Zebeta vs Bystolic

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For patients with hypertension or certain types of heart diseases, specific drugs that alter the function of beta receptors in the body can help in managing high blood pressure and slowing heart rate. Zebeta and Bystolic are two such drugs that are prescribed for these conditions. They each impact different aspects of cardiovascular health, but both have beneficial effects on controlling blood pressure and reducing the risk of severe cardiac events. Zebeta is a cardioselective beta1-adrenergic receptor blocker also known as bisoprolol, which primarily affects levels of norepinephrine at the heart muscle cells to decrease workload on your heart. On the other hand, Bystolic (Nebivolol) not only blocks beta1-receptors but also induces vasodilation (widening of blood vessels), primarily by its interaction with nitric oxide pathways, thus having dual benefits.

What is Zebeta?

Bisoprolol (the generic name for Zebeta) and Nebivolol (the generic name for Bystolic) are both beta-blockers used to manage hypertension, or high blood pressure. Beta blockers work by reducing the workload on your heart and widening your blood vessels, which helps lower your blood pressure. Bisoprolol was first approved by the FDA in 1992, it works specifically by blocking the effect of adrenaline on your heart's beta-1 receptors, slowing down heart rate and reducing force with which heart muscle contracts. It is widely prescribed to treat hypertension and prevent angina.

Nebivolol has a unique mechanism of action compared to other drugs in its class; apart from being a selective beta-1 adrenergic receptor blocker like bisoprolol, nebivolol also stimulates nitric oxide release in the endothelium leading to vasodilation. This dual mechanism can offer certain advantages such as improved arterial stiffness and endothelial function making it preferable choice over bisoprolol in some cases.

Both medications have relatively well-tolerated side effect profiles though individual reactions may vary. Some people might experience fewer side effects with one drug over another due to their body's individual response.

What conditions is Zebeta approved to treat?

Zebeta is approved for the treatment of various cardiovascular conditions:

  • Hypertension, also known as high blood pressure
  • Angina pectoris due to coronary atherosclerosis (chest pain due to blockage in the arteries of your heart)
  • Heart Failure (as an adjunctive therapy with other medications)

How does Zebeta help with these illnesses?

Zebeta (bisoprolol) works to manage hypertension or high blood pressure by reducing the amount of work the heart has to do. It achieves this by blocking beta receptors, thus slowing down the heart rate and decreasing cardiac output. These beta receptors are part of our sympathetic nervous system which plays a role in "fight or flight" responses including increasing heart rate and blood pressure. By blocking these receptors, Zebeta effectively lowers the blood pressure and decreases strain on the heart.

Bystolic (nebivolol), on the other hand, is another type of beta blocker with a slightly different mechanism that not only blocks beta-receptors but also causes vasodilation - widening of your arteries and veins - which further reduces blood pressure. This dual action can be beneficial for patients who need both their heart rate controlled and their vessels relaxed to reduce overall cardiovascular stress.

Both medications serve as efficient choices for managing hypertension; however, individual patient's condition should guide medication selection.

What is Bystolic?

Bystolic, a brand name for nebivolol, is a beta-blocker that's commonly used to treat high blood pressure. It functions 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. Bystolic was first approved by the FDA in 2007. Unlike Zebeta (bisoprolol), another type of beta-blocker which specifically targets one type of beta receptor (beta-1 receptors), Bystolic works on both types (beta-1 and beta-2 receptors) but with higher selectivity for beta-1 receptors at low doses. This difference results in different side-effect profiles between these two medications: while both can cause fatigue or dizziness, Bystolic tends to be better tolerated with fewer reports of cold hands or feet — common side effects associated with other nonselective beta blockers like Zebeta.

What conditions is Bystolic approved to treat?

Bystolic is a medication that has received approval for the management of:

  • Hypertension (also known as high blood pressure)
  • Heart failure, particularly in conjunction with other medications. This drug works by slowing down your heart rate and relaxing your blood vessels, which improves overall blood flow and lowers blood pressure.

How does Bystolic help with these illnesses?

Bystolic, like Zebeta, is a type of drug known as a beta blocker which slows down your heart rate and makes it less forceful. This helps to reduce blood pressure and decrease the amount of work your heart has to do. Bystolic works by blocking the effects of epinephrine (also known as adrenaline), a hormone that plays significant roles in various body functions including elevating heart rate and blood pressure when necessary such as during stress or exercise. In contrast to other beta-blockers, Bystolic has an additional property called nitric oxide-potentiating vasodilatory effect which can further help in reducing blood pressure. Therefore, it might be preferred over traditional beta blockers like Zebeta for certain patients with hypertension or those who have not responded well enough to other antihypertensive medications.

