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Identification
NameNebivolol
Accession NumberDB04861
TypeSmall Molecule
GroupsApproved, Investigational
Description

Nebivolol is a highly cardioselective vasodilatory beta1 receptor blocker used in treatment of hypertension. In most countries, this medication is available only by prescription. [Wikipedia]

Structure
Thumb
Synonyms
1,1'-[Bis(6-fluoro-3,4-dihydro-2H-1-benzopyran-2-yl)]-2,2'-iminodiethanol
1,1'-Bis(6-fluoro-3,4-dihydro-2H-1-benzopyran-2-yl)-2,2'-iminodiethanol
alpha,alpha'-(iminobismethylene)bis-(6-fluoro-3,4-dihydro-2H-1-benzopyran-2-methanol)
alpha,alpha'-(iminodimethylene)bis-(6-fluoro-2-chromanmethanol)
Narbivolol
Nebivololum
External Identifiers
  • PI-21858
  • R65,824
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Bystolictablet20.0 mgoralForest Laboratories Canada Inc2013-04-02Not applicableCanada
Bystolictablet2.5 mg/1oralForest Laboratories, Inc.2008-01-22Not applicableUs
Bystolictablet5 mg/1oralCardinal Health2008-01-22Not applicableUs
Bystolictablet10.0 mgoralForest Laboratories Canada Inc2013-04-02Not applicableCanada
Bystolictablet10 mg/1oralPhysicians Total Care, Inc.2009-04-15Not applicableUs
Bystolictablet5.0 mgoralForest Laboratories Canada Inc2013-04-02Not applicableCanada
Bystolictablet5 mg/1oralPhysicians Total Care, Inc.2008-10-02Not applicableUs
Bystolictablet2.5 mgoralForest Laboratories Canada Inc2013-04-02Not applicableCanada
Bystolictablet20 mg/1oralForest Laboratories, Inc.2008-01-22Not applicableUs
Bystolictablet10 mg/1oralCarilion Materials Management2008-01-22Not applicableUs
Bystolictablet10 mg/1oralForest Laboratories, Inc.2008-01-22Not applicableUs
Bystolictablet10 mg/1oralCardinal Health2008-01-22Not applicableUs
Bystolictablet5 mg/1oralAvera Mc Kennan Hospital2015-03-19Not applicableUs
Bystolictablet5 mg/1oralForest Laboratories, Inc.2008-01-22Not applicableUs
Bystolictablet20 mg/1oralCardinal Health2008-01-22Not applicableUs
Approved Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Nebivololtablet2.5 mg/1oralAmerigen Pharmaceuticals Inc.2015-04-28Not applicableUs
Nebivololtablet20 mg/1oralAmerigen Pharmaceuticals Inc.2015-04-28Not applicableUs
Nebivololtablet10 mg/1oralAmerigen Pharmaceuticals Inc.2015-04-28Not applicableUs
Nebivololtablet5 mg/1oralAmerigen Pharmaceuticals Inc.2015-04-28Not applicableUs
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International Brands
NameCompany
LobivonNot Available
NebicardNot Available
NebiletNot Available
NebilongNot Available
NodonNot Available
NubetaNot Available
Brand mixturesNot Available
Salts
Name/CASStructureProperties
Nebivolol hydrochloride
152520-56-4
ThumbNot applicableDBSALT001027
Categories
UNII030Y90569U
CAS number118457-14-0
WeightAverage: 405.435
Monoisotopic: 405.175164703
Chemical FormulaC22H25F2NO4
InChI KeyInChIKey=KOHIRBRYDXPAMZ-UHFFFAOYSA-N
InChI
InChI=1S/C22H25F2NO4/c23-15-3-7-19-13(9-15)1-5-21(28-19)17(26)11-25-12-18(27)22-6-2-14-10-16(24)4-8-20(14)29-22/h3-4,7-10,17-18,21-22,25-27H,1-2,5-6,11-12H2
IUPAC Name
1-(6-fluoro-3,4-dihydro-2H-1-benzopyran-2-yl)-2-{[2-(6-fluoro-3,4-dihydro-2H-1-benzopyran-2-yl)-2-hydroxyethyl]amino}ethan-1-ol
SMILES
OC(CNCC(O)C1CCC2=C(O1)C=CC(F)=C2)C1CCC2=C(O1)C=CC(F)=C2
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as 1-benzopyrans. These are organic aromatic compounds that 1-benzopyran, a bicyclic compound made up of a benzene ring fused to a pyran, so that the oxygen atom is at the 1-position.
KingdomOrganic compounds
Super ClassOrganoheterocyclic compounds
ClassBenzopyrans
Sub Class1-benzopyrans
Direct Parent1-benzopyrans
Alternative Parents
Substituents
  • 1-benzopyran
  • Aralkylamine
  • Fluorobenzene
  • Alkyl aryl ether
  • Benzenoid
  • Aryl halide
  • Aryl fluoride
  • Secondary alcohol
  • 1,2-aminoalcohol
  • Oxacycle
  • Secondary amine
  • Ether
  • Secondary aliphatic amine
  • Hydrocarbon derivative
  • Organooxygen compound
  • Organonitrogen compound
  • Organofluoride
  • Organohalogen compound
  • Amine
  • Alcohol
  • Aromatic heteropolycyclic compound
Molecular FrameworkAromatic heteropolycyclic compounds
External DescriptorsNot Available
Pharmacology
IndicationFor the treatment of essential hypertension.
