Lopressor vs Bystolic

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For patients with hypertension or certain types of heart disease, specific medications that alter the function and workload of the heart can help in managing symptoms and reducing risks. Lopressor (metoprolol tartrate) and Bystolic (nebivolol) are two such drugs that are prescribed for these conditions. Both belong to a group of medicines known as beta-blockers which work by blocking the effects of certain hormones on the heart, thus slowing down your heartbeat and lowering blood pressure.

Lopressor is a selective beta1 receptor blocker. It affects only one type of beta receptor (beta1), primarily found in the heart, thereby selectively decreasing cardiac output without affecting bronchial or vascular smooth muscle tone significantly.

On the other hand, Bystolic is unique among beta blockers due to its vasodilating properties — it not only blocks beta receptors but also releases nitric oxide in the endothelium which helps dilate blood vessels. This dual action may make it more effective at reducing blood pressure while minimizing side effects associated with traditional nonselective beta blockers.

What is Lopressor?

Metoprolol (the generic name for Lopressor) is a beta-blocker that was approved by the FDA in 1978 and represents a major advancement over earlier anti-hypertensive medications. Metoprolol works by blocking the effects of certain natural chemicals on the heart and blood vessels, effectively slowing down your heart rate to decrease blood pressure. It is prescribed often for treating hypertension, angina pectoris (chest pain), myocardial infarction (heart attack), as well as some types of arrhythmias.

On the other hand, Nebivolol (sold under the brand name Bystolic) is a newer generation beta-blocker approved by FDA in 2007. Unlike metoprolol which targets both β1- and β2-adrenergic receptors, nebivolol selectively influences only β1-receptors with minimal effect on β2-receptors found mostly in lung tissue; this results in fewer respiratory side effects such as shortness of breath or asthma exacerbation usually associated with non-selective beta-blockers like metoprolol.

What conditions is Lopressor approved to treat?

Lopressor is approved for the treatment of several cardiovascular conditions:

How does Lopressor help with these illnesses?

Lopressor helps to manage hypertension and heart-related conditions by decreasing the amount of work the heart has to do. It does this by blocking beta-adrenergic receptors in the body, so that adrenaline cannot have as strong an effect, leading to a reduction in blood pressure and heart rate. Adrenaline is a hormone and neurotransmitter that plays an essential role in the fight-or-flight response, increasing heart rate, blood pressure, and glucose levels. By blocking its effects with Lopressor (a type of beta-blocker), patients can experience lower blood pressure and reduced risk for serious cardiovascular events.

On the other hand, Bystolic works similarly but targets more specifically beta-1 receptors which are predominantly found within cardiac tissues. This specificity makes Bystolic less likely than non-selective beta blockers like Lopressor to cause side effects related to obstructing beta-2 receptors such as bronchospasm or cold extremities. Therefore patients who have other medical conditions like chronic lung diseases may benefit from choosing Bystolic over Lopressor for their hypertension management.

What is Bystolic?

Bystolic, a brand name for nebivolol, is a beta blocker that works by blocking the action of certain natural substances in your body, such as epinephrine, on the heart and blood vessels. This effect reduces heart rate, blood pressure, and strain on the heart. Nebivolol was first approved by the FDA in 2007. Unlike Lopressor (metoprolol), Bystolic is unique among beta blockers because it has nitric oxide-potentiating vasodilatory effect which can be beneficial in patients with certain conditions like hypertension or chronic heart failure. As Bystolic does not have significant intrinsic sympathomimetic activity (ISA), its side-effect profile may differ from those of other beta-blockers including metoprolol; it often results in fewer cardioselective effects and is less likely to cause reduced peripheral circulation or cold extremities – common side effects seen with other beta-blockers like Lopressor.

What conditions is Bystolic approved to treat?

Bystolic has been approved by the FDA for treating conditions such as:

  • Hypertension (high blood pressure) It is a beta-blocker medication that can be used alone or in combination with other drugs to manage these conditions effectively.

How does Bystolic help with these illnesses?

Bystolic, like Lopressor, is a beta-blocker which works by blocking the effects of epinephrine on the heart and blood vessels. This results in lowered blood pressure, reduced heart rate and decreased force with which the heart muscles contract. Bystolic is unique among this class of drugs as it also releases nitric oxide into the linings of arteries, promoting vasodilation or widening of these blood vessels. This dual action mechanism can be especially beneficial for patients who have hypertension along with other co-existing conditions such as angina or certain types of arrhythmias. Compared to more traditional beta blockers like Lopressor (metoprolol), Bystolic may cause fewer side effects such as fatigue or cold hands/feet due to its selectivity for cardio-specific beta-1 receptors and its vasodilatory properties.

How effective are both Lopressor and Bystolic?

Both metoprolol (Lopressor) and nebivolol (Bystolic) have established histories of success in treating high blood pressure, with the former being approved by the FDA in 1978 and the latter in 2007. Since they act on different beta-adrenergic receptors, they may be prescribed under different circumstances. The effectiveness of metoprolol and nebivolol in managing hypertension was directly studied in a double-blind clinical trial; both drugs exhibited similar efficacy at reducing blood pressure levels as well as promising safety profiles.

A review published in 2010 reported that metoprolol is effective at lowering systolic and diastolic pressures within two weeks of treatment initiation. Its side effect profile is generally favorable over many other antihypertensive medications, making it suitable for long-term use even among elderly populations. Metoprolol has become one of the most widely prescribed beta-blockers due to its proven track record.

On the other hand, a 2013 meta-analysis indicated that nebivolol appears to be more effective than placebo at treating hypertension and performs similarly to other common antihypertensive agents like ACE inhibitors or calcium channel blockers. Nebivolol tends to be considered after first-line treatments fail due to its relatively recent entry into clinical practice compared with longer-standing options like metoprolol. Significant research on its use involves nebivolol co-prescribed alongside an angiotensin-converting enzyme inhibitor or calcium channel blocker, so data confirming its efficacy as a stand-alone treatment are less robust than those for metoprolol. Nonetheless, owing to its unique vasodilatory properties - not seen with traditional beta-blockers - Bystolic might serve as an optimal option for patients who did not respond well to first-line therapies or require additional benefits such as improved endothelial function.

abstract image of a researcher studying a bottle of drug.

At what dose is Lopressor typically prescribed?

Oral dosages of Lopressor typically range from 25–100 mg per day taken in a single dose or divided into two doses. However, research has shown that for most individuals, a daily dosage of 50 mg is adequate to control hypertension and angina. For Bystolic, the usual starting dose for treating high blood pressure in adults is generally 5mg once daily, but it can be increased to a maximum of 40mg/day if an optimal response isn't achieved. Children's dosing recommendations are not established for these drugs; medical professionals should make decisions based on individual patient need and tolerance.

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At what dose is Bystolic typically prescribed?

Bystolic treatment is usually initiated at a dosage of 5 mg/day. Depending on the response and tolerance, the dose can then be increased to 10 mg/day, typically taken once daily. If further blood pressure reduction is needed, the dose may be incrementally raised to a maximum of 20 mg/day, which could be explored if there's no sufficient response to treatment at lower doses after several weeks. As it's designed for single-dose daily intake, Bystolic doesn't require splitting into multiple intakes throughout the day; however this should always be in accordance with your healthcare provider's advice.

What are the most common side effects for Lopressor?

Common side effects of Lopressor and Bystolic may include:

  • Tiredness or dizziness (due to lowered blood pressure)
  • Cold hands and feet
  • Depression or feelings of sadness
  • Insomnia
  • Nausea, vomiting, diarrhea, constipation (upset stomach)
  • Dry mouth
  • Shortness of breath
  • Decreased libido (sex drive), difficulty having an erection
  • Headache
  • Weight gain

These medications also have the potential to cause more serious side effects such as slow heart rate, very low blood pressure, masking symptoms of low blood sugar in diabetics. If any severe symptoms occur while taking either medication, it is important to seek immediate medical assistance.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Lopressor?

While Lopressor and Bystolic are both beta-blockers used to treat high blood pressure, they can have different side effects. Potential severe side effects of Lopressor include:

  • Signs of a serious allergic reaction: hives, difficulty breathing, swelling in your face or throat
  • Heart-related side effects: slow or uneven heartbeats; chest pain or discomfort; feeling light-headed (like you might pass out)
  • Issues related to circulation: cold hands or feet; numbness or tingling in your fingers and toes
  • Respiratory problems: wheezing, shortness of breath
  • Mental health concerns: confusion, memory problems

On the other hand, potential severe side effects for Bystolic may include:

  • Allergic reactions such as itching, rash, swelling especially around face/tongue/throat
  • Severe dizziness
  • Breathing difficulties
  • Abnormal weight gain -Symptoms of heart failure like swollen ankles/feet

Always remember that medical treatment should be individualized. If you experience any severe symptoms after taking either medication speak with your healthcare provider immediately.

What are the most common side effects for Bystolic?

Bystolic, similar to Lopressor, may result in side effects such as:

  • Slow heartbeat
  • Dizziness or lightheadedness
  • Shortness of breath
  • Swelling ankles or feet
  • Unusual tiredness or weakness
  • Nausea and stomach upset
  • Headache
    While rash is less common with Bystolic than it is with Lopressor, always be alert for any unusual skin reactions. Also, although weight loss isn't a typical side effect of Bystolic compared to other beta-blockers like Lopressor, each individual's reaction can vary. Always discuss your symptoms promptly with your healthcare provider if you experience these or any other unexpected conditions while taking this medication.

