Nebivolol
beta-blocker
Our referenceBy the Layer Nutrition editorial team · How the atlas classifies the 664 molecules
What this medicine is for
Nebivolol is a medicine in the category "beta-blocker". Beta-blockers slow and relieve the heart and lower blood pressure. They are never stopped abruptly.
In practical terms, for Nebivolol: Slows the heart and lowers blood pressure. It is most often a long-term background treatment, taken at regular times over extended periods; its benefit is assessed over time, not by how you feel on a given day.
Under which brands it is found
In France, about 21 reimbursable presentations containing Nebivolol are recorded. It is found under several brand names and as generics.
- Conebilox
- Nebilox
- Nebivolol Almus
- Nebivolol Arrow Lab
- Nebivolol Biogaran
- Nebivolol Cristers
- Nebivolol Eg
- Nebivolol Evolugen
- and other presentations
Generics and the original brand are equivalent for the active substance; only the appearance, the name or the excipients may differ.
Our product for this treatment
You take Nebivolol. For people who follow this type of treatment every day, we have designed a dedicated product.
Layer Nutrition Beta-Blockers
Melatonin helps you fall asleep faster. Magnesium and vitamin B6 help you reduce tiredness during the day.
- Contributes to the reduction of time taken to fall asleep (melatonin 1 mg, at bedtime)
- Contributes to the reduction of tiredness (magnesium, vitamin B6)
- Contributes to normal muscle function and to the normal functioning of the nervous system (magnesium)
Melatonin 1 mg · Magnesium 100 mg · B6 1.4 mg
One bottle, one dose per day. Reduced price from the second box, free delivery from two boxes.
How nebivolol works
Nebivolol belongs to the beta-blocker family. At doses of 10 mg or less, in people who metabolize it quickly, it selectively blocks the beta-1 adrenergic receptors, those found mainly on the heart. By occupying them, it slows the action of adrenaline and noradrenaline on the heart muscle: the heart beats more slowly and with less force, which lowers blood pressure. This selectivity for beta-1 receptors weakens as the dose rises.
Nebivolol stands out for a second mechanism, one that goes beyond simple beta-1 blockade. It produces an endothelium-dependent vasodilation, the endothelium being the inner lining of the vessels, by stimulating the L-arginine / nitric oxide pathway. The nitric oxide released in this way relaxes the muscle of the arteries, which widen and offer less resistance to blood flow. This dilation adds to the slowing of the heart to bring pressure down.
Why it is prescribed
Nebivolol is indicated for the treatment of high blood pressure, to lower the pressure. Pressure that stays too high over time forces the heart to work against increased resistance and relentlessly strains the walls of the arteries. By slowing the heart and dilating the vessels, nebivolol reduces this double load. A systematic review with meta-analysis confirmed its efficacy in essential arterial hypertension.
The goal of treatment is not to relieve a symptom, since high blood pressure is rarely felt, but to keep pressure within a safer range over time. This is why it is taken daily, even on days when everything seems fine. The benefit builds through continuity, as the load placed on the heart and the arteries decreases day after day.
How to take it day to day
Nebivolol is taken once a day. The half-life of its active isomer, d-nebivolol, is about 12 hours in fast metabolizers and about 19 hours in slow metabolizers of CYP2D6, which is enough to cover the day with a single dose. Food does not change its absorption: it can be swallowed with or without a meal. Taking it at a set time simply helps to avoid forgetting it.
Nebivolol is processed by the liver, through glucuronidation and through hydroxylation via the CYP2D6 enzyme. People who metabolize CYP2D6 slowly show an exposure to d-nebivolol roughly ten times higher, which is part of the reason the dose is adjusted individually. A beta-blocker should not be stopped on one's own initiative, nor changed from one day to the next: adjusting the dose is up to the prescriber, who proceeds in steps.
The effects to know about
In placebo-controlled trials, headache is the most frequently reported effect: 9 % of people at 5 mg, compared with 6 % on placebo. Fatigue reaches up to 5 % at doses of 20 to 40 mg, compared with 1 % on placebo. Dizziness affects up to 4 % of people, compared with 2 %. These effects most often remain mild and appear mainly at the start of treatment or after a dose increase.
Digestive complaints are rarer: diarrhea up to 3 % compared with 2 %, nausea up to 3 % compared with 0 %. Insomnia affects 1 % of people compared with 0 % on placebo. Slowing of the heart, or bradycardia, occurs in about 1 % of patients at doses of 20 to 40 mg, compared with 0 % on placebo: this is the expected extension of the molecule's action on heart rhythm, and not a side effect.
Interactions and monitoring
Because nebivolol depends on CYP2D6, any medicine that slows this enzyme increases its exposure. Fluoxetine, an antidepressant, multiplies the area under the curve eightfold and the peak concentration of d-nebivolol threefold. Quinidine, propafenone and paroxetine call for the same caution. It is therefore useful to report all of one's treatment to the doctor and the pharmacist before adding a new molecule.
