Cardioselective β1-blocker (with NO release)
Nebivolol
Brand names: Nebilet
Adult dose
Dose: Hypertension: 5mg OD (2.5mg in elderly/renal impairment). HF: initial 1.25mg OD, titrate weekly to 10mg OD
Route: PO
Frequency: OD
Clinical pearls
- Hypertension; chronic stable HFrEF in elderly (SENIORS trial)
- Less metabolic effect than older β-blockers
Contraindications
- Asthma
- Severe bradycardia
- 2nd/3rd degree AV block
- Cardiogenic shock
- Acute decompensated heart failure
- Severe hepatic impairment
Side effects
- Bradycardia
- Cold extremities
- Fatigue
- Headache
- Erectile dysfunction
Interactions
- Verapamil/diltiazem
- Other antihypertensives
- NSAIDs (reduce effect)
Monitoring
- BP
- HR
Reference: BNF; NICE NG136/NG106; ESC; https://bnf.nice.org.uk/drugs/nebivolol/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines