[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Beta blockers](https://durgical.com/en/pharmacology/classes/beta-blockers/) › Nebivolol

[Pharmacology](https://durgical.com/en/pharmacology/) · [Beta blockers](https://durgical.com/en/pharmacology/classes/beta-blockers/)

# Nebivolol

A β1-selective beta blocker that also promotes nitric oxide release from vessel walls, adding vasodilation. Used for high blood pressure.

Updated 2026-11-01

- Class: [Beta blockers](https://durgical.com/en/pharmacology/classes/beta-blockers/)
- Receptor: β1-adrenergic receptor
- ATC code: C07AB12

◎**β1-adrenergic receptor**Nebivolol

ⓘ The figure shows the turkey β1 receptor with cyanopindolol, another beta blocker in the same binding site where nebivolol acts; no structure with nebivolol bound is available.

**Target in 3D:** β1-adrenergic receptor. PDB structure 2VT4 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/2VT4) · Drag to rotate · pinch to zoom

## Mechanism of action

Nebivolol blocks β1 receptors with high selectivity, slowing the heart and lowering renin. It also promotes endothelium-dependent vasodilation through nitric oxide, so resistance falls as well. At higher exposure, or in people who metabolise it slowly by CYP2D6, it loses part of its β1 selectivity.

- Nebivolol selectively blocks β1 receptors
- Heart rate and renin release fall
- Nitric oxide from the endothelium dilates vessels

## Pharmacokinetics

**Metabolism**
Liver, mainly by CYP2D6; slow metabolisers have much higher exposure

**Half-life**
About 12 hours for the active form, longer in CYP2D6 poor metabolisers

## Indications

- High blood pressure [Arterial hypertension →](https://durgical.com/en/conditions/arterial-hypertension/)

## Adverse effects

### Common

- Headache
- Fatigue
- Dizziness
- Bradycardia

### Serious (rare, important)

- Angina or infarction after abrupt withdrawal
- Bronchospasm in reactive airways
- Severe bradycardia or heart block

## Contraindications

- Severe bradycardia or heart block greater than first degree
- Cardiogenic shock or decompensated heart failure
- Sick sinus syndrome without a pacemaker
- Severe liver impairment

## Key interactions

**CYP2D6 inhibitors (fluoxetine, paroxetine, quinidine, propafenone)**
Higher nebivolol levels

**Verapamil or diltiazem**
Added bradycardia and AV block

**Clonidine**
Excessive fall in sympathetic activity

## What is monitored

- Heart rate and blood pressure
- Signs of heart failure

## Administration and safety

- Given by mouth once a day, with or without food
- Withdrawn gradually, never stopped suddenly
- Many «-olol» names look alike: the name is checked on every order

## Nursing care

- Check pulse and blood pressure before doses
- Review other drugs for CYP2D6 inhibitors
- Teach the patient not to stop it abruptly and to report wheezing or fainting

## Pregnancy and breastfeeding

Human data are limited; beta blockers can slow fetal growth and cause bradycardia and hypoglycaemia in the newborn.

## Memory aid

NEBIvolol brings NEw Bonus: β1 block plus a puff of nitric oxide.

## Test yourself

Think of the answer, then tap the question to see it.

## What extra vasodilating action does nebivolol have?

It promotes nitric oxide-mediated, endothelium-dependent vasodilation.

## Which enzyme metabolises nebivolol, and why does it matter?

CYP2D6: poor metabolisers and patients on CYP2D6 inhibitors reach much higher levels.

## Which liver condition is a contraindication to nebivolol?

Severe hepatic impairment.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/nebivolol/)

## Related drugs

- [Bisoprolol](https://durgical.com/en/pharmacology/bisoprolol/)
- [Atenolol](https://durgical.com/en/pharmacology/atenolol/)
- [Carvedilol](https://durgical.com/en/pharmacology/carvedilol/)

## Related conditions

- [Arterial hypertension](https://durgical.com/en/conditions/arterial-hypertension/)

[← Back to the class: Beta blockers](https://durgical.com/en/pharmacology/classes/beta-blockers/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - NEBIVOLOL tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6e43a4e2-574e-4f4a-804d-e346b4edd2f1) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=C07AB12) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 14 (McGraw Hill, 2023).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/nebivolol/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/nebivolol/