Nebivolol is a beta-blocker that is used to treat hypertension (high blood pressure). Lowering blood pressure may lower your risk of a stroke or heart attack.

Nebivolol may also be used for purposes not listed in this medication guide.

Do not skip doses or stop taking nebivolol without first talking to your doctor.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take nebivolol with or without food.

Your blood pressure will need to be checked often.

If you need surgery, tell the surgeon ahead of time that you are using nebivolol.

You should not skip doses or stop using nebivolol suddenly. Stopping suddenly may make your condition worse or cause serious heart problems, including heart attack. Follow your doctor's instructions about tapering your dose.

Keep using nebivolol as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store at room temperature away from moisture and heat.

Usual Adult Dose for Hypertension:

Initial dose: 5 mg orally once a day
Dose adjustment: Titrate dose at 2-week intervals up to 40 mg once a day as needed.
Maximum dose: 40 mg per day

Comments:
-Titrating doses more frequently than every 2 weeks is unlikely to be beneficial.
-The dose should be individualized to patient requirements.

Use: For the management of hypertension, alone or with another antihypertensive agent.

You should not take nebivolol if you are allergic to it, or if you have:

• a serious heart condition such as heart failure, "AV block" (2nd or 3rd degree), or sick sinus syndrome (unless you have a pacemaker);

• very slow heartbeats;

• severe liver disease; or

• if your heart cannot pump blood properly.

Tell your doctor if you have ever had:

• asthma, bronchitis, emphysema;

• a heart attack;

• problems with circulation (especially in your feet and legs);

• diabetes (taking nebivolol can make it harder for you to tell when you have low blood sugar);

• a thyroid disorder;

• liver or kidney disease;

• allergies; or

• pheochromocytoma (tumor of the adrenal gland).

Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether nebivolol will harm an unborn baby. However, having high blood pressure during pregnancy may cause complications such as diabetes or eclampsia (dangerously high blood pressure that can lead to medical problems in both mother and baby). The benefit of treating hypertension may outweigh any risks to the baby.

You should not breastfeed while using nebivolol.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include slow heart rate, dizziness, vomiting, trouble breathing, or feeling like you might pass out.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unless your doctor tells you otherwise, continue your normal diet.

Avoid driving or hazardous activity until you know how nebivolol will affect you. Your reactions could be impaired.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Nebivolol may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• rapid weight gain;

• shortness of breath;

• slow or uneven heartbeats; or

• numbness or cold feeling in your hands and feet.

Common side effects of nebivolol may include:

• dizziness;

• swelling in your legs;

• slow heartbeats;

• tiredness; or

• headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Many drugs can affect nebivolol. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Keep all appointments with your doctor. Your blood pressure should be checked regularly to determine your response to nebivolol. Your doctor may ask you to check your pulse (heart rate). Ask your pharmacist or doctor to teach you how to take your pulse. If your pulse is faster or slower than it should be, call your doctor.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking nebivolol.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.