Beta-blockers can mask the early signs of low blood sugar, in particular the quickening of the heart, which matters above all in people with diabetes: monitoring blood glucose keeps its full value in this context. On the laboratory side, nebivolol has been associated with a rise in blood urea, uric acid and triglycerides, as well as a fall in HDL cholesterol and platelet count. These are the parameters that monitoring checks over the course of treatment.
On the plate
The best-documented point of contact between this treatment and the plate concerns sleep. The synthesis of melatonin by the pineal gland is commanded by the beta-1 adrenergic receptors, the very ones that nebivolol occupies. As a result, beta-1 beta-blockers reduce the nighttime secretion of melatonin, the hormone that signals night to the body; atenolol, for example, suppresses this nighttime production. In hypertensive patients treated with a beta-blocker, a melatonin intake over three weeks improved sleep quality in a randomized controlled trial.
Food provides melatonin, but in tiny amounts, and the body makes most of it from tryptophan, an amino acid present in eggs, walnuts, seeds and legumes. A banana or a bowl of oats supplies this kind of raw material. When beta-1 receptor blockade lowers nighttime production, the plate alone does not close this gap, and this is where a targeted intake makes sense. On top of your treatment, never in its place.
Sources
- Nebivolol (nebivolol hydrochloride) tablet label
- Nebivolol for the Treatment of Essential Systemic Arterial Hypertension: A Systematic Review and Meta-Analysis
- Atenolol facilitates light-induced phase shifts in humans
- Repeated melatonin supplementation improves sleep in hypertensive patients treated with beta-blockers: a randomized controlled trial
Related molecules
To explore in the « Heart and blood pressure » family and its neighbours.
See the whole « Heart and blood pressure » family · Back to the atlas
Frequently asked questions
What is nebivolol used for?
Nebivolol is a third-generation beta-blocker, prescribed in particular for high blood pressure and certain forms of heart failure. Its exact indication depends on your situation: refer to the patient leaflet in your pack and discuss it with your doctor or pharmacist.
What are the side effects of nebivolol?
Among the common side effects, the leaflet lists tiredness, headaches, dizziness, a slower heart rate, digestive problems and sleep disturbances. The full list, together with the warning signs to watch for, is set out in the leaflet; if in doubt, consult your doctor or pharmacist.
Does nebivolol make you tired?
Tiredness is one of the effects reported with beta-blockers, which slow the heart rate. If the tiredness is unusual or if your pulse drops noticeably, do not adjust anything on your own and speak to your doctor about it.
Does nebivolol cause weight gain?
A change in weight is sometimes mentioned by people treated with a beta-blocker, but it depends on many factors specific to each person. If you notice weight gain or swelling, report it to your doctor rather than changing your treatment yourself.
Can you drink alcohol while taking nebivolol?
Alcohol and beta-blockers can add to each other's effects on blood pressure and promote dizziness or light-headedness. For your specific case, follow the instructions in the leaflet and the advice of your doctor or pharmacist.
What does nebivolol interact with?
Many medicines can interact with nebivolol: other blood pressure treatments, certain heart-rhythm medicines, anti-inflammatories and antidepressants, among others. Give your doctor or pharmacist a list of everything you take, supplements included, and check the leaflet.
Can you stop nebivolol suddenly?
The leaflet advises against stopping a beta-blocker abruptly, as this can worsen the cardiovascular condition. Any discontinuation is done gradually and under the supervision of your doctor: do not stop it on your own.
What should you do if you miss a dose?
What to do if you miss a dose is described in the leaflet for your medicine, and it never involves doubling the next dose. If in doubt, ask your pharmacist for advice.
Is nebivolol safe during pregnancy or breastfeeding?
Pregnancy and breastfeeding call for specific precautions with beta-blockers. Use nebivolol in these situations only on medical advice, relying on the leaflet and on your doctor.
Can nebivolol affect your sleep?
Sleep disturbances, insomnia or vivid dreams are among the effects reported with beta-blockers. If your sleep gets worse, make a note of it and raise it with your doctor rather than changing anything about your dose.
Why is melatonin mentioned with a beta-blocker like nebivolol?
Studies link the use of beta-blockers to a reduction in the night-time secretion of melatonin, the hormone that accompanies falling asleep (Stoschitzky et al., 1999). It is this documented connection with sleep that brings melatonin to the fore. Our BB01 reference is built on this active ingredient, in the form of melatonin.
What is the point of magnesium in this context?
Magnesium is a mineral associated with muscular and nervous relaxation and with better-quality sleep, which is why it accompanies melatonin in our BB01 reference. For good digestive tolerance, a form such as magnesium bisglycinate is preferred.
Ces réponses portent sur le volet nutritionnel. Pour toute question sur votre médicament, la notice et votre médecin ou pharmacien font foi.