PharmacodynamicsNebivolol is a competitive and highly selective beta-1 receptor antagonist with mild vasodilating properties, possibly due to an interaction with the L-arginine/nitric oxide pathway. In preclinical studies, nebivolol has been shown to induce endothelium-dependent arterial relaxation in a dose dependent manner, by stimulation of the release of endothelial nitric oxide. Nitric oxide acts to relax vascular smooth muscle cells and inhibits platelet aggregation and adhesion.
Mechanism of actionNebivolol is a selective β1-receptor antagonist. Activation of β1-receptors by epinephrine increases the heart rate and the blood pressure, and the heart consumes more oxygen. Nebivolol blocks these receptors which reverses the effects of epinephrine, lowering the heart rate and blood pressure. In addition, beta blockers prevent the release of renin, which is a hormone produced by the kidneys which leads to constriction of blood vessels. At high enough concentrations, this drug may also bind beta 2 receptors.
Related Articles
AbsorptionThe absorption of nebivolol is rapid and not affected by food.
Volume of distributionNot Available
Protein binding98%
Metabolism

Hepatic (CYP2D6-mediated)

Route of eliminationNot Available
Half life10 hours
ClearanceNot Available
ToxicityThe most common signs and symptoms associated with nebivolol overdosage are bradycardia and hypotension. Other important adverse events reported with nebivolol overdose include cardiac failure, dizziness, hypoglycemia, fatigue and vomiting. Other adverse events associated with β-blocker overdose include bronchospasm and heart block. The largest known ingestion of nebivolol worldwide involved a patient who ingested up to 500 mg of nebivolol along with several 100 mg tablets of acetylsalicylic acid in a suicide attempt. The patient experienced hyperhydrosis, pallor, depressed level of consciousness, hypokinesia, hypotension, sinus bradycardia, hypoglycemia, hypokalemia, respiratory failure and vomiting. The patient recovered.
Affected organisms
  • Humans and other mammals
Pathways
PathwayCategorySMPDB ID
Nebivolol Action PathwayDrug actionSMP00366
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.8483
Blood Brain Barrier+0.7802
Caco-2 permeable-0.5549
P-glycoprotein substrateSubstrate0.7928
P-glycoprotein inhibitor INon-inhibitor0.7443
P-glycoprotein inhibitor IINon-inhibitor0.567
Renal organic cation transporterNon-inhibitor0.8016
CYP450 2C9 substrateNon-substrate0.8738
CYP450 2D6 substrateNon-substrate0.7248
CYP450 3A4 substrateNon-substrate0.6822
CYP450 1A2 substrateInhibitor0.5145
CYP450 2C9 inhibitorNon-inhibitor0.7876
CYP450 2D6 inhibitorNon-inhibitor0.5994
CYP450 2C19 inhibitorNon-inhibitor0.5923
CYP450 3A4 inhibitorNon-inhibitor0.9441
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.8336
Ames testNon AMES toxic0.7132
CarcinogenicityNon-carcinogens0.9402
BiodegradationNot ready biodegradable0.9953
Rat acute toxicity2.7228 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Strong inhibitor0.5769
hERG inhibition (predictor II)Inhibitor0.8381
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
ManufacturersNot Available
Packagers
Dosage forms
FormRouteStrength
Tabletoral10 mg/1
Tabletoral10.0 mg
Tabletoral2.5 mg/1
Tabletoral2.5 mg
Tabletoral20 mg/1
Tabletoral20.0 mg
Tabletoral5 mg/1
Tabletoral5.0 mg
Prices
Unit descriptionCostUnit
Bystolic 10 mg tablet2.09USD tablet
Bystolic 20 mg tablet2.09USD tablet
Bystolic 2.5 mg tablet2.06USD tablet
Bystolic 5 mg tablet2.06USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US5759580 No1995-06-022015-06-02Us
US6545040 No2001-12-172021-12-17Us
Properties
StateSolid
Experimental PropertiesNot Available
Predicted Properties
PropertyValueSource
Water Solubility0.0403 mg/mLALOGPS
logP2.44ALOGPS
logP3.21ChemAxon
logS-4ALOGPS
pKa (Strongest Acidic)13.52ChemAxon
pKa (Strongest Basic)8.9ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count5ChemAxon
Hydrogen Donor Count3ChemAxon
Polar Surface Area70.95 Å2ChemAxon
Rotatable Bond Count6ChemAxon
Refractivity103.32 m3·mol-1ChemAxon
Polarizability41.98 Å3ChemAxon
Number of Rings4ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Spectra
Mass Spec (NIST)Not Available
Spectra
Spectrum TypeDescriptionSplash Key
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, NegativeNot Available
References
Synthesis Reference

Thomas Bader, Alfred Stutz, Harald Hofmeier, Hans-Ulrich Bichsel, “Process for preparation of racemic Nebivolol.” U.S. Patent US20070149612, issued June 28, 2007.

