Short answer: The Bystolic label starting dose for most people is 5 mg by mouth once daily, with or without food. If blood pressure needs to come down further, the dose can be raised at 2-week intervals up to 40 mg. Severe kidney impairment or moderate liver impairment starts at 2.5 mg. A missed dose is not doubled, and the label says Bystolic is not stopped suddenly.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Bystolic is approved for: Bystolic is a beta-blocker approved to treat high blood pressure, alone or with other blood pressure medicines (section 1.1). The label notes that no controlled trials have shown that Bystolic itself lowers the risk of heart events. It is not approved for children under 18.
Source
BYSTOLIC (nebivolol) tablets, for oral use, prescribing information and Patient Information. Allergan (AbbVie). DailyMed, version published December 31, 2025. DailyMed setid 8b8ad213-1dc8-454e-a524-075685c0e1a8
Bystolic is a tablet taken by mouth once daily, with or without food. It comes in 2.5 mg, 5 mg, 10 mg and 20 mg tablets (sections 2.1 and 3).
The dose is individualized, and people are monitored while it is raised. The label says dosing more often than once a day is unlikely to help (section 2.1).
It is taken regularly and continuously, and not stopped or interrupted without the prescriber (section 17).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Group | Starting dose | Step-up |
|---|---|---|
| Most patients with hypertension | 5 mg once daily | May be increased at 2-week intervals up to 40 mg |
| Severe renal impairment (ClCr less than 30 mL/min) | 2.5 mg once daily | Titrate up slowly if needed; not studied on dialysis |
| Moderate hepatic impairment | 2.5 mg once daily | Titrate up slowly if needed |
| Severe hepatic impairment | Not recommended (contraindicated if Child-Pugh above B, section 4) | Not applicable |
| Geriatric patients or CYP2D6 poor metabolizers | No dose adjustment necessary | Same as most patients |
When stopping is planned, Bystolic is tapered over 1 to 2 weeks when possible, with physical activity kept low. If angina worsens, it is restarted promptly, at least for a time.
With CYP2D6 inhibitors such as fluoxetine, paroxetine, quinidine or propafenone, the Bystolic dose may need to be lowered.
Bystolic is not used with other beta-blockers. For people on Bystolic and clonidine, Bystolic is stopped for several days before clonidine is slowly tapered.
With verapamil- or diltiazem-type calcium channel blockers, ECG and blood pressure are monitored.
Tablets are stored at 20 to 25 C (68 to 77 F) in a tight, light-resistant container.
If a dose is missed, take the next scheduled dose only, without doubling it. The Patient Information words it differently: take the dose as soon as you remember, unless it is close to the time of your next dose; do not take 2 doses at the same time, and take the next dose at the usual time.
More on this: missed a dose of Bystolic.
In Dose Track you set up Bystolic as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.