Bystolic (Nebivolol)

Name: Bystolic
Brand: Abbvie
SKU: 6549
Availability: InStock

Type

Product

Manufacturer

Country

Dosage

Qty-Price (USD)

Type:

Product: Bystolic Tablet

Manufacturer: Abbvie

Country: Canada

Dosage: 2.5 mg

Qty-Price (USD):

Type:

Product: Bystolic Tablet

Manufacturer: Abbvie

Country: Canada

Dosage: 5 mg

Qty-Price (USD):

Type:

Product: Bystolic Tablet (Known as Vasoxen)

Manufacturer: Ulagaylar Pharma

Country: Turkey

Dosage: 5 mg

Qty-Price (USD):

Type:

Product: Bystolic Tablet

Manufacturer: Abbvie

Country: Canada

Dosage: 10 mg

Qty-Price (USD):

Generic Equivalent of Bystolic

Type

Product

Manufacturer

Country

Dosage

Qty-Price (USD)

Type:

Product: Nebivolol Tablet

Manufacturer: Generic

Country: India

Dosage: 2.5 mg

Qty-Price (USD):

Type:

Product: Nebivolol Tablet

Manufacturer: Generic

Country: Canada

Dosage: 5 mg

Qty-Price (USD):

Type:

Product: Nebivolol Tablet

Manufacturer: Generic

Country: India

Dosage: 5 mg

Qty-Price (USD):

Type:

Product: Nebivolol Tablet

Manufacturer: Generic

Country: United Kingdom

Dosage: 5 mg

Qty-Price (USD):

Type:

Product: Nebivolol Tablet

Manufacturer: Generic

Country: India

Dosage: 10 mg

Qty-Price (USD):

Type:

Product: Nebivolol Tablet (Nebisava) (ON BACKORDER)

Manufacturer: Generic

Country: India

Dosage: 10 mg

Qty-Price (USD):

Bystolic Information

medically reviewed by Carol Hou (BSc. Pharm) on June 19, 2025.

A licensed pharmacist (Licensed Community Pharmacies Directory | College of Pharmacists of British Columbia) with over 20 years of experience in medication management, specifically medication safety, she has reviewed the information for accuracy and completeness.

Bystolic and Nebivolol at CanadaPharmacyOnline.com

The brand name Bystolic (nebivolol) is available in Canada, manufactured by AbbVie. CanadaPharmacyOnline.com also carries Vasoxen, which contains nebivolol and is manufactured by a company in Turkey. This is a different brand name for nebivolol and may have different packaging and inactive ingredients than Bystolic or generic nebivolol available in Canada.

Generic nebivolol is sourced from manufacturers that meet applicable regulatory standards. The specific manufacturer of your dispensed medication may vary.

Important Information about Generic Nebivolol:

Generic nebivolol contains the same active ingredient as brand-name Bystolic and is required to meet the same safety, effectiveness, and quality standards. This means it is designed to work in the same way as Bystolic. Studies have shown that generic nebivolol is bioequivalent to brand-name Bystolic, meaning they have similar absorption rates and reach similar concentrations in the bloodstream. However, individual responses to medication can vary due to factors such as metabolism, genetics, and other health conditions.

For more information about generic drug approval and bioequivalence, you can visit the FDA website: https://www.fda.gov/drugs/generic-drugs/generic-drug-facts

Dosage:

Brand Bystolic and generic nebivolol are commonly available in 2.5 mg, 5 mg, 10 mg, and 20 mg oral tablets.

Your doctor will determine the appropriate dose based on your individual needs and medical conditions.

Usage:

Bystolic (nebivolol) is a prescription medication for the treatment of hypertension (high blood pressure). It can be used alone or with other antihypertensive agents to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.

Mechanism of Action:
Bystolic (nebivolol) effectively lowers blood pressure through a dual mechanism. Primarily, it acts as a highly selective beta-1 adrenergic receptor blocker, reducing heart rate and contractility, which leads to a decrease in cardiac output. This beta-1 selectivity, while significant, is dose-dependent and may diminish at higher doses. Distinctively, nebivolol also possesses vasodilatory properties mediated by its beta-3 adrenergic receptor agonism in the vascular endothelium. This stimulation activates endothelial nitric oxide synthase (eNOS), enhancing the conversion of L-arginine to nitric oxide (NO). The increased NO activates soluble guanylate cyclase, elevating cyclic guanosine monophosphate (cGMP) levels in vascular smooth muscle cells, resulting in relaxation and reduced peripheral vascular resistance. This NO-mediated vasodilation gives nebivolol a distinct advantage over many other beta-blockers in managing hypertension.

Take Bystolic exactly as your doctor prescribes, following the instructions in the product monograph in Canada. Consult your doctor for personalized guidance and safe use.

The information below summarizes some, but not all, potential side effects, risks, and interactions. Before taking Bystolic, it is essential to discuss all possible side effects, risks, and interactions with your doctor or pharmacist.

Side Effects:

The information below outlines potential side effects associated with Bystolic (nebivolol). It is not an exhaustive list, and individual reactions can vary.