US20070149612
General References
  1. Gielen W, Cleophas TJ, Agrawal R: Nebivolol: a review of its clinical and pharmacological characteristics. Int J Clin Pharmacol Ther. 2006 Aug;44(8):344-57. [PubMed:16961165 ]
External Links
ATC CodesC07FB12C07AB12C07BB12
AHFS CodesNot Available
PDB EntriesNot Available
FDA labelNot Available
MSDSDownload (69.1 KB)
Interactions
Drug Interactions
Drug
7,8-DICHLORO-1,2,3,4-TETRAHYDROISOQUINOLINE7,8-DICHLORO-1,2,3,4-TETRAHYDROISOQUINOLINE may increase the hypotensive activities of Nebivolol.
AbirateroneThe serum concentration of Nebivolol can be increased when it is combined with Abiraterone.
AcebutololAcebutolol may increase the hypotensive activities of Nebivolol.
AcetazolamideThe risk or severity of adverse effects can be increased when Acetazolamide is combined with Nebivolol.
AldesleukinThe risk or severity of adverse effects can be increased when Aldesleukin is combined with Nebivolol.
AlfuzosinAlfuzosin may increase the hypotensive activities of Nebivolol.
AliskirenNebivolol may increase the hypotensive activities of Aliskiren.
AlprenololAlprenolol may increase the hypotensive activities of Nebivolol.
AmbrisentanNebivolol may increase the hypotensive activities of Ambrisentan.
AmifostineNebivolol may increase the hypotensive activities of Amifostine.
AmilorideThe risk or severity of adverse effects can be increased when Amiloride is combined with Nebivolol.
AminophyllineNebivolol may decrease the bronchodilatory activities of Aminophylline.
AmiodaroneThe serum concentration of Nebivolol can be increased when it is combined with Amiodarone.
AmiodaroneNebivolol may increase the bradycardic activities of Amiodarone.
AmlodipineAmlodipine may increase the hypotensive activities of Nebivolol.
AmobarbitalAmobarbital may increase the hypotensive activities of Nebivolol.
Amyl NitriteThe risk or severity of adverse effects can be increased when Amyl Nitrite is combined with Nebivolol.
ApraclonidineThe risk or severity of adverse effects can be increased when Apraclonidine is combined with Nebivolol.
ArbutamineNebivolol may decrease the bronchodilatory activities of Arbutamine.
ArformoterolNebivolol may decrease the bronchodilatory activities of Arformoterol.
AripiprazoleAripiprazole may increase the hypotensive activities of Nebivolol.
ArtemetherThe serum concentration of Nebivolol can be increased when it is combined with Artemether.
AtenololAtenolol may increase the hypotensive activities of Nebivolol.
AtomoxetineThe serum concentration of Nebivolol can be increased when it is combined with Atomoxetine.
Azilsartan medoxomilThe risk or severity of adverse effects can be increased when Nebivolol is combined with Azilsartan medoxomil.
BambuterolNebivolol may decrease the bronchodilatory activities of Bambuterol.
BarbitalBarbital may increase the hypotensive activities of Nebivolol.
BenazeprilBenazepril may increase the hypotensive activities of Nebivolol.
BendroflumethiazideBendroflumethiazide may increase the hypotensive activities of Nebivolol.
BenmoxinBenmoxin may increase the hypotensive activities of Nebivolol.
BepridilBepridil may increase the hypotensive activities of Nebivolol.
BeractantNebivolol may increase the bradycardic activities of Beractant.
BetaxololThe serum concentration of Nebivolol can be increased when it is combined with Betaxolol.
BetaxololNebivolol may increase the hypotensive activities of Betaxolol.
BethanidineBethanidine may increase the hypotensive activities of Nebivolol.
BimatoprostBimatoprost may increase the hypotensive activities of Nebivolol.
BisoprololBisoprolol may increase the hypotensive activities of Nebivolol.
BosentanBosentan may increase the hypotensive activities of Nebivolol.
BretyliumBretylium may increase the bradycardic activities of Nebivolol.
BretyliumNebivolol may increase the hypotensive activities of Bretylium.
BrimonidineNebivolol may increase the hypotensive activities of Brimonidine.
BrimonidineBrimonidine may increase the antihypertensive activities of Nebivolol.
BumetanideThe risk or severity of adverse effects can be increased when Bumetanide is combined with Nebivolol.
BupranololNebivolol may increase the hypotensive activities of Bupranolol.
BupropionThe serum concentration of Nebivolol can be increased when it is combined with Bupropion.
CalfactantNebivolol may increase the bradycardic activities of Calfactant.
CanagliflozinThe risk or severity of adverse effects can be increased when Nebivolol is combined with Canagliflozin.
CandesartanCandesartan may increase the hypotensive activities of Nebivolol.
CandoxatrilCandoxatril may increase the hypotensive activities of Nebivolol.
CaptoprilCaptopril may increase the hypotensive activities of Nebivolol.
CaroxazoneCaroxazone may increase the hypotensive activities of Nebivolol.
CarteololCarteolol may increase the hypotensive activities of Nebivolol.
CarvedilolCarvedilol may increase the hypotensive activities of Nebivolol.