How effective are both Zebeta and Bystolic?

Bisoprolol (Zebeta) and Nebivolol (Bystolic) both belong to the class of drugs known as beta-blockers, commonly used to treat hypertension, angina, arrhythmias, and heart failure. They were approved by the FDA several years apart - Bisoprolol in 1992 and Nebivolol in 2007. While they function similarly in reducing blood pressure by blocking beta-receptors which reduces heart rate, cardiac output and renin secretion; their molecular structures are different thus leading them to be prescribed under varied circumstances.

The effectiveness of both these medications has been studied extensively. For instance, a double-blind clinical trial conducted between Zebeta and Bystolic showed comparable efficacy in managing hypertension symptoms with similar safety profiles. None of the metrics measured for controlling hypertension differed significantly between patients receiving Bisoprolol or those on Nebivolol therapy.

In a meta-analysis report from 2010 about Bisoprolol's effectiveness revealed that it is efficient at alleviating symptoms of high blood pressure from the initial treatment phase onward. The side effect profile was found favorable over other many other antihypertensive agents making it well-tolerated even among elderly populations.

A later review from 2014 indicated that Nebivolol seems more effective than placebo in treating hypertension while being equally potent compared to common antihypertensives like ACE inhibitors or calcium channel blockers. However, Bystolic is often considered as an alternative when first-line treatments prove ineffective or cause intolerable side effects due its unique pharmacology offering vasodilatory properties besides regular beta-blocking action.

abstract image of a researcher studying a bottle of drug.

At what dose is Zebeta typically prescribed?

Oral dosages of Zebeta start from 5-20 mg/day, though research has shown that many patients with mild to moderate hypertension respond to a dose of 5-10 mg/day. For Bystolic, the recommended starting dosage is typically lower at 2.5–5 mg once daily and can be gradually increased after two weeks depending on patient response. In both cases, the maximum dosage should not exceed 40 mg for Zebeta or 20mg for Bystolic per day in any circumstance. Children's doses are determined by their doctors based on factors like weight and overall health condition.

At what dose is Bystolic typically prescribed?

Bystolic treatment typically begins at a dosage of 5 mg/day. If required, the dose can be increased to 10 mg/day after a few weeks, taken once daily. For some patients with severe hypertension or heart conditions, the maximum dosage may reach up to 20-40 mg/day under close medical supervision. An increase in Bystolic dosage should only be considered if there is no significant response to treatment at lower doses and always under the guidance of a healthcare professional due to potential side effects and interactions with other medications.

What are the most common side effects for Zebeta?

Common side effects of Zebeta (bisoprolol) can include:

  • Dizziness or light-headedness
  • Fatigue, somnolence
  • Weakness and asthenia
  • Diarrhea or constipation
  • Nausea
  • Dry mouth
  • Headache, anxiety and nervousness
  • Shortness of breath
  • Swelling in the feet or hands (edema)
  • Chest pain

On the other hand, Bystolic (nebivolol) may cause these common side effects:

  • Headache
  • Fatigue and drowsiness
  • Dizziness
  • Insomnia
  • Nausea and stomach upset
  • Diarrhea or constipation
  • Slow heart rate.

If you experience any severe symptoms like chest pain, short breath, slow heartbeat or if your condition does not improve after a few weeks of treatment with either medication, consult your healthcare provider immediately.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Zebeta?

While both Zebeta and Bystolic are beta blockers used to treat high blood pressure, they can have different side effects. For Zebeta:

  • Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
  • Slow heart rate with dizziness
  • Lightheadedness
  • Fainting spells
  • Shortness of breath (even with mild exertion)
  • Swelling or rapid weight gain

In comparison, for Bystolic:

  • Allergic reactions such as skin rash, itching or hives, swelling of the face/lips/tongue/throat
  • Unusually slow heartbeat
  • Irregular heartbeat patterns Difficulty in breathing, tightness in chest.

Both medications may cause other side effects so it is important to discuss these potential risks with a healthcare professional before starting treatment. If you experience any severe symptoms while taking either medication, seek immediate medical attention.

What are the most common side effects for Bystolic?

Bystolic, another beta-blocker similar to Zebeta, can also produce various side effects. These may include:

  • A dry mouth or sore throat
  • Headache or dizziness
  • Nausea and stomach upset
  • Fatigue or weakness
  • Insomnia or other sleep disturbances
  • Shortness of breath
  • Slow heart rate (bradycardia)
  • Swelling in your legs and feet (edema)

Remember that while these potential side effects seem daunting, they are not guaranteed for every individual who takes the medication. It's important to discuss any concerns with your healthcare provider so you can make an informed decision about your treatment options.

Are there any potential serious side effects for Bystolic?