Are there any potential serious side effects for Bystolic?

Rare but severe side effects of Bystolic may include:

  • Allergic reactions such as hives, rash or itching, swelling on the face, lips, tongue or throat
  • Difficulty with breathing and swallowing due to an allergic reaction
  • Jaundice-like symptoms like yellowing of your eyes or skin
  • Lightheadedness leading to fainting spells
  • Unusually slow heartbeats that you can feel
  • Numbness or cold feeling in your hands and feet
  • Shortness of breath even with mild exertion; swelling ankles/feet; sudden weight gain

If you experience any of these serious side effects while taking Bystolic, seek immediate medical attention. As always, it's important to discuss potential risks with a healthcare professional before starting any new medication regimen.

Contraindications for Lopressor and Bystolic?

Just like with any medication, both Lopressor (Metoprolol) and Bystolic (Nebivolol), which are types of beta-blockers, could potentially worsen certain cardiovascular symptoms in some individuals. If you notice an increase in chest pain, rapid weight gain, shortness of breath or slow heartbeats after starting either medicine, please seek immediate medical attention.

Neither Lopressor nor Bystolic should be taken if you're already on medications such as monoamine oxidase inhibitors (MAOIs), calcium channel blockers or other beta-blocking agents without consulting your physician first. These drugs can interact negatively with Lopressor and Bystolic leading to severe side effects. It is critical to inform your doctor about all the medications you are currently taking; MAOIs will require a period of about two weeks to clear from the system before starting therapy with these beta-blockers.

How much do Lopressor and Bystolic cost?

For the brand name versions of these drugs:

  • The price for 60 tablets of Lopressor (50 mg) averages around $70, which works out to approximately $1.16–$2.33/day depending on your dose.
  • The price for 30 tablets of Bystolic (5 mg) averages about $150, working out to approximately $5/day.

Thus, if you are in the higher dosage range for Lopressor (i.e., 200 mg/day or higher), then brand-name Bystolic might be less expensive on a per-day treatment basis. However, cost should not be a primary consideration when deciding between these two medications.

As far as generics go:

  • Metoprolol tartrate (the generic version of Lopressor) is available in packs from 15 up to 1000 tablets with costs starting as low as $0.04 per day and not exceeding about $0.40 per day.
  • Nebivolol (generic Bystolic) is also more affordable than its branded counterpart with costs ranging from roughly $1 - $3 per day depending upon pharmacy pricing and insurance coverage.

Remember that while prices can guide you towards affordability, it's crucial to discuss efficacy and potential side effects with your healthcare provider before making any decisions about medication changes or choices.

Popularity of Lopressor and Bystolic

Metoprolol, available under the brand name Lopressor among others, was prescribed to approximately 19 million individuals in the United States in 2020. Metoprolol accounted for nearly 20% of beta blocker prescriptions and is a popular choice due to its proven efficacy and cost-effectiveness. It has been found effective especially for the treatment of hypertension, angina pectoris, heart failure and acute myocardial infarction.

Nebivolol is another beta-blocker that is sold under the brand name Bystolic amongst others. In comparison to metoprolol's wide use, nebivolol had around 5.4 million prescriptions filled in the US in 2020 which accounts for about 6% of all beta blocker prescriptions during this period. Its prevalence has seen an upward trend since it came on market due to its vasodilatory properties and favorable metabolic profile making it particularly beneficial for hypertensive patients with certain co-morbidities like diabetes or peripheral vascular disease.


Both Lopressor (metoprolol tartrate) and Bystolic (nebivolol) have long-standing records of usage in patients with hypertension, angina, and heart failure. They are backed by clinical evidence indicating that they're more effective than placebo treatments. In some cases, the two drugs may be combined under careful consideration by a physician as they work through similar mechanisms but with different effects on the body's physiology. Lopressor is a selective beta-1 blocker reducing heart rate and blood pressure while reducing oxygen consumption by the heart muscle. On the other hand, Bystolic is unique because it also has nitric oxide-potentiating vasodilatory effect helpful in certain patient populations.

Both drugs are available generically which represents significant cost savings especially for patients who must pay out of pocket. Both medications may require an adjustment period - during this time blood pressure or chest pain can fluctuate.

The side-effects profile is similar between both drugs; however, nebivolol tends to have fewer reports of fatigue than metoprolol due to its vasodilatory properties; yet both are generally well-tolerated. For both medications, patients need to monitor their symptoms closely when starting treatment and should seek medical help immediately if they notice worsening chest pain or signs indicative of slow heart rate/low blood pressure such as dizziness or fainting.