Bystolic

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Aug 03, 2022

Warnings


Bystolic Risks, Warnings, and Complications


Bystolic can cause serious health problems, especially in certain high-risk patients. Some of the risks of Bystolic therapy include:

  • CHEST PAIN, HEART ATTACK, OR IRREGULAR HEART RHYTHM: Suddenly stopping Bystolic can lead to high blood pressure, angina (chest pain), irregular heart rhythm, and an increased risk of heart attack, especially if you have pre-existing heart disease, poor blood circulation, or blood flow problems in the heart. Talk to your doctor if you want to come off Bystolic. Your doctor will tell you how to lower the dose gradually over time.

  • BRONCHOSPASTIC DISEASE: Bystolic and other beta-blocker medications can trigger difficulty breathing and are therefore generally not recommended in people with a bronchospastic disease such as asthma or COPD. Among all the beta-blockers, Bystolic has a lower chance of causing breathing problems because it works selectively on the heart. However, if you have an underlying respiratory condition and your doctor decides to put you on this medication, it will be under careful supervision.

  • LOW BLOOD SUGAR: Bystolic causes a slow heartbeat. Therefore, taking Bystolic can mask the symptoms of hypoglycemia (low blood sugar), such as fast heartbeat and shakiness. Very low blood sugar can be potentially life-threatening. People who have diabetes and take medications to control blood sugar should be aware of the other signs and symptoms of low blood sugar, such as headache, confusion, irritability, sweating, and hunger. 

If you are at a high risk of complications from Bystolic use, your doctor or pharmacist can adjust the dose or offer alternative treatments.

Precautions Before Starting Bystolic

Tell your healthcare provider if you have ever had an allergic reaction to Bystolic, any ingredients in Bystolic tablets, or any other medications. Your pharmacy can give you a list of ingredients.

Give your healthcare provider a complete medical history. Bystolic may not be right for people with certain medical conditions such as slow or uneven heartbeats, heart failure, coronary artery disease, severe liver damage, severe liver disease, severe hepatic impairment, severe renal impairment, kidney disease, diabetes, asthma, lung disease, hyperthyroidism (overactive thyroid), pheochromocytoma (a rare adrenal gland tumor), or severe allergies.

Give your doctor a complete list of all your medications, including prescription drugs, over-the-counter medications, vitamins, dietary supplements, and herbal products. This can help avoid serious interactions between Bystolic and your other medications.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

Precautions During Use of Bystolic

Keep all your medical and lab appointments while on Bystolic. Your doctor may want to check how well the medication is working to control high blood pressure. They may also want to keep an eye on your heart rate while you are taking this blood pressure medicine. 

Tell all your healthcare providers and lab personnel you are taking Bystolic.

Bystolic can cause drowsiness and dizziness. This effect can vary from person to person. Do not drive or operate heavy machinery until you know how Bystolic affects you.

Tell your health care professionals you are on Bystolic before undergoing any surgery, including dental procedures. 

Call your doctor for medical advice if you become pregnant while on Bystolic. It is unclear if Bystolic passes into breast milk. Do not breastfeed while on this medicine.

You should know that Bystolic can make allergic reactions to different substances worse, and your allergic symptoms may not respond as well to epinephrine while you’re on Bystolic.

Bystolic Drug Interactions

Taking Bystolic with some other medications can affect how the medications work. Interactions between medications can also increase the risk of serious adverse reactions. Your physician may choose different blood pressure medicines for you, change the dose or frequency of one or both medicines, and/or closely monitor you for side effects if there are known interactions between Bystolic and your other medicines.

There can be potential interactions between Bystolic and the following medications:

  • Other beta-blockers like atenolol (Tenormin, in Tenoretic), metoprolol (Lopressor, Toprol XL), carvedilol (Coreg), propranolol (Inderal, InnoPran XL, in Inderide), labetalol, bisoprolol (Zebeta, in Ziac), betaxolol, acebutolol (Sectral), nadolol (Corgard, in Corzide), sotalol (Betapace, Betapace AF, Sorine), pindolol, and timolol
  • Certain calcium channel blockers such as verapamil (Covera, Calan, Verelan, Isoptin, in Tarka) and diltiazem (Dilacor, Cardizem, others)
  • Heart medications such as amiodarone (Cordarone, Pacerone), clonidine (Catapres, Kapvay, in Clorpres), disopyramide (Norpace), digoxin (Lanoxin), propafenone (Rythmol), reserpine, and quinidine 
  • Antidepressant medications like bupropion (Wellbutrin, Zyban, Aplenzin, Forfivo XL), fluoxetine (Prozac, Selfemra, Sarafem, in Symbyax), and duloxetine (Cymbalta)
  • Medications used to treat psychiatric disorders such as clomipramine (Anafranil), haloperidol (Haldol), and paroxetine (Paxil)
  • Chlorpheniramine, an antihistamine commonly found in cold and allergy medications
  • Cimetidine, which is used to treat stomach acidity
  • Insulin and oral diabetes medications 
  • Methadone (Dolophine, Methadose)
  • Antiviral agents like ritonavir (Norvir, in Kaletra)
  • Sildenafil (Revatio, Viagra)

This list does not describe all possible Bystolic interactions. Give your healthcare professionals a complete list of your medications, including prescription drugs, over-the-counter medications, vitamins, dietary supplements, and herbal products. Also, tell your health care provider if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription drugs.