A new medicine from Mylan and Forest Laboratories, nebivolol hydrochloride, a new beta-blocker, has been approved and will be sold as Bystolic. It can be used alone or with other medicines to treat high blood pressure.
At doses of 10 mg or less, and in people who metabolise drugs quickly through the liver enzyme cytochrome P450 2D6, nebivolol selectively blocks beta-1 receptors. At higher doses, and in people who metabolise it slowly, it also blocks beta-2 receptors. It doesn't block alpha-1 receptors.
In clinical trials, the most common side effects compared with placebo were headache, tiredness and dizziness. Less commonly, there were abnormal liver tests, kidney problems, fluid on the lungs and heart block.
It shouldn't be used in people with a slow heart rate, cardiogenic shock, uncontrolled heart failure, second-degree or higher heart block, or severe liver disease. It comes as 2.5, 5 and 10 mg tablets.
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