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Bystolic vs Carvedilol – Comparison of Uses & Side Effects

Bystolic vs Carvedilol:


Hypertension is an asymptomatic condition of persistently elevated blood pressure that affects over 50 million people in the United States and 1 billion people worldwide.

Pharmacological treatment of hypertension includes management with one or more agents belonging to the following medication classes:

  • angiotensin receptor blockers (ARBs);
  • angiotensin-converting enzyme (ACE)–inhibitors;
  • calcium-channel blockers;
  • beta-blockers;
  • thiazide diuretics.

Here Is A Comparison Between Two Beta-Blockers:

Bystolic (generic name – nebivolol) is a third-generation beta-blocker that belongs to the class of drugs called selective beta-blockers.

It was first approved by the FDA in 2007 and is manufactured and marketed by Mylan Bertek Pharmaceuticals.

Coreg (generic name – carvedilol) is also a third-generation beta-blocker that has a complex pharmacological profile, including alpha-1 adrenergic and non-selective beta-adrenergic receptor blocking properties as well as anti-oxidant actions.

It is produced and marketed by GlaxoSmithKline, and it was approved by the US FDA in 1995.



It is used alone or with angiotensin-converting enzyme (ACE) inhibitors or diuretics to treat mild to moderately high blood pressure.


It is used alone or together with other medicines to treat high blood pressure.

Note – in sufferers with heart failure who have not previously used a beta-blocker, it may be considered as the first choice agent.

Mechanism of Action

Bystolic works by relaxing blood vessels and slowing heart rate to decrease blood pressure.

Its half-life is about 10.3 hours in extensive metabolizers and approximately 31.9 hours in poor metabolizers.

Coreg works by blocking certain receptors in the heart to reduce your heartbeat and blood pressure in the body.

Its elimination is via the biliary route and excretion in the feces. It has an elimination half-life of 7 to 10 hours.

Side Effects


The most common adverse events associated with this medication treatment during clinical studies included:

  • nausea;
  • dizziness;
  • diarrhea;
  • tiredness;
  • headache;
  • a slower heart rate.

Call your doctor at once if you have a serious side effect such as:

  • feeling dizzy or like you’re going to faint;
  • shortness of breath and wheezing;
  • a strange feeling in the hands or feet;
  • sudden weight gain;
  • chest discomfort;
  • sudden weight loss;
  • heart beating very slowly;
  • tightness in the chest.


The most common adverse events associated with this medication treatment during clinical studies included:

  • slower heart rate;
  • dizziness;
  • dry, itchy skin;
  • unusual tiredness;
  • nausea;
  • low blood pressure;
  • headache;
  • diarrhea;
  • dry eyes;
  • high blood sugar;
  • changes in sex drive;
  • unexplained weight gain;
  • lack of energy.

Call your doctor at once if you have a serious side effect such as:

  • trouble breathing;
  • low or uneven heartbeats;
  • chest tightness;
  • swelling;
  • wheezing;
  • rapid weight gain;
  • chest pain;
  • loss of bladder control.



The usual recommended starting dose is 5 mg once per day, as monotherapy or in combination with other drugs.

For sufferers requiring further reduction in blood pressure, the dosage can be increased at 14 days intervals up to 40 mg. This is also the maximum recommended dosage.


The usual recommended starting dose is 6.25 mg two times per day.

If this dosage is tolerated, it should be maintained for 2 weeks and then increased to 12.5 mg two times per day.

This dose should be maintained for 2 weeks and can then be adjusted upward to 25 mg two times per day if needed.

The maximum recommended daily dose is 50 mg.

Warnings & Precautions


It is not approved for use in children or teens. Also, before starting this medication, tell your doctor about all of your medical conditions, including if you:

  • have pheochromocytoma (a rare tumor of adrenal gland tissue);
  • have asthma or bronchitis;
  • have had allergic reactions to drugs or have allergies;
  • have problems with blood flow in your feet and legs;
  • have kidney problems:
  • have liver problems:
  • have thyroid problems:
  • take medicines to control blood sugar (glucose).


This medication is contraindicated in people with:

  • known hypersensitivity to the drug;
  • severe bradycardia (a condition wherein an individual has a very slow heart rate);
  • cardiogenic shock (a condition in which the heart suddenly can’t pump sufficient blood to meet the body’s needs);
  • sick sinus syndrome (a group of abnormal heart rhythms presumably caused by a malfunction of the sinus node);
  • second- or third-degree atrioventricular block;
  • severe liver impairment;
  • decompensated NYHA functional class IV heart failure needing intravenous inotropic therapy;
  • bronchial asthma.

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Drug Interactions


It may interact in a negative way with the following medications:

  • hydrochlorothiazide;
  • Advil (ibuprofen);
  • prednisone;
  • amlodipine;
  • Viagra (sildenafil);
  • aspirin;
  • Xanax (alprazolam);
  • Benadryl (diphenhydramine);
  • valsartan;
  • diltiazem;
  • Norvasc (amlodipine);
  • ibuprofen;
  • furosemide.


It may interact in a negative way with the following medications:

  • procainamide;
  • amiodarone;
  • sotalol;
  • bretylium;
  • propafenone;
  • quinidine;
  • moricizine;
  • digoxin;
  • flecainide;
  • encainide;
  • disopyramide.

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Alcohol or Tobacco


Using alcohol or tobacco with this third-generation beta-blocker may cause unpleasant interactions to occur.

Discuss with your doctor the use of your medicine with alcohol, or tobacco.


Talk to your healthcare provider before using alcohol while taking this beta-blocker.

However, if you drink alcoholic beverages while taking this medication, your blood pressure may decrease to levels that are lower than normal.

Is It Safe During Pregnancy or Breastfeeding?


It is not recommended that breastfeeding mothers take this medicine.

Also, using it during pregnancy may cause harm to a developing fetus.


There is no conclusive evidence as to whether this medication might harm your baby if taken while breastfeeding. Also, there are no adequate clinical studies to determine how this beta-blocker might affect you if you are pregnant.

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Conclusion – Bystolic vs Coreg (Carvedilol)

Bystolic (generic name – nebivolol) is a prescription medicine that is used to treat high blood pressure (hypertension). Also, it has been paired with the angiotensin receptor blocker valsartan, another blood pressure-lowering medication.

Coreg (generic name – carvedilol) is a prescription medicine that is used to treat heart failure and high blood pressure. It is the first beta-blocker approved for the treatment of all forms of congestive heart failure.

As per a 2017 study, Bystolic has a unique mechanism of action involving the release of nitric oxide (a vasodilator that causes the blood vessels to widen), resulting in penile vasodilation, that may be beneficial in male patients with a history of high blood pressure.



Saturday 3rd of December 2022

I am taking carvedilol 12.5 mg twice a day and bystolic 25 mg once a day.Was told by pharmacist these are same medications. Should I be taking both ? 82 years old