Side Effects of nebivolol: A Synthesis of Findings from 29 Studies

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Original Abstract of the Article

Main Research Findings

Nebivolol is an effective drug for treating hypertension and has been shown to be well-tolerated in multiple studies, with fewer side effects compared to other beta-blockers. 29 , 8 , 7 Nebivolol selectively targets beta-1 receptors in the heart, reducing heart contractility and lowering blood pressure. 6 Additionally, nebivolol has vasodilatory effects, relaxing blood vessels and further lowering blood pressure. 6 Furthermore, nebivolol has been shown to improve endothelial function in blood vessels. 6 Nebivolol has also demonstrated effectiveness in treating heart failure. 11 It has the potential to improve heart failure symptoms and enhance exercise capacity. 11 However, like other beta-blockers, nebivolol carries the risk of side effects. 7 Potential side effects include dizziness, fatigue, and sexual dysfunction. 7 Consulting with a doctor about the risk of side effects is crucial before taking nebivolol.

Reasons for Side Effects

The side effects of nebivolol stem from its actions on beta receptors in the heart and its vasodilatory properties. 6 Beta-blockers work by affecting beta receptors in the heart, reducing heart contractility and lowering blood pressure. 6 However, these receptors are involved not only in heart contractility but also in heart rate and respiration. 6 Therefore, beta-blockers can potentially cause side effects like decreased heart rate or breathing difficulties. 6 Nebivolol also has a vasodilatory effect, relaxing blood vessels. 6 While vasodilation lowers blood pressure, it can also lead to dizziness or lightheadedness. 6

Common Side Effects

Dizziness

Dizziness has been reported as a side effect of nebivolol. 7 , 11 Nebivolol lowers blood pressure by dilating blood vessels, which can cause dizziness if blood pressure drops too quickly. 6 Additionally, nebivolol can lower heart rate, potentially contributing to dizziness. 6

Fatigue

Fatigue has been reported as a side effect of nebivolol. 7 Nebivolol works by affecting beta receptors in the heart, reducing heart contractility. 6 This reduction in heart contractility can lower overall energy expenditure, leading to increased fatigue. 6

Sexual Dysfunction

Sexual dysfunction has been reported as a side effect of nebivolol. 7 Beta-blockers can potentially cause sexual dysfunction. 1 This is thought to be due to the constriction of blood vessels by beta-blockers, reducing blood flow to the penis. 1 However, nebivolol has been reported to have a lower risk of sexual dysfunction compared to other beta-blockers. 3

Breathing Difficulty

Nebivolol is less likely to cause bronchospasm due to its weak effect on beta-2 receptors. 25 However, breathing difficulty may occur in patients with respiratory illnesses such as asthma. 25 It is essential to inform your doctor about any respiratory conditions you have before taking nebivolol. 25

Hypoglycemia

Nebivolol may increase the risk of hypoglycemia in diabetic patients. 4 This is attributed to the potential enhancement of insulin action by nebivolol. 4 If you are diabetic and taking nebivolol, it is crucial to carefully monitor your blood sugar levels. 4

Liver Dysfunction

Nebivolol has the potential to cause liver dysfunction. 9 Regular liver function tests are important when taking nebivolol. 9

Skin Reactions

Nebivolol may cause skin reactions. 21 If you experience any skin abnormalities while taking nebivolol, consult your doctor immediately. 21

Side Effect Management

Dizziness

To manage dizziness caused by nebivolol, it is important to get up slowly to avoid sudden drops in blood pressure. 6 If dizziness is severe, consult your doctor. 6

Fatigue

Fatigue caused by nebivolol may be alleviated by getting enough sleep and engaging in light exercise. 6 However, if fatigue is persistent or severe, consult your doctor. 6

Sexual Dysfunction

Sexual dysfunction caused by nebivolol can be addressed by consulting your doctor, who may consider switching you to a different medication. 1

Breathing Difficulty

Breathing difficulties caused by nebivolol can be addressed by consulting your doctor, who may consider switching you to a different medication. 25

Hypoglycemia

Hypoglycemia caused by nebivolol can be prevented by careful blood sugar management. 4 If your blood sugar is low, consume glucose. 4

Liver Dysfunction

Early detection of liver dysfunction caused by nebivolol can be achieved through regular liver function tests. 9 If your liver function test results are abnormal, consult your doctor. 9

