Metoprolol can cause erectile dysfunction while bystolic is not known to do that because it increases nitric oxide. Metoprolol is generally better for heart rate control though.
Bystolic should have more affect on BP via that nitric oxide pathway while metoprolol can only reduce BP by reducing cardiac output, it does not affect systemic vascular resistance.
Why is your doc looking to start you on a beta blocker?
Metoprolol is anything but cardioselective. Nebivolol is very cardioselective.
Depending on what your problem is, metoprolol can be the better option. But it does have a ton of downsides that modern betablockers like nebivolol dont have (no lipid worsening, no blood glucose and insulin resistance worsening, no limiting of cardiovascular training capacity, and so on).
Yes but the overall reduction in all heart events is 10 times the miniscule ding in lipids and insulin sensitivity (Am J Cardiol. 1990 Jun 1;65(20):1287-91).Metoprolol can worsen lipids and glucose levels?
Yes, there's a ton of studies comparing nebivolol with metoprolol. Nebivolol has a very favorable effect profile compared with other betablockers. It does have a side effect profile that was comparable to the placebo group.Metoprolol can worsen lipids and glucose levels?
The tolerability of nebivolol has been shown to be superior to that of atenolol and metoprolol. In controlled clinical trials, nebivolol has a side effect profile that is similar to placebo, in particular as it relates to fatigue and sexual dysfunction.
You may have anecdotal experience that metoprolol might seem non-selective but it is in fact beta-1 selective at common doses. My understanding is that as doses increase the beta-1 selective beta blockers can spill over into antagonism of the peripheral beta receptors, even nebivolol will do this as doses increase. The side effects you listed regarding lipids and insulin resistance are generally associated with the non-selective beta blockers more so than the beta-1 selective drugs.Metoprolol is anything but cardioselective. Nebivolol is very cardioselective.
Depending on what your problem is, metoprolol can be the better option. But it does have a ton of downsides that modern betablockers like nebivolol dont have (no lipid worsening, no blood glucose and insulin resistance worsening, no limiting of cardiovascular training capacity, and so on).
This is correct, yet nebivolol even at higher doses at up to 40mg a day showed no significant metabolic or hematologic side effect. Metoprolol at higher dosed did show these side effects. The difference is the nitric oxide mediated and pleiotropic effects that have a strong influence on cholesterol and blood glucose levels. You are correct about them all being cardioselective, I should have been more specific.My understanding is that as doses increase the beta-1 selective beta blockers can spill over into antagonism of the peripheral beta receptors, even nebivolol will do this as doses increase. The side effects you listed regarding lipids and insulin resistance are generally associated with the non-selective beta blockers more so than the beta-1 selective drugs.
I sent you a PM if you have time to check. ThanksThe role of nitric oxide on endothelial function - PubMed
The vascular endothelium is a monolayer of cells between the vessel lumen and the vascular smooth muscle cells. Nitric oxide (NO) is a soluble gas continuously synthesized from the amino acid L-arginine in endothelial cells by the constitutive calcium-calmodulin-dependent enzyme nitric oxide...pubmed.ncbi.nlm.nih.gov
This was just a quick google search, lots of info on it
According to my German equivalent dose paper it is 5mg nebivolol.Does anyone know the equivalent bystolic dose of 100mg metoprolol? I tried to google it but not sure if it's correct. Does 100mg metoprolol equal 10mg bystolic?
Thank you. That's very helpful!According to my German equivalent dose paper it is 5mg nebivolol.
10mg is equivalent to 200mg metoprolol. You can see it here:
Edit: I deleted the link to PDF file and instead made a screenshot.
View attachment 175560
Take it every day. Mornings on non-training days, and after training on training days. Adrenaline is vital for workout intensity. This would essentially block those receptors - not exactly good for pushing limits. Although pushing those limits has led to a lot of injuries. It has reduced my GH-induced tachycardia and keeps my heart from pounding before a tense meeting or confrontation - neither of which are physically healthy. Are there better beta cell blockers out there? I guess it all comes down to the specific ailments you're treating in that individual patient. Some sexual related sides but whether 5 times a week is that worse for either of us than 7, who knows?Not to hijack thread lol ,but does anyone have any experience with propranolol? is it useful in anyway?