CelecoxibThe serum concentration of Nebivolol can be increased when it is combined with Celecoxib.
CeliprololCeliprolol may increase the hypotensive activities of Nebivolol.
CeritinibNebivolol may increase the bradycardic activities of Ceritinib.
ChloroquineThe serum concentration of Nebivolol can be increased when it is combined with Chloroquine.
ChlorothiazideChlorothiazide may increase the hypotensive activities of Nebivolol.
ChlorpromazineThe serum concentration of Nebivolol can be increased when it is combined with Chlorpromazine.
ChlorthalidoneChlorthalidone may increase the hypotensive activities of Nebivolol.
CholecalciferolThe serum concentration of Nebivolol can be increased when it is combined with Cholecalciferol.
CilazaprilCilazapril may increase the hypotensive activities of Nebivolol.
CimetidineThe serum concentration of Nebivolol can be increased when it is combined with Cimetidine.
CinacalcetThe serum concentration of Nebivolol can be increased when it is combined with Cinacalcet.
CitalopramThe serum concentration of Nebivolol can be increased when it is combined with Citalopram.
ClemastineThe serum concentration of Nebivolol can be increased when it is combined with Clemastine.
ClenbuterolNebivolol may decrease the bronchodilatory activities of Clenbuterol.
ClevidipineThe risk or severity of adverse effects can be increased when Nebivolol is combined with Clevidipine.
ClobazamThe serum concentration of Nebivolol can be increased when it is combined with Clobazam.
ClomipramineThe serum concentration of Nebivolol can be increased when it is combined with Clomipramine.
ClonidineClonidine may increase the hypotensive activities of Nebivolol.
ClotrimazoleThe serum concentration of Nebivolol can be increased when it is combined with Clotrimazole.
ClozapineThe serum concentration of Nebivolol can be increased when it is combined with Clozapine.
CobicistatThe serum concentration of Nebivolol can be increased when it is combined with Cobicistat.
CocaineThe serum concentration of Nebivolol can be increased when it is combined with Cocaine.
CrizotinibNebivolol may increase the bradycardic activities of Crizotinib.
CryptenamineCryptenamine may increase the hypotensive activities of Nebivolol.
CyclothiazideCyclothiazide may increase the hypotensive activities of Nebivolol.
DapagliflozinThe risk or severity of adverse effects can be increased when Nebivolol is combined with Dapagliflozin.
DarifenacinThe serum concentration of Nebivolol can be increased when it is combined with Darifenacin.
DarunavirThe serum concentration of Nebivolol can be increased when it is combined with Darunavir.
DebrisoquinDebrisoquin may increase the hypotensive activities of Nebivolol.
DelavirdineThe serum concentration of Nebivolol can be increased when it is combined with Delavirdine.
DeserpidineNebivolol may increase the hypotensive activities of Deserpidine.
DesipramineThe serum concentration of Nebivolol can be increased when it is combined with Desipramine.
DexmedetomidineThe risk or severity of adverse effects can be increased when Dexmedetomidine is combined with Nebivolol.
DiazoxideDiazoxide may increase the hypotensive activities of Nebivolol.
DiclofenamideThe risk or severity of adverse effects can be increased when Diclofenamide is combined with Nebivolol.
DigoxinDigoxin may increase the bradycardic activities of Nebivolol.
DiltiazemDiltiazem may increase the hypotensive activities of Nebivolol.
DinutuximabThe risk or severity of adverse effects can be increased when Nebivolol is combined with Dinutuximab.
DiphenhydramineThe serum concentration of Nebivolol can be increased when it is combined with Diphenhydramine.
DipivefrinNebivolol may decrease the bronchodilatory activities of Dipivefrin.
DipyridamoleThe risk or severity of adverse effects can be increased when Dipyridamole is combined with Nebivolol.
DobutamineNebivolol may decrease the bronchodilatory activities of Dobutamine.
DonepezilDonepezil may increase the bradycardic activities of Nebivolol.
DorzolamideDorzolamide may increase the hypotensive activities of Nebivolol.
DoxazosinDoxazosin may increase the hypotensive activities of Nebivolol.
DronedaroneThe serum concentration of Nebivolol can be increased when it is combined with Dronedarone.
DronedaroneNebivolol may increase the bradycardic activities of Dronedarone.
DroxidopaNebivolol may decrease the bronchodilatory activities of Droxidopa.
DuloxetineNebivolol may increase the orthostatic hypotensive activities of Duloxetine.
DuloxetineThe serum concentration of Nebivolol can be increased when it is combined with Duloxetine.
DyphyllineNebivolol may decrease the bronchodilatory activities of Dyphylline.
EfonidipineNebivolol may increase the hypotensive activities of Efonidipine.
EliglustatThe serum concentration of Nebivolol can be increased when it is combined with Eliglustat.
EmpagliflozinThe risk or severity of adverse effects can be increased when Nebivolol is combined with Empagliflozin.
EnalaprilEnalapril may increase the hypotensive activities of Nebivolol.
EnalaprilatNebivolol may increase the hypotensive activities of Enalaprilat.
EphedraNebivolol may decrease the bronchodilatory activities of Ephedra.
EpinephrineNebivolol may decrease the bronchodilatory activities of Epinephrine.