Skin Reactions

Skin reactions caused by nebivolol may improve if you stop taking the medication. 21 However, if the skin reaction is severe, consult your doctor. 21

Comparison Across Studies

Commonalities

Multiple studies have consistently shown that nebivolol is an effective treatment for hypertension and is well-tolerated, with fewer side effects compared to other beta-blockers. 29 , 8 , 7

Differences

There are discrepancies in the reported side effects of nebivolol across different studies. 7 For example, some studies indicate that nebivolol has a lower risk of sexual dysfunction compared to other beta-blockers, while others provide less conclusive evidence. 3 , 1 Similarly, opinions on the risk of hypoglycemia from nebivolol vary across studies. 4 Further research is necessary to better understand the side effects of nebivolol.

Real-World Application Considerations

While nebivolol is an effective treatment for hypertension and heart failure, it does carry the risk of side effects. 7 It is essential to discuss the potential risks of side effects with your doctor before taking nebivolol. 7 If you experience side effects such as dizziness, fatigue, or sexual dysfunction while taking nebivolol, consult your doctor immediately. 7

Limitations of Current Research

Research on nebivolol is still ongoing and not comprehensive. 19 In particular, long-term effects of nebivolol are not yet fully understood. 19 Furthermore, research on the side effects of nebivolol is limited, especially regarding sexual dysfunction and other potential side effects. 19 Additional research is necessary to thoroughly understand the side effects of nebivolol.

Future Research Directions

Further research is needed on the long-term effects and side effects of nebivolol. 19 Research on the combined use of nebivolol with other medications is also necessary. 19 Through these research efforts, a deeper understanding of the safety of nebivolol can be achieved. 19

Conclusion

Nebivolol is an effective treatment for hypertension and heart failure, with fewer side effects and better tolerability than other beta-blockers, as evidenced by multiple studies. 29 , 8 , 7 However, nebivolol carries the risk of side effects. 7 Consulting with your doctor about the potential side effects before taking nebivolol is crucial. 7 Further research is necessary to understand the long-term effects and side effects of nebivolol more comprehensively. 19

Keywords
Benefit Keywords
Endothelial dysfunction treatment
Heart failure treatment
Hypertension treatment
2
Hypertension
Nebivolol
Sexual Function
3
Brain health
Cholesterol regulation
4
Hypertension treatment
5
Anti-ischemic effects
Antihypertensive effects
Improved endothelial function
6
Hypertension treatment
Reduced side effects
7
Antihypertensive effect
Better tolerability
Lower side-effect incidence
8
Hypotensive activity
Improved baroreceptor control
Improved vascular endothelium function
Regression of left ventricular myocardium hypertrophy
10
Improved exercise capacity
11
Heart failure treatment
Hypertension treatment
12
Nephroprotection
Reduced apoptosis
Reduced inflammation
Reduced oxidative stress
13
Improved blood flow
14
Nebivolol effectiveness
Nebivolol tolerability
15
Heart failure treatment
16
GLP-1 analogues for weight loss
Metformin for weight loss
17
Blood pressure control
18
Benefits post-MI patients
Improves heart failure
Lowers BP
19
BB choice
Drug adherence
20
Blood pressure reduction
22
Heart failure treatment
23
Arterial stiffness reduction
Blood pressure control
24
Hypertension treatment
25
Effective for hypertension
26
CVD treatment
27
Reduce mortality
28
Improved blood flow
Lowered blood pressure
29
Risk Keywords
Sexual dysfunction
1
Erectile dysfunction
2
7-DHC elevation
Fetal development
Pregnancy complications
4
Beta-blocker side effects
6
Cancer risk
Nitrosamine exposure
9
Amlodipine side effects
Metoprolol side effects
15
Bradycardia
Dizziness
Hypotension
16
Fenfluramine cardiovascular risk
Rimonobant psychiatric problems
Sibutramine cardiovascular risk
17
Atrioventricular block
Bradycardia
18
Cold extremities
Depression
Fatigue
Sexual dysfunction
19
BB side effects
20
Bronchospasm
Metabolic disturbance
Sexual dysfunction
23
Asthma exacerbation
25
Dizziness
Headache
26
Edema
Flushing
Headache
29
Literature analysis of 29 papers
Positive Content
27
Neutral Content
0
Negative Content
2
Article Type
5
0
0
11
29
2.

A Review of Nebivolol Pharmacology and Clinical Evidence.

