Hi there,
Thanks for writing in.
I am a qualified and certified cardiologist and I read your mail with diligence.
I did some physician drug reference search about this drug. You must be knowing that Bystolic (nebivolol) also belongs to a group of beta-blockers. Personally, since B blockers cross blood brain barrier and prone to cause depression. Unless critically indicated I avoid this group of drugs in young persons. Well, medical literature reveals those who are sensitive to this drug (you are not allergic to it) should
get immediate medical help if you have any of these signs of an allergic reaction to Bystolic: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

feeling short of breath, even with mild exertion;
swelling of your ankles or feet;
slow or uneven heartbeats; or
numbness or cold feeling in your hands and feet.
Less serious Bystolic side effects may include:
General
The most common adverse events leading to discontinuation of nebivolol (the active ingredient contained in Bystolic) in clinical trials were headache (0.4%), nausea (0.2%), and bradycardia (0.2%). In fact it is for the last side effect you have been prescribed this drug.

Cardiovascular
Cardiovascular side effects have included bradycardia, chest pain, and peripheral edema. Well medical literature says it even if your cardiologist may not agree.
Nervous system
Nervous system side effects have included headache, dizziness, paraesthesias (pain in various body parts), asthenia, insomnia, and fatigue.

Gastrointestinal
Gastrointestinal side effects have included nausea, diarrhea, and abdominal pain.

Respiratory
Respiratory side effects have included dyspnea.

Dermatologic
Dermatologic side effects have included rash.

Metabolic
Metabolic side effects have included hypercholesterolemia and hyperuricemia.
I would suggest that you ought to call your doctor for medical advice these side effects. Ninety five percent chances are he/she will change the drugs. You may report side effects to FDA at 1-800-FDA-1088. You can chose a different cardiologist are other less pleasant options. For, your cardiologist has prescribed the drug in good faith. Since, alternative drugs are available to lower the heart rate if that is only indication for prescribing b blocker. But no drug will be completely free from some side effect, a fact you have to keep in mind while taking a decision.
I hope that answers your question. Good luck.
If you have any more query I will be most happy to answer it.
Regards
Dr Anil Grover,
Cardiologist & Internist
M.B.;B.S, M.D. (Internal Medicine) D.M(Cardiology)
http://www/ WWW.WWWW.WW

---

Thanks for getting back with a very pertinent question.
I am not privy to your basic electrophysiological cause of your tachycardia. However, commonest drugs used in situations when beta blockers can not be given are calcium channel blockers namely:
VERAPAMIL or
DILTIAZEM

Short acting that needs to be taken thrice a day or long acting preparation which can be taken once a day are available. You can politely ask your doctor as to 'how about trying?' type of diplomatic question. Good Luck.
Regards

Dr Anil Grover

---

Thanks for writing back.
That makes your complete diagnosis of:
Inappropriate Sinus Tachycardia episodic
Gastro esophageal Reflux disease (GERD)

Now then, part of your symptoms like pain can be due to GERD. These(symptom of chest) are rare side effects of b blockers as opposed to common manifestation of GERD. There is obvious merit in your doctor's suggestion. For your condition drug of choice for sinus tachycardia remains a beta blocker. However, if you can not tolerate it then either of the two drugs I named can be used. There is catch in that too. Calcium channel blocker tend to relax the sphincter which connects esophagus to stomach so doctors treating GERD are not very fond of prescribing. In any case you might have been advised to keep yourself upright after a meal as lying down helps in gravitating the stomach contents to food pipe thus aggravating GERD symptoms. My suggestion would still be either verapamil or diltiazem instead of any beta blocker.

Healthcaremagic can only discuss about prescription drug but it is your real doctor who prescribes these (not virtual doctors who do not see the patients and vice versa). I will therefore urge you to have a talk with your doctor and both of you finally decide on a prescription. Good Luck.
Best Wishes

Dr Anil Grover

---