Short answer: Nebivolol has a half-life of about 12 hours (19 hours in poor CYP2D6 metabolizers). Levels peak 1.5 to 4 hours after a dose. People vary, so treat these as estimates.
Nebivolol is a beta blocker: it blocks the effect of adrenaline on beta receptors, slowing the heart and lowering blood pressure. It is sold as Bystolic and as generic tablets for high blood pressure. At doses up to 10 mg in most people it acts mainly on the heart's beta-1 receptors.
Also known as: Bystolic.
Bystolic comes as 2.5 mg, 5 mg, 10 mg and 20 mg tablets.
The FDA Bystolic label approves nebivolol for high blood pressure, alone or with other blood pressure drugs. For most people it starts at 5 mg once a day, with or without food, and can be raised at 2-week intervals up to 40 mg; with severe kidney impairment or moderate liver impairment it starts at 2.5 mg. It is not used with a very slow heart rate, heart block beyond first degree, cardiogenic shock, decompensated heart failure, sick sinus syndrome without a pacemaker, or severe liver impairment.
The label warns not to stop it suddenly in people with coronary artery disease, because worse angina, heart attacks and dangerous rhythms have followed abrupt stops of beta blockers. It can hide signs of low blood sugar and of an overactive thyroid, such as a fast heartbeat. The label lists a slower heart rate, decreased contractility, less nerve signalling to the blood vessels, lower renin and widening of the blood vessels as possible ways it lowers blood pressure.
WADA lists nebivolol among beta-blockers (P1), banned in competition in sports such as archery, golf, darts, billiards, motor racing and shooting, and also out of competition in archery, shooting and some underwater sports.
The FDA Bystolic label gives the active form (d-nebivolol) an effective half-life of about 12 hours in most people (CYP2D6 extensive metabolizers) and 19 hours in poor metabolizers, with peak levels 1.5 to 4 hours after a dose. The label notes that this genetic difference matters less than usual because its active breakdown products also lower blood pressure.
Numbers shown are taken from the source above. Half-life varies from person to person.
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