Common side effects - These are some common side effects of Bystolic, but others are possible. Contact your doctor promptly if any side effects are persistent, worsening, or concerning, or if you experience any other concerning symptoms.
• Diarrhea
• Dizziness
• Fatigue (tiredness)
• Headache
• Nausea

Other less common side effects include:
• Cough
• Dry mouth
• Joint or back pain
• Nasal congestion and sore throat
• Rash
• Shortness of breath (dyspnea)
• Trouble sleeping (insomnia)

Serious Side Effects: These are rare but potentially severe side effects. Seek immediate medical attention or call emergency services if you experience any of the following:
• Allergic reactions: Rash, itching, swelling of the face, lips, or tongue, or difficulty breathing.
• Breathing problems: Wheezing, tightness in the chest, or difficulty breathing.
• Chest pain: New or worsening chest pain.
• Low blood pressure (hypotension): Dizziness, lightheadedness, or fainting, especially when changing positions.
• Memory problems or confusion.
• Peripheral vascular disease: Worsening of blood flow problems in the arms and legs, such as numbness, coldness, or pain.
• Slow heartbeat (bradycardia): Feeling dizzy, lightheaded, or fainting.
• Unusual weight gain
• Vision problems
• Worsening heart failure: Increased tiredness, shortness of breath, or swelling in the ankles or legs.

Contraindications:

The following is not an exhaustive list of contraindications. Before starting Bystolic, it is crucial to discuss all your medical conditions, past and present, and all medications you are taking with your doctor or pharmacist.

Bystolic should not be used if you:
• Are allergic to nebivolol or any of the inactive ingredients in Bystolic.
• Have cardiogenic shock(a condition where your heart cannot pump enough blood to the rest of your body).
• Have decompensated heart failure (heart failure that is getting worse).
• Have second-degree or third-degree atrioventricular (AV) block. First-degree AV block generally requires careful clinical judgment and monitoring. The use of Bystolic in patients with first-degree AV block should be approached with caution and under close medical supervision due to the potential for further prolongation of AV conduction.
• Have severe hepatic impairment (Child-Pugh >B)
• Have severe bradycardia (a heart rate that is too slow).
• Have sick sinus syndrome (unless a permanent pacemaker is in place)

Tell your doctor about all your medical conditions, past and present, before starting Bystolic. This is crucial because certain conditions can affect whether Bystolic is right for you. These conditions may include, but are not limited to:
• Bradycardia (slow heart rate): Bystolic can further slow your heart rate.
• Bronchospastic diseases (e.g., asthma, COPD): Bystolic can cause breathing difficulties.
• Diabetes: Beta-blockers can mask some symptoms of hypoglycemia, such as tachycardia (fast heartbeat), but not others like sweating. While beta-1 selective, nebivolol can still mask tachycardia, an adrenergic symptom of hypoglycemia, especially at higher doses. Patients with diabetes should be vigilant in monitoring their blood glucose levels as non-adrenergic symptoms like sweating and hunger are not masked.
• Heart block: Even first-degree heart block requires monitoring.
• Heart failure: While sometimes used in stable heart failure, it can worsen decompensated heart failure.
• Moderate hepatic impairment (Child-Pugh B): Lower initial doses and slow titration may be necessary.
• Myasthenia gravis: A chronic autoimmune neuromuscular disease.
• Peripheral vascular disease: Bystolic can worsen symptoms of reduced blood flow to the limbs.
• Pheochromocytoma: A rare adrenal gland tumor; Bystolic may worsen symptoms unless an alpha-blocker is used first.
• Psoriasis: Bystolic may worsen psoriasis.
• Recent heart attack or unstable angina: Use with caution and close monitoring due to limited data.
• Severe allergies: Beta-blockers, including nebivolol, can potentially reduce the effectiveness of epinephrine in treating anaphylaxis by blocking beta-adrenergic receptors. Individuals with severe allergies should always carry an epinephrine auto-injector and inform healthcare providers about their nebivolol use.
• Thyroid problems: Bystolic blood pressure can mask signs of hyperthyroidism (an overactive thyroid), such as a fast heart rate, and abrupt withdrawal can worsen this condition.

Drug Interactions:

Before taking Bystolic, it is essential to discuss all potential risks and interactions with your doctor or pharmacist. For complete and up-to-date information, refer to the Bystolic prescribing information.

