Pharmacology of nebivolol

Nebivolol is a new selective beta(1)-adrenergic blocking agent, that posses ses a peculiar pharmacodynamic profile and an original chemical structure, by which it differs from traditional beta(1)-blockers. Nebivolol is a racem ic mixture of two enantiomers in equal ratios. It is endowed with a highly selective beta(1)-blocking activity, and does not show an intrinsic sympath omimetic activity. Nebivolol is endowed with peripheral vasodilating proper ties mediated by the modulation of the endogenous production of nitric oxid e. It does not significantly decrease airway conductance compared with aten olol and propranolol. Nebivolol does not compromise the left ventricular fu nction, but it may increase stroke volume, and does not reduce heart inotro pism during exertion. Nebivolol is quite safe and is well tolerated, also w hen compared to traditional beta-blockers. The most common adverse effects are dizziness, headache and fatigue. Owing to its combined dual mechanism o f action, nebivolol leads to a unique haemodynamic and therapeutic profile by which it may be advantageous in essential hypertension, ischaemic heart disease and congestive heart failure. (C) 1998 The Italian Pharmacological Society.