EplerenoneThe risk or severity of adverse effects can be increased when Eplerenone is combined with Nebivolol.
EpoprostenolEpoprostenol may increase the hypotensive activities of Nebivolol.
EprosartanEprosartan may increase the hypotensive activities of Nebivolol.
EsmololThe risk or severity of adverse effects can be increased when Esmolol is combined with Nebivolol.
Etacrynic acidThe risk or severity of adverse effects can be increased when Etacrynic acid is combined with Nebivolol.
FelodipineFelodipine may increase the hypotensive activities of Nebivolol.
FenoldopamFenoldopam may increase the hypotensive activities of Nebivolol.
FenoterolNebivolol may decrease the bronchodilatory activities of Fenoterol.
FingolimodNebivolol may increase the bradycardic activities of Fingolimod.
FluoxetineThe serum concentration of Nebivolol can be increased when it is combined with Fluoxetine.
FluvoxamineThe serum concentration of Nebivolol can be increased when it is combined with Fluvoxamine.
FormoterolNebivolol may decrease the bronchodilatory activities of Formoterol.
FosinoprilFosinopril may increase the hypotensive activities of Nebivolol.
FurazolidoneFurazolidone may increase the hypotensive activities of Nebivolol.
FurosemideThe risk or severity of adverse effects can be increased when Furosemide is combined with Nebivolol.
GalantamineGalantamine may increase the bradycardic activities of Nebivolol.
GuanabenzGuanabenz may increase the hypotensive activities of Nebivolol.
GuanadrelGuanadrel may increase the hypotensive activities of Nebivolol.
GuanethidineGuanethidine may increase the hypotensive activities of Nebivolol.
GuanfacineGuanfacine may increase the hypotensive activities of Nebivolol.
HaloperidolThe serum concentration of Nebivolol can be increased when it is combined with Haloperidol.
HexamethoniumNebivolol may increase the hypotensive activities of Hexamethonium.
HexobarbitalHexobarbital may increase the hypotensive activities of Nebivolol.
HydracarbazineHydracarbazine may increase the hypotensive activities of Nebivolol.
HydralazineHydralazine may increase the hypotensive activities of Nebivolol.
HydrochlorothiazideHydrochlorothiazide may increase the hypotensive activities of Nebivolol.
HydroflumethiazideHydroflumethiazide may increase the hypotensive activities of Nebivolol.
IloprostIloprost may increase the hypotensive activities of Nebivolol.
ImipramineThe serum concentration of Nebivolol can be increased when it is combined with Imipramine.
IndacaterolNebivolol may decrease the bronchodilatory activities of Indacaterol.
IndapamideIndapamide may increase the hypotensive activities of Nebivolol.
IndenololNebivolol may increase the hypotensive activities of Indenolol.
IndinavirThe serum concentration of Nebivolol can be increased when it is combined with Indinavir.
IndoraminNebivolol may increase the hypotensive activities of Indoramin.
IproclozideIproclozide may increase the hypotensive activities of Nebivolol.
IproniazidIproniazid may increase the hypotensive activities of Nebivolol.
IrbesartanIrbesartan may increase the hypotensive activities of Nebivolol.
IsocarboxazidIsocarboxazid may increase the hypotensive activities of Nebivolol.
IsoetarineNebivolol may decrease the bronchodilatory activities of Isoetarine.
IsoniazidThe serum concentration of Nebivolol can be increased when it is combined with Isoniazid.
IsoprenalineNebivolol may decrease the bronchodilatory activities of Isoprenaline.
Isosorbide DinitrateThe risk or severity of adverse effects can be increased when Isosorbide Dinitrate is combined with Nebivolol.
Isosorbide MononitrateThe risk or severity of adverse effects can be increased when Isosorbide Mononitrate is combined with Nebivolol.
IsoxsuprineThe risk or severity of adverse effects can be increased when Nebivolol is combined with Isoxsuprine.
IsradipineIsradipine may increase the hypotensive activities of Nebivolol.
IvabradineNebivolol may increase the bradycardic activities of Ivabradine.
KetoconazoleThe serum concentration of Nebivolol can be increased when it is combined with Ketoconazole.
LabetalolLabetalol may increase the hypotensive activities of Nebivolol.
LacidipineNebivolol may increase the hypotensive activities of Lacidipine.
LacosamideNebivolol may increase the atrioventricular blocking (AV block) activities of Lacosamide.
LanreotideNebivolol may increase the bradycardic activities of Lanreotide.
LatanoprostLatanoprost may increase the hypotensive activities of Nebivolol.
LercanidipineLercanidipine may increase the hypotensive activities of Nebivolol.
LevobunololThe risk or severity of adverse effects can be increased when Levobunolol is combined with Nebivolol.
LevodopaNebivolol may increase the orthostatic hypotensive activities of Levodopa.
LisinoprilLisinopril may increase the hypotensive activities of Nebivolol.
LofexidineNebivolol may increase the hypotensive activities of Lofexidine.
LopinavirThe serum concentration of Nebivolol can be increased when it is combined with Lopinavir.
LorcaserinThe serum concentration of Nebivolol can be increased when it is combined with Lorcaserin.
