen Pharmaceutica</a> N.V. in 2001. Nebivolol is already registered and successfully marketed in more than 50 countries, including the United States where it is marketed under the brand name Bystolic from <a href="/wiki/Mylan_Laboratories" class="mw-redirect" title="Mylan Laboratories">Mylan Laboratories</a> and <a href="/wiki/Forest_Laboratories" title="Forest Laboratories">Forest Laboratories</a>. Nebivolol is manufactured by Forest Laboratories. </p><p>In India, nebivolol is available as Nebula (Zydus Healthcare Ltd), Nebizok (Eris life-sciences), Nebicip (Cipla ltd), Nebilong (Micro Labs), Nebistar (Lupin ltd), Nebicard (Torrent), Nubeta (<a href="/wiki/Abbot_Laboratories" class="mw-redirect" title="Abbot Laboratories">Abbott</a> Healthcare Pvt Ltd – India), and Nodon (Cadila Pharmaceuticals). </p><p>In Greece and Italy, nebivolol is marketed by <a href="/wiki/Menarini" title="Menarini">Menarini</a> as Lobivon. </p><p>In Germany it is marketed as Nebilet by <a href="/wiki/Berlin_Chemie" title="Berlin Chemie">Berlin Chemie</a>. </p><p>In the Middle East, Russia and Australia, it is marketed under the name Nebilet and in Pakistan it is marketed by The Searle Company Limited as Byscard. </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nebivolol&action=edit&section=13" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://go.drugbank.com/drugs/DB04861">"Nebivolol"</a>. <i>go.drugbank.com</i><span class="reference-accessdate">. Retrieved <span class="nowrap">17 August</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=go.drugbank.com&rft.atitle=Nebivolol&rft_id=https%3A%2F%2Fgo.drugbank.com%2Fdrugs%2FDB04861&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANebivolol" class="Z3988"></span></span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021742s022lbl.pdf">"Drugs@FDA: FDA-Approved Drugs Nebivolol - ALLERGAN"</a> <span class="cs1-format">(PDF)</span>. <i>accessdata.fda.gov</i><span class="reference-accessdate">. Retrieved <span class="nowrap">17 August</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=accessdata.fda.gov&rft.atitle=Drugs%40FDA%3A+FDA-Approved+Drugs+Nebivolol+-+ALLERGAN&rft_id=https%3A%2F%2Fwww.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2017%2F021742s022lbl.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANebivolol" class="Z3988"></span></span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGilesCockcroftPittJakate2017" class="citation journal cs1">Giles TD, Cockcroft JR, Pitt B, Jakate A, Wright HM (September 2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548499">"Rationale for nebivolol/valsartan combination for hypertension: review of preclinical and clinical data"</a>. <i>Journal of Hypertension</i>. <b>35</b> (9): 1758–1767. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2FHJH.0000000000001412">10.1097/HJH.0000000000001412</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548499">5548499</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28509722">28509722</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Hypertension&rft.atitle=Rationale+for+nebivolol%2Fvalsartan+combination+for+hypertension%3A+review+of+preclinical+and+clinical+data&rft.volume=35&rft.issue=9&rft.pages=1758-1767&rft.date=2017-09&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5548499%23id-name%3DPMC&rft_id=info%3Apmid%2F28509722&rft_id=info%3Adoi%2F10.1097%2FHJH.0000000000001412&rft.aulast=Giles&rft.aufirst=TD&rft.au=Cockcroft%2C+JR&rft.au=Pitt%2C+B&rft.au=Jakate%2C+A&rft.au=Wright%2C+HM&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5548499&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANebivolol" class="Z3988"></span></span> </li> <li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://go.drugbank.com/drugs/DB04861#half-life">"DrugBank Nebivolol"</a>. <i>go.drugbank.com</i><span class="reference-accessdate">. Retrieved <span class="nowrap">17 August</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=go.drugbank.com&rft.atitle=DrugBank+Nebivolol&rft_id=https%3A%2F%2Fgo.drugbank.com%2Fdrugs%2FDB04861%23half-life&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANebivolol" class="Z3988"></span></span> </li> <li id="cite_note-BNF76-5"><span class="mw-cite-backlink">^ <a href="#cite_ref-BNF76_5-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-BNF76_5-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-BNF76_5-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-BNF76_5-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1"><i>British national formulary : BNF 76</i> (76 ed.). 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"Effects of nebivolol and atenolol on insulin sensitivity and haemodynamics in hypertensive patients". <i>Journal of Hypertension</i>. <b>19</b> (8): 1429–1435. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00004872-200108000-00011">10.1097/00004872-200108000-00011</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11518851">11518851</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:35105142">35105142</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Hypertension&rft.atitle=Effects+of+nebivolol+and+atenolol+on+insulin+sensitivity+and+haemodynamics+in+hypertensive+patients&rft.volume=19&rft.issue=8&rft.pages=1429-1435&rft.date=2001-08&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A35105142%23id-name%3DS2CID&rft_id=info%3Apmid%2F11518851&rft_id=info%3Adoi%2F10.1097%2F00004872-200108000-00011&rft.aulast=Poirier&rft.aufirst=L&rft.au=Cl%C3%A9roux%2C+J&rft.au=Nadeau%2C+A&rft.au=Lacourci%C3%A8re%2C+Y&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANebivolol" class="Z3988"></span></span> </li> <li id="cite_note-Thomas_Abrams_2008-38"><span class="mw-cite-backlink">^ <a href="#cite_ref-Thomas_Abrams_2008_38-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Thomas_Abrams_2008_38-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFThomas_Abrams2008" class="citation web cs1">Thomas Abrams (28 August 2008). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20170428041103/https://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/enforcementactivitiesbyfda/warninglettersandnoticeofviolationletterstopharmaceuticalcompanies/ucm054010.pdf">"Warning Letter"</a> <span class="cs1-format">(PDF)</span>. Food and Drug Administration. Archived from <a rel="nofollow" class="external text" href="https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/WarningLettersandNoticeofViolationLetterstoPharmaceuticalCompanies/ucm054010.pdf">the original</a> <span class="cs1-format">(PDF)</span> on 28 April 2017<span class="reference-accessdate">. Retrieved <span class="nowrap">16 December</span> 2019</span>. <q>FDA is not aware of any substantial evidence or substantial clinical experience that demonstrates that Bystolic represents a 'novel' or 'next generation' beta blocker for the treatment of hypertension. Indeed, we are not aware of any well-designed trials comparing Bystolic to other β-blockers. Furthermore, FDA is not aware of any data that would render Bystolic's mechanism of action 'unique.'<span class="cs1-kern-right"></span></q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Warning+Letter&rft.pub=Food+and+Drug+Administration&rft.date=2008-08-28&rft.au=Thomas+Abrams&rft_id=https%3A%2F%2Fwww.fda.gov%2Fdownloads%2FDrugs%2FGuidanceComplianceRegulatoryInformation%2FEnforcementActivitiesbyFDA%2FWarningLettersandNoticeofViolationLetterstoPharmaceuticalCompanies%2Fucm054010.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANebivolol" class="Z3988"></span></span> </li> </ol></div></div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output 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navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Beta_blockers" title="Template:Beta blockers"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Beta_blockers" class="mw-redirect" title="Template talk:Beta blockers"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Beta_blockers" title="Special:EditPage/Template:Beta blockers"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Beta_blockers_(C07)" style="font-size:114%;margin:0 4em"><a href="/wiki/Beta_blocker" title="Beta blocker">Beta blockers</a> (<a href="/wiki/ATC_code_C07" title="ATC code C07">C07</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Beta_adrenergic_receptor" class="mw-redirect" title="Beta adrenergic receptor">β</a>, non-selective</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alprenolol" title="Alprenolol">Alprenolol</a></li> <li><a href="/wiki/Bopindolol" title="Bopindolol">Bopindolol</a></li> <li><a href="/wiki/Bupranolol" title="Bupranolol">Bupranolol</a></li> <li><a href="/wiki/Carteolol" title="Carteolol">Carteolol</a></li> <li><a href="/wiki/Cloranolol" title="Cloranolol">Cloranolol</a></li> <li><a href="/wiki/Mepindolol" title="Mepindolol">Mepindolol</a></li> <li><a href="/wiki/Nadolol" title="Nadolol">Nadolol</a></li> <li><a href="/wiki/Oxprenolol" title="Oxprenolol">Oxprenolol</a></li> <li><a href="/wiki/Penbutolol" title="Penbutolol">Penbutolol</a></li> <li><a href="/wiki/Pindolol" title="Pindolol">Pindolol</a>/<a href="/wiki/Iodopindolol" title="Iodopindolol">Iodopindolol</a></li> <li><a href="/wiki/Propranolol" title="Propranolol">Propranolol</a><sup>#</sup></li> <li><a href="/wiki/Sotalol" title="Sotalol">Sotalol</a></li> <li><a href="/wiki/Tertatolol" title="Tertatolol">Tertatolol</a></li> <li><a href="/wiki/Timolol" title="Timolol">Timolol</a><sup>#</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Beta-1_adrenergic_receptor" title="Beta-1 adrenergic receptor">β<sub>1</sub></a>-selective</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acebutolol" title="Acebutolol">Acebutolol</a></li> <li><a href="/wiki/Atenolol" title="Atenolol">Atenolol</a></li> <li><a href="/wiki/Betaxolol" title="Betaxolol">Betaxolol</a></li> <li><a href="/wiki/Bevantolol" title="Bevantolol">Bevantolol</a></li> <li><a href="/wiki/Bisoprolol" title="Bisoprolol">Bisoprolol</a><sup>#</sup></li> <li><a href="/wiki/Celiprolol" title="Celiprolol">Celiprolol</a></li> <li><a href="/wiki/Epanolol" title="Epanolol">Epanolol</a></li> <li><a href="/wiki/Esmolol" title="Esmolol">Esmolol</a></li> <li><a href="/wiki/Landiolol" title="Landiolol">Landiolol</a></li> <li><a href="/wiki/Metoprolol" title="Metoprolol">Metoprolol</a></li> <li><a class="mw-selflink selflink">Nebivolol</a></li> <li><a href="/wiki/Practolol" title="Practolol">Practolol</a></li> <li><a href="/wiki/Talinolol" title="Talinolol">Talinolol</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Beta-2_adrenergic_receptor" title="Beta-2 adrenergic receptor">β<sub>2</sub></a>-selective</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Butaxamine" title="Butaxamine">Butaxamine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Alpha-1_adrenergic_receptor" title="Alpha-1 adrenergic receptor">α<sub>1</sub></a>- + β-selective</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Arotinolol" title="Arotinolol">Arotinolol</a></li> <li><a href="/wiki/Carvedilol" title="Carvedilol">Carvedilol</a></li> <li><a href="/wiki/Labetalol" title="Labetalol">Labetalol</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table></div> <style 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