Author: FongemieJustin, Felix-GetzikErika

Endothelial dysfunction treatment
Heart failure treatment
Hypertension treatment
Erectile dysfunction

Nebivolol is a beta-blocker that is effective in treating hypertension. It may also be useful in patients who have experienced erectile dysfunction while on other beta-blockers.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Comparison of Effect of Nebivolol and Bisoprolol on Sexual Function of Hypertensive Female Patients.

Author: KumarNomesh, KhanShayan Iqbal, VershaFnu, GargIshan, BachaniParkash, GulAmbresha, JahangirMaha, KhalidHaya, KhanSidrah, MemonSidra

Hypertension
Nebivolol
Sexual Function

This study investigated the effect of nebivolol and bisoprolol on sexual function in hypertensive women. Nebivolol was associated with a significant improvement in sexual function, potentially due to its vasodilation properties and low risk of sexual side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Metoprolol Inhibits Developmental Brain Sterol Biosynthesis in Mice.

Author: AllenLuke B, MirnicsKároly

Brain health
Cholesterol regulation
7-DHC elevation
Fetal development
Pregnancy complications

This study investigated the effects of beta-blockers on brain sterol biosynthesis in vitro. The findings suggest that metoprolol (MTP) may elevate levels of 7-dehydrocholesterol (7-DHC), a potentially teratogenic compound, and may be detrimental for offspring development.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

7.

Beta-blockers in the management of hypertension: focus on nebivolol.

Author: WojciechowskiDavid, PapademetriouVasilios

Hypertension treatment
Reduced side effects

Nebivolol, a new beta-blocker, is effective in treating hypertension with fewer side effects than other beta-blockers.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Efficacy and tolerability profile of nebivolol vs atenolol in mild-to-moderate essential hypertension: results of a double-blind randomized multicentre trial.

Author: GrassiGuido, TrevanoFosca Quarti, FacchiniAnnalisa, ToutouzasTorakis, ChanuBernard, ManciaGiuseppe

Antihypertensive effect
Better tolerability
Lower side-effect incidence

Nebivolol (5 mg daily) and atenolol (100 mg daily) showed similar antihypertensive effects in a 12-week double-blind randomized study of mild-to-moderate hypertensives. Nebivolol had a better tolerability profile and a lower incidence of side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

11.

Effect of the long-term administration of nebivolol on clinical symptoms, exercise capacity and left ventricular function in patients with heart failure and preserved left ventricular ejection fraction: background, aims and design of the ELANDD study.

Author: KampOtto, MetraMarco, De KeulenaerGilles W, PieskeBurkert, ConraadsViviane, ZamoranoJosé, HuysseLieven, VardasPanos E, BöhmMichael, Dei CasLivio

Improved exercise capacity

A multicenter trial is underway to assess the long-term effects of nebivolol compared to placebo in patients with heart failure and preserved left ventricular ejection fraction. The primary endpoint is change in 6-minute walk test distance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Influence of nebivolol and enalapril on metabolic parameters and arterial stiffness in hypertensive type 2 diabetic patients.

Author: KaiserThomas, HeiseTim, NosekLeszek, EckersUta, SawickiPeter T

Improved blood flow

Nebivolol and enalapril did not show different effects on insulin sensitivity, peripheral blood flow, and arterial stiffness in hypertensive diabetic patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

A retrospective study evaluating the tolerability and effectiveness of adjunctive antihypertensive drugs in patients with inadequate response to initial treatment.

Author: AyyagariRajeev, XieJipan, ChengDavid, WuEric Q, HuangXing-Yue, ChenStephanie

Nebivolol effectiveness
Nebivolol tolerability
Amlodipine side effects
Metoprolol side effects

Nebivolol as first add-on therapy was associated with fewer side effects than metoprolol or amlodipine and with a higher BP control rate than hydrochlorothiazide, metoprolol, or amlodipine.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Cardiovascular effects of current and future anti-obesity drugs.