LosartanLosartan may increase the hypotensive activities of Nebivolol.
LucinactantNebivolol may increase the bradycardic activities of Lucinactant.
LumefantrineThe serum concentration of Nebivolol can be increased when it is combined with Lumefantrine.
MacitentanNebivolol may increase the hypotensive activities of Macitentan.
ManidipineNebivolol may increase the hypotensive activities of Manidipine.
MannitolThe risk or severity of adverse effects can be increased when Mannitol is combined with Nebivolol.
MebanazineMebanazine may increase the hypotensive activities of Nebivolol.
MecamylamineMecamylamine may increase the hypotensive activities of Nebivolol.
MethadoneThe serum concentration of Nebivolol can be increased when it is combined with Methadone.
MethazolamideThe risk or severity of adverse effects can be increased when Methazolamide is combined with Nebivolol.
MethohexitalMethohexital may increase the hypotensive activities of Nebivolol.
MethotrimeprazineThe serum concentration of Nebivolol can be increased when it is combined with Methotrimeprazine.
MethyclothiazideThe risk or severity of adverse effects can be increased when Methyclothiazide is combined with Nebivolol.
MethyldopaMethyldopa may increase the hypotensive activities of Nebivolol.
Methylene blueMethylene blue may increase the hypotensive activities of Nebivolol.
MethylphenidateMethylphenidate may decrease the antihypertensive activities of Nebivolol.
MethylphenobarbitalMethylphenobarbital may increase the hypotensive activities of Nebivolol.
MetipranololMetipranolol may increase the hypotensive activities of Nebivolol.
MetolazoneMetolazone may increase the hypotensive activities of Nebivolol.
MetoprololThe serum concentration of Nebivolol can be increased when it is combined with Metoprolol.
MetoprololNebivolol may increase the hypotensive activities of Metoprolol.
MibefradilMibefradil may increase the hypotensive activities of Nebivolol.
MinaprineMinaprine may increase the hypotensive activities of Nebivolol.
MinoxidilMinoxidil may increase the hypotensive activities of Nebivolol.
MirabegronThe serum concentration of Nebivolol can be increased when it is combined with Mirabegron.
MoclobemideMoclobemide may increase the hypotensive activities of Nebivolol.
MoexiprilMoexipril may increase the hypotensive activities of Nebivolol.
MolsidomineMolsidomine may increase the hypotensive activities of Nebivolol.
MoxonidineNebivolol may increase the hypotensive activities of Moxonidine.
NadololNadolol may increase the hypotensive activities of Nebivolol.
NesiritideThe risk or severity of adverse effects can be increased when Nebivolol is combined with Nesiritide.
NevirapineThe serum concentration of Nebivolol can be increased when it is combined with Nevirapine.
NialamideNialamide may increase the hypotensive activities of Nebivolol.
NicardipineThe serum concentration of Nebivolol can be increased when it is combined with Nicardipine.
NicardipineNebivolol may increase the hypotensive activities of Nicardipine.
NicorandilNicorandil may increase the hypotensive activities of Nebivolol.
NifedipineThe risk or severity of adverse effects can be increased when Nifedipine is combined with Nebivolol.
NiguldipineNebivolol may increase the hypotensive activities of Niguldipine.
NilotinibThe serum concentration of Nebivolol can be increased when it is combined with Nilotinib.
NilvadipineNebivolol may increase the hypotensive activities of Nilvadipine.
NimodipineNimodipine may increase the hypotensive activities of Nebivolol.
NisoldipineNisoldipine may increase the hypotensive activities of Nebivolol.
NitrendipineNitrendipine may increase the hypotensive activities of Nebivolol.
NitroglycerinThe risk or severity of adverse effects can be increased when Nitroglycerin is combined with Nebivolol.
NitroprussideNitroprusside may increase the hypotensive activities of Nebivolol.
NorepinephrineNebivolol may decrease the bronchodilatory activities of Norepinephrine.
ObinutuzumabNebivolol may increase the hypotensive activities of Obinutuzumab.
OctamoxinOctamoxin may increase the hypotensive activities of Nebivolol.
OctreotideOctreotide may increase the bradycardic activities of Nebivolol.
OlmesartanOlmesartan may increase the hypotensive activities of Nebivolol.
OlodaterolNebivolol may decrease the bronchodilatory activities of Olodaterol.
OmapatrilatOmapatrilat may increase the hypotensive activities of Nebivolol.
OrciprenalineNebivolol may decrease the bronchodilatory activities of Orciprenaline.
OxprenololOxprenolol may increase the hypotensive activities of Nebivolol.
PanobinostatThe serum concentration of Nebivolol can be increased when it is combined with Panobinostat.
PapaverineThe risk or severity of adverse effects can be increased when Papaverine is combined with Nebivolol.
PargylinePargyline may increase the hypotensive activities of Nebivolol.
ParoxetineThe serum concentration of Nebivolol can be increased when it is combined with Paroxetine.
PasireotideNebivolol may increase the bradycardic activities of Pasireotide.
Peginterferon alfa-2bThe serum concentration of Nebivolol can be decreased when it is combined with Peginterferon alfa-2b.
PenbutololPenbutolol may increase the hypotensive activities of Nebivolol.