Provide your doctor with a complete list of all your medications, including prescriptions, over-the-counter (OTC) drugs, vitamins, and herbal supplements. It is also important to inform your doctor about any herbal teas, recreational drugs, or significant dietary changes you are making, as these could potentially interact with Bystolic. Bystolic may interact with other medicines but is not limited to:
• Calcium Channel Blockers (Verapamil and Diltiazem types): Combining Bystolic with certain calcium channel blockers (like verapamil and diltiazem) can exacerbate their effects on heart muscle contraction and electrical conduction, potentially leading to excessively low heart rate, low blood pressure, and reduced heart function.
• Catecholamine-Depleting Drugs: Medications like reserpine or guanethidine can have an additive effect with Bystolic, potentially causing a significant drop in sympathetic activity, leading to very low blood pressure.
• Certain Anesthetics: If you are undergoing surgery, inform your doctor that you are taking Bystolic. Some anesthetic agents can depress heart function, and combining them with a beta-blocker requires careful monitoring.
• Clonidine: If you are taking both Bystolic and clonidine, do not stop taking clonidine abruptly. Bystolic should be discontinued several days before gradually stopping clonidine to avoid a potential increase in blood pressure.
• CYP2D6 Inhibitors: Certain antidepressants (e.g., fluoxetine, paroxetine, bupropion) and antipsychotics (e.g., thioridazine, perphenazine) can increase nebivolol levels. This may lead to an increased risk of side effects such as a slower heart rate and lower blood pressure, examples include certain antidepressants (fluoxetine and paroxetine), certain antiarrhythmics (quinidine and propafenone), and cimetidine. Other examples include some other antidepressants and antipsychotics.
• Diabetes Medications (Insulin and Oral Hypoglycemic Agents): Beta-blockers, including Bystolic, can mask some of the warning signs of low blood sugar (hypoglycemia), such as a fast heartbeat. While nebivolol is beta-1 selective, caution is advised in patients with diabetes, and blood glucose monitoring may be needed.
• Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen may, in some individuals, slightly reduce the blood pressure-lowering effects of Bystolic, possibly due to increased sodium and water retention. Patients should discuss their use of NSAIDs with their doctor while taking nebivolol to monitor for any changes in blood pressure control.
• Other Antihypertensive Agents: Bystolic can have additive effects with other blood pressure-lowering medications, increasing the risk of hypotension (low blood pressure). This includes ACE inhibitors, angiotensin receptor blockers (ARBs), and diuretics.
• Other Beta-Blockers: Using Bystolic with other beta-blockers is not recommended as it can lead to excessive heart rate and blood pressure reduction.

Pregnancy and Breastfeeding:

Bystolic use during pregnancy is generally not recommended, particularly in the second and third trimesters, due to potential risks to the newborn, such as bradycardia, hypotension, and hypoglycemia. The use of Bystolic during pregnancy, including earlier trimesters, should only be considered if the potential benefits justify the risks to the fetus and under close medical supervision, as data on its safety across all trimesters is limited. Alcohol: It's generally advisable to limit alcohol consumption while taking Bystolic. Alcohol can also lower blood pressure through vasodilation, potentially increasing the risk of dizziness, lightheadedness, and fainting, particularly when starting or adjusting the dose of nebivolol. Consult your doctor for personalized advice on alcohol consumption.

Frequently Asked Questions about Bystolic at Canada Pharmacy Online:

Why is Bystolic more affordable in Canada than in the United States?

Prescription drug prices, including Bystolic, are generally lower in Canada than in the US due to a combination of factors, primarily government price regulations, differing market dynamics, and other economic considerations. In Canada, provincial and federal governments negotiate drug prices with pharmaceutical companies, which often results in lower costs compared to the U.S., where market forces play a more significant role. For more information, see the FAQs on Prescription Drug Importation from the Kaiser Family Foundation (KFF): https://www.kff.org/health-costs/issue-brief/faqs-on-prescription-drug-importation/

What is the difference between Bystolic 2.5 mg and 5 mg?

The dosage difference represents the different amounts of the same active ingredient (nebivolol) present in each tablet.

How much is the shipping?

Our shipping fee is a flat rate of $10.00 per order. Our pharmacy focuses on offering you the lowest prices on high-quality products.

How do I order from your pharmacy?

Ordering from us is very simple. You can purchase online or call Customer Service at 1866.920.3784; for more information or to learn about the ordering process, visit our How to Order page.

Is there a limit on how many tablets I am allowed to order at one time?

CanadaPharmacyOnline.com can only dispense a maximum of a three-month supply of Bystolic at once, per your doctor's prescription.

Can I buy over the counter from you?

No, Bystolic requires a valid prescription from your doctor. We do not sell this product without a valid prescription.

Do you ship to the United States?

Yes, we do. It usually takes 7 to 18 business days to receive your order from our pharmacy.

Is there a generic for Bystolic?

Yes, there is a generic alternative for this product called nebivolol.

How quickly does Bystolic work?

Bystolic starts working within a few hours to lower blood pressure. However, it may take one to two weeks to see the full effect on your blood pressure readings.

Can I stop taking Bystolic abruptly?

Suddenly stopping Bystolic can lead to severe withdrawal symptoms, especially if you have heart disease. If your doctor decides that you should stop taking Bystolic, they will provide you with a plan to gradually reduce your dosage over some time (usually one to two weeks). This slow tapering helps your body adjust to the absence of the medication and minimizes the risk of withdrawal symptoms. Abrupt cessation of beta-blockers, especially in patients with ischemic heart disease, can lead to angina, myocardial infarction, and sudden death. This is why gradual tapering is crucial.

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The information on this page is sourced from independent third parties contracted by CanadaPharmacyOnline. While we cannot guarantee its medical accuracy, we strongly recommend consulting a healthcare professional for personalized advice regarding medications or medical conditions.

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