While Bystolic is generally well-tolerated, it can carry certain side effects that warrant immediate attention. These include:

  • Signs of an allergic reaction such as hives, difficulty breathing or swallowing, swelling of the face, lips, tongue or throat.
  • Symptoms of heart failure such as shortness of breath (even with mild exertion), swelling in your feet or ankles, rapid weight gain.
  • Slow heartbeat with dizziness and fatigue.
  • Liver problems including nausea, upper stomach pain, itching,tired feeling jaundice (yellowing of the skin or eyes).
  • Significant changes in mood and behavior like confusion and feelings of being lightheaded.

If you experience any of these symptoms while taking Bystolic, seek immediate medical assistance. Always consult your healthcare provider for personalized advice regarding medication usage.

Contraindications for Zebeta and Bystolic?

Both Zebeta and Bystolic, like most beta blockers, may cause or worsen symptoms of heart failure in some individuals. If you notice any severe side effects such as shortness of breath, swelling ankles/feet, unusual tiredness, or sudden weight gain while taking these medications, please seek immediate medical attention.

Neither Zebeta nor Bystolic should be taken if you are currently on mibefradil. Always inform your physician about the current list of medications you're using; mibefradil must be stopped at least two weeks before starting either Zebeta or Bystolic to prevent dangerous drug interactions. Moreover people with certain conditions such as asthma and certain types of heart rhythm disorders should also avoid taking these drugs.

How much do Zebeta and Bystolic cost?

For the brand name versions of these drugs:

  • The price of 30 tablets of Bystolic (5 mg) averages around $160, which works out to approximately $5.33/day.
  • The price of 60 tablets of Zebeta (10 mg) averages around $90, working out to be about $1.50/day.

Thus, if you are on a standard dosage for Bystolic (i.e., 5–20 mg per day), then brand-name Zebeta is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which drug is right for you.

In terms of generic versions; Nebivolol (generic form of Bystolic) and Bisoprolol fumarate (generic form of Zebeta), costs are significantly lower:

  • Nebivolol is available in packs ranging from 30 to 90 capsules with approximate costs starting as low as $0.80/day up to roughly around $2/day depending upon your dosage and pack size.
  • Bisoprolol fumarate can come in packs from 15 up to even more than 100 tablets with the cost varying anywhere between near negligible amounts like $0.04/day when bought upfront or at most very cheap prices such as about $0.40/per day based on typical dosages and number purchased together.

Popularity of Zebeta and Bystolic

Bisoprolol, available in generic form and under brand names such as Zebeta, was estimated to have been prescribed to about 6 million people in the US in 2020. Bisoprolol accounted for just over 7% of beta-blocker prescriptions in the US. As a selective beta-1 receptor blocker, it is often preferred due to its lower propensity for side effects related to bronchial and vascular constriction compared with non-selective beta blockers.

Nebivolol, including brand versions like Bystolic, was prescribed to approximately 4.5 million individuals within the USA during the same year. In terms of overall prescription numbers amongst beta blockers within America's borders, nebivolol accounts for slightly more than 5%. It's worth noting that while both bisoprolol and nebivolol are cardioselective beta-1 antagonists used commonly for hypertension management and heart failure treatment, Nebivolol also has nitric oxide-mediated vasodilating properties which can be beneficial especially among patients with certain co-morbidities. Over time however broadly speaking their usage trends appear relatively stable.


Both Zebeta (bisoprolol) and Bystolic (nebivolol) are beta blockers used in managing conditions like hypertension, heart failure, and angina. They have a solid record of usage with clinical studies demonstrating their efficacy over placebo treatments. These drugs may be combined with other medications for better results but this is subject to careful consideration by a physician as they also have contraindications.

Zebeta acts primarily on the β1 receptor subtype found mainly in cardiac tissues reducing heart rate and contractility thus decreasing blood pressure while Bystolic has effects on both β1 and β3 receptors providing additional vasodilatory action which helps to lower blood pressure without increasing heart rate.

The choice between these two medications often depends on individual patient needs. For instance, Zebeta could be considered as the first-line treatment option for high-risk patients such as those with diabetes or renal impairment due to its cardio-selectivity characteristics whereas Bystolic might be selected when additional arterial dilation would benefit the patient.

Both drugs are available in generic forms representing significant cost savings especially for those who must pay out-of-pocket. An adjustment period may be required meaning that effects might not be noticeable right away after starting therapy.

Side effect profiles of Zebeta and Bystolic are similar, generally well-tolerated with fatigue being most common but fewer sexual side effects compared than other classes of antihypertensive agents. Patients should monitor their blood pressure regularly especially when initiating treatment; seek medical help if experiencing symptoms like slow heartbeat, severe dizziness or fainting.