PentobarbitalPentobarbital may increase the hypotensive activities of Nebivolol.
PentoliniumPentolinium may increase the hypotensive activities of Nebivolol.
PentoxifyllinePentoxifylline may increase the hypotensive activities of Nebivolol.
PerindoprilPerindopril may increase the hypotensive activities of Nebivolol.
PhenelzinePhenelzine may increase the hypotensive activities of Nebivolol.
PheniprazinePheniprazine may increase the hypotensive activities of Nebivolol.
PhenobarbitalPhenobarbital may increase the hypotensive activities of Nebivolol.
PhenoxybenzaminePhenoxybenzamine may increase the hypotensive activities of Nebivolol.
PhenoxypropazinePhenoxypropazine may increase the hypotensive activities of Nebivolol.
PhentolaminePhentolamine may increase the hypotensive activities of Nebivolol.
PhenylpropanolamineNebivolol may decrease the bronchodilatory activities of Phenylpropanolamine.
PinacidilNebivolol may increase the hypotensive activities of Pinacidil.
PindololPindolol may increase the hypotensive activities of Nebivolol.
PirbuterolNebivolol may decrease the bronchodilatory activities of Pirbuterol.
PirlindolePirlindole may increase the hypotensive activities of Nebivolol.
PivhydrazinePivhydrazine may increase the hypotensive activities of Nebivolol.
PolythiazidePolythiazide may increase the hypotensive activities of Nebivolol.
Poractant alfaNebivolol may increase the bradycardic activities of Poractant alfa.
PrazosinPrazosin may increase the hypotensive activities of Nebivolol.
PrimidonePrimidone may increase the hypotensive activities of Nebivolol.
ProcaterolNebivolol may decrease the bronchodilatory activities of Procaterol.
PromazineThe serum concentration of Nebivolol can be increased when it is combined with Promazine.
PropafenonePropafenone may increase the bradycardic activities of Nebivolol.
PropranololPropranolol may increase the hypotensive activities of Nebivolol.
QuetiapineThe risk or severity of adverse effects can be increased when Quetiapine is combined with Nebivolol.
QuinaprilQuinapril may increase the hypotensive activities of Nebivolol.
QuinidineThe serum concentration of Nebivolol can be increased when it is combined with Quinidine.
QuinineThe serum concentration of Nebivolol can be increased when it is combined with Quinine.
RamiprilRamipril may increase the hypotensive activities of Nebivolol.
RanolazineThe serum concentration of Nebivolol can be increased when it is combined with Ranolazine.
RasagilineRasagiline may increase the hypotensive activities of Nebivolol.
RemikirenRemikiren may increase the hypotensive activities of Nebivolol.
RescinnamineNebivolol may increase the hypotensive activities of Rescinnamine.
ReserpineReserpine may increase the hypotensive activities of Nebivolol.
RiociguatNebivolol may increase the hypotensive activities of Riociguat.
RisperidoneNebivolol may increase the hypotensive activities of Risperidone.
RitodrineNebivolol may decrease the bronchodilatory activities of Ritodrine.
RitonavirThe serum concentration of Nebivolol can be increased when it is combined with Ritonavir.
RituximabNebivolol may increase the hypotensive activities of Rituximab.
RivastigmineRivastigmine may increase the bradycardic activities of Nebivolol.
RolapitantThe serum concentration of Nebivolol can be increased when it is combined with Rolapitant.
RopiniroleThe serum concentration of Nebivolol can be increased when it is combined with Ropinirole.
RuxolitinibRuxolitinib may increase the bradycardic activities of Nebivolol.
SafrazineSafrazine may increase the hypotensive activities of Nebivolol.
SalbutamolNebivolol may decrease the bronchodilatory activities of Salbutamol.
SalmeterolNebivolol may decrease the bronchodilatory activities of Salmeterol.
SaprisartanSaprisartan may increase the hypotensive activities of Nebivolol.
SecobarbitalSecobarbital may increase the hypotensive activities of Nebivolol.
SelegilineSelegiline may increase the hypotensive activities of Nebivolol.
SelexipagNebivolol may increase the hypotensive activities of Selexipag.
SertralineThe serum concentration of Nebivolol can be increased when it is combined with Sertraline.
SildenafilSildenafil may increase the antihypertensive activities of Nebivolol.
SitaxentanNebivolol may increase the hypotensive activities of Sitaxentan.
SotalolThe risk or severity of adverse effects can be increased when Sotalol is combined with Nebivolol.
SpiraprilSpirapril may increase the hypotensive activities of Nebivolol.
SpironolactoneThe risk or severity of adverse effects can be increased when Spironolactone is combined with Nebivolol.
StiripentolThe serum concentration of Nebivolol can be increased when it is combined with Stiripentol.
SufentanilSufentanil may increase the bradycardic activities of Nebivolol.
TadalafilTadalafil may increase the antihypertensive activities of Nebivolol.
TelmisartanTelmisartan may increase the hypotensive activities of Nebivolol.
TemocaprilNebivolol may increase the hypotensive activities of Temocapril.
TerazosinThe risk or severity of adverse effects can be increased when Terazosin is combined with Nebivolol.
