| Hypertensive disease
Bystolic vs Qbrelis
Side-by-side clinical, coverage, and cost comparison for hypertensive disease.Deep comparison between: Bystolic vs Qbrelis with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsQbrelis has a higher rate of injection site reactions vs Bystolic based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Qbrelis but not Bystolic, including UnitedHealthcare
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Category
Bystolic
Qbrelis
At A Glance
Oral
Daily
Selective beta-1 blocker
Oral
Once daily
ACE inhibitor
Indications
- Hypertensive disease
- Hypertensive disease
- Heart Failure, Systolic
- Acute myocardial infarction
Dosing
Hypertensive disease Start at 5 mg once daily, with or without food; increase at 2-week intervals up to 40 mg. In severe renal impairment (ClCr <30 mL/min), start at 2.5 mg once daily. In moderate hepatic impairment (Child-Pugh Class B), start at 2.5 mg once daily.
Hypertensive disease Adults: initial 10 mg once daily (5 mg once daily if on diuretics), titrate to 20-40 mg once daily; pediatric patients >=6 years with GFR >30 mL/min/1.73m2: initial 0.07 mg/kg (up to 5 mg) once daily, maximum 0.61 mg/kg (up to 40 mg) once daily, oral.
Heart Failure, Systolic Initial 5 mg once daily (2.5 mg once daily if hyponatremia present) with diuretics and digitalis; increase as tolerated to 40 mg once daily, oral.
Acute myocardial infarction 5 mg within 24 hours of onset, then 5 mg at 24 hours, then 10 mg once daily for at least 6 weeks; initiate at 2.5 mg once daily if systolic BP <=120 mmHg, oral.
Contraindications
- Severe bradycardia
- Heart block greater than first degree
- Cardiogenic shock
- Decompensated cardiac failure
- Sick sinus syndrome (unless a permanent pacemaker is in place)
- Severe hepatic impairment (Child-Pugh >B)
- Hypersensitivity to any component of this product
- History of angioedema or hypersensitivity related to previous ACE inhibitor treatment
- Hereditary or idiopathic angioedema
- Co-administration of aliskiren in patients with diabetes
- Combination with a neprilysin inhibitor (e.g., sacubitril); do not administer within 36 hours of switching to or from sacubitril/valsartan
Adverse Reactions
Most common (>=1%) Headache, fatigue, diarrhea, nausea, dizziness, bradycardia, chest pain, peripheral edema, insomnia, dyspnea, rash
Postmarketing Abnormal hepatic function, acute pulmonary edema, acute renal failure, atrioventricular block (second and third degree), bronchospasm, erectile dysfunction, hypersensitivity (urticaria, allergic vasculitis, angioedema), hypotension, myocardial infarction, pruritus, psoriasis, Raynaud's phenomenon, peripheral ischemia/claudication, somnolence, syncope, thrombocytopenia, vertigo, vomiting
Most common (>=2%) Hypertension: headache, dizziness, cough; Heart Failure: hypotension, chest pain; Acute MI: hypotension.
Serious Bone marrow depression, hemolytic anemia, leukopenia/neutropenia, thrombocytopenia, toxic epidermal necrolysis, Stevens-Johnson syndrome, pancreatitis, hyperkalemia, renal dysfunction.
Postmarketing Hyponatremia, hypoglycemia in diabetic patients, mood alterations, mental confusion, hallucinations, psoriasis.
Pharmacology
Nebivolol is a beta-adrenergic receptor blocking agent; at doses <=10 mg in extensive metabolizers it is preferentially beta1-selective, while in poor metabolizers or at higher doses it inhibits both beta1- and beta2-adrenergic receptors, lacking intrinsic sympathomimetic and membrane-stabilizing activity at therapeutically relevant concentrations.
ACE inhibitor; lisinopril inhibits angiotensin-converting enzyme, reducing conversion of angiotensin I to angiotensin II, thereby decreasing vasopressor activity and aldosterone secretion to lower blood pressure in hypertension, heart failure, and post-myocardial infarction.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Bystolic
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (4/12) · Qty limit (1/12)
Qbrelis
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Bystolic
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Qbrelis
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Bystolic
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · Qty limit (2/3)
Qbrelis
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Bystolic.
No savings programs available for Qbrelis.
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BystolicView full Bystolic profile
QbrelisView full Qbrelis profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.