Author: Comerma-SteffensenSimon, GrannMartin, AndersenCharlotte U, RungbyJorgen, SimonsenUlf

GLP-1 analogues for weight loss
Metformin for weight loss
Fenfluramine cardiovascular risk
Rimonobant psychiatric problems
Sibutramine cardiovascular risk

Obesity is linked to various health issues, and there is a need for safe and effective treatments. Anti-obesity drugs like fenfluramine and sibutramine were withdrawn due to cardiovascular risks, and rimonobant was withdrawn due to psychiatric problems. Current treatments like orlistat, phentermine, topiramate, and lorcaserin have limited efficacy and potential cardiovascular side effects. Drugs for type 2 diabetes, such as GLP-1 analogues and metformin, can cause moderate weight loss and have a favorable cardiovascular profile.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Combining other antihypertensive drugs with β-blockers in hypertension: a focus on safety and tolerability.

Author: RichardsTiffany R, TobeSheldon W

Blood pressure control
Atrioventricular block
Bradycardia

Combining multiple classes of antihypertensive drugs is often essential for blood pressure control in patients with hypertension. This review discusses the benefits of combination therapy and provides recommendations for effective drug combinations based on their efficacy and potential side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Contraindications Differ Widely Among Beta Blockers and Ought to be Cited for an Individual Drug, Not for the Entire Class.

Author: KoraćevićGoran, StojanovićMilovan, KostićTomislav, LovićDragan, ZdravkovićMarija, KoraćevićMaja, PavlovićDimitrije, MićićSlađana

BB choice
Drug adherence
BB side effects

Beta-blockers (BBs) are commonly prescribed medications, but their side effects can lead to poor adherence. This paper suggests an improved method of reporting contraindications for BBs by listing specific contraindications for individual BBs rather than the entire class. This approach could potentially improve drug adherence and patient outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Comparison of antihypertensive efficacy of carvedilol and nebivolol in mild-to-moderate primary hypertension: a randomized trial.

Author: ErdoğanOkan, ErtemBülent, AltunArmağan

Blood pressure reduction

Both carvedilol and nebivolol effectively decreased blood pressure compared to placebo, but showed similar efficacy for lowering blood pressure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

23.

Beta-blockers and heart failure.

Author: CruickshankJohn M

Heart failure treatment
Bronchospasm
Metabolic disturbance
Sexual dysfunction

This review discusses the use of beta-blockers (BB) in the treatment of heart failure (HF). BB are effective in treating systolic HF, reducing all-cause death by 34-5%. Bisoprolol, metoprolol, and carvedilol are considered the most effective BB for treating systolic HF. The choice of BB is important, as benefit is not a class-effect. Adverse effects are mainly associated with beta-2 blockade and alpha-blockade.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

25.

The pharmacologic treatment of uncomplicated arterial hypertension in patients with airway dysfunction.

Author: CazzolaMario, NoschesePaolo, D'AmatoGennaro, MateraMaria Gabriella

Hypertension treatment
Asthma exacerbation

This article discusses the complex management of hypertension in patients with airway dysfunction, highlighting the potential risks and benefits of various antihypertensive drugs on airway function.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

26.

[Use of nebivolol in patients with mild and moderate hypertension].

Author: ZhigunovaL V, LakhovaE L, IurenevA P

Effective for hypertension
Dizziness
Headache

Nebivolol was effective in reducing blood pressure in patients with mild and moderate essential hypertension and was well tolerated.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Russian

27.

Adverse effects of interactions between antipsychotics and medications used in the treatment of cardiovascular disorders.

Author: SiwekMarcin, WorońJarosław, GorostowiczAleksandra, WordliczekJerzy

CVD treatment

This study aimed to evaluate the potential for harmful interactions between antipsychotics and medications used to treat cardiovascular diseases (CVD) in patients with bipolar disorder or schizophrenia who are at risk of CVD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

28.

[Beta blockers and cardiac decompensation].

Author: PudduG M, CraveroE, PudduP

Reduce mortality

Beta blockers have been demonstrated to modify the course of chronic heart failure by reducing hemodynamic instability and mortality. Third generation beta blockers, such as carvedilol, nebivolol, and bucindolol, have shown to possess some peculiar characteristics, in particular the ability of reducing the number of side effects which may be seen while using beta blockers of the first generations.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Italian

29.

Nebivolol versus nifedipine in the treatment of essential hypertension: a double-blind, randomized, comparative trial.

Author: Van NuetenL, LacourcièreY, VyssoulisG, KorliparaK, MarcadetD M, DupontA G, RobertsonJ I

Improved blood flow
Lowered blood pressure
Edema
Flushing
Headache

This double-blind, randomized trial found that nebivolol was significantly more effective than nifedipine in lowering blood pressure in patients with essential hypertension.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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