TerbinafineThe serum concentration of Nebivolol can be increased when it is combined with Terbinafine.
TerbutalineNebivolol may decrease the bronchodilatory activities of Terbutaline.
TerlipressinTerlipressin may increase the hypotensive activities of Nebivolol.
TheophyllineNebivolol may decrease the bronchodilatory activities of Theophylline.
ThiamylalThiamylal may increase the hypotensive activities of Nebivolol.
ThiopentalThiopental may increase the hypotensive activities of Nebivolol.
ThioridazineThe serum concentration of Nebivolol can be increased when it is combined with Thioridazine.
TiboloneNebivolol may increase the hypotensive activities of Tibolone.
TiclopidineThe serum concentration of Nebivolol can be increased when it is combined with Ticlopidine.
TicrynafenTicrynafen may increase the hypotensive activities of Nebivolol.
TimololTimolol may increase the hypotensive activities of Nebivolol.
TipranavirThe serum concentration of Nebivolol can be increased when it is combined with Tipranavir.
TizanidineThe risk or severity of adverse effects can be increased when Tizanidine is combined with Nebivolol.
TofacitinibTofacitinib may increase the bradycardic activities of Nebivolol.
TolazolineTolazoline may increase the hypotensive activities of Nebivolol.
ToloxatoneToloxatone may increase the hypotensive activities of Nebivolol.
TorasemideTorasemide may increase the hypotensive activities of Nebivolol.
TrandolaprilTrandolapril may increase the hypotensive activities of Nebivolol.
Trans-2-PhenylcyclopropylamineTrans-2-Phenylcyclopropylamine may increase the hypotensive activities of Nebivolol.
TranylcypromineThe serum concentration of Nebivolol can be increased when it is combined with Tranylcypromine.
TravoprostTravoprost may increase the hypotensive activities of Nebivolol.
TreprostinilTreprostinil may increase the hypotensive activities of Nebivolol.
TriamtereneThe risk or severity of adverse effects can be increased when Triamterene is combined with Nebivolol.
TrichlormethiazideTrichlormethiazide may increase the hypotensive activities of Nebivolol.
TrimazosinNebivolol may increase the hypotensive activities of Trimazosin.
TrimethaphanTrimethaphan may increase the hypotensive activities of Nebivolol.
UdenafilUdenafil may increase the antihypertensive activities of Nebivolol.
UnoprostoneNebivolol may increase the hypotensive activities of Unoprostone.
ValsartanValsartan may increase the hypotensive activities of Nebivolol.
VardenafilVardenafil may increase the antihypertensive activities of Nebivolol.
VenlafaxineThe serum concentration of Nebivolol can be increased when it is combined with Venlafaxine.
VerapamilThe risk or severity of adverse effects can be increased when Verapamil is combined with Nebivolol.
VilanterolNebivolol may decrease the bronchodilatory activities of Vilanterol.
XylometazolineNebivolol may increase the hypotensive activities of Xylometazoline.
YohimbineYohimbine may decrease the antihypertensive activities of Nebivolol.
ZiprasidoneThe serum concentration of Nebivolol can be increased when it is combined with Ziprasidone.
Food InteractionsNot Available

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
antagonist
General Function:
Receptor signaling protein activity
Specific Function:
Beta-adrenergic receptors mediate the catecholamine-induced activation of adenylate cyclase through the action of G proteins. This receptor binds epinephrine and norepinephrine with approximately equal affinity. Mediates Ras activation through G(s)-alpha- and cAMP-mediated signaling.
Gene Name:
ADRB1
Uniprot ID:
P08588
Molecular Weight:
51322.1 Da
References
  1. Gielen W, Cleophas TJ, Agrawal R: Nebivolol: a review of its clinical and pharmacological characteristics. Int J Clin Pharmacol Ther. 2006 Aug;44(8):344-57. [PubMed:16961165 ]
  2. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352 ]
  3. de Boer RA, Voors AA, van Veldhuisen DJ: Nebivolol: third-generation beta-blockade. Expert Opin Pharmacother. 2007 Jul;8(10):1539-50. [PubMed:17661735 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
antagonist
General Function:
Protein homodimerization activity
Specific Function:
Beta-adrenergic receptors mediate the catecholamine-induced activation of adenylate cyclase through the action of G proteins. The beta-2-adrenergic receptor binds epinephrine with an approximately 30-fold greater affinity than it does norepinephrine.
Gene Name:
ADRB2
Uniprot ID:
P07550
Molecular Weight:
46458.32 Da
References
  1. Nuttall SL, Routledge HC, Kendall MJ: A comparison of the beta1-selectivity of three beta1-selective beta-blockers. J Clin Pharm Ther. 2003 Jun;28(3):179-86. [PubMed:12795776 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Steroid hydroxylase activity
Specific Function:
Responsible for the metabolism of many drugs and environmental chemicals that it oxidizes. It is involved in the metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic antidepressants.
Gene Name:
CYP2D6
Uniprot ID:
P10635
Molecular Weight:
55768.94 Da
References
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]
  2. Drug Interactions: Cytochrome P450 Drug Interaction Table [Link]
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Drug created on October 19, 2007 15:00 / Updated on August 30, 2016 02:12