Do NOT use Bystolic if:

• you are allergic to any ingredient in Bystolic
• you have moderate to severe heart block, uncontrolled heart failure, shock caused by serious heart problems, very slow heartbeat, or very low blood pressure after a heart attack
• you have asthma or Raynaud syndrome
• you have severe liver problems
• the patient is a child with diabetes or heart failure
• you are taking mibefradil.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Bystolic. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances, or are taking medicine for allergies
• if you have a history of other heart problems (eg, heart failure, slow heartbeat)
• if you have a history of liver or kidney problems, blood vessel disease, lung or breathing problems (eg, chronic bronchitis, chronic obstructive pulmonary disease, emphysema), diabetes, low blood sugar, overactive thyroid, or glaucoma
• if you have Wolff-Parkinson-White syndrome, Down syndrome, or an adrenal gland tumor (pheochromocytoma)
• if you smoke or drink alcohol.

Some medicines may interact with Bystolic. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Mibefradil because the risk of serious heart side effects may be increased
• Many prescription and nonprescription medicines (eg, used for diabetes, infections, inflammation, aches and pains, high blood pressure, high cholesterol, seizures), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John's wort) may interact with Bystolic, increasing the risk of side effects.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Bystolic may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

• Bystolic may cause drowsiness, dizziness, lightheadedness, or vision changes. These effects may be worse if you take it with alcohol or certain medicines. Use Bystolic with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
• Check with your doctor before you drink alcohol while you are taking Bystolic; it may increase the risk of Bystolic's side effects.
• Do NOT take more than the recommended dose without checking with your doctor.
• Do not suddenly stop taking Bystolic. Sharp chest pain, irregular heartbeat, and sometimes heart attack may occur if you suddenly stop Bystolic. The risk may be greater if you have certain types of heart disease. Your doctor should slowly lower your dose over several weeks if you need to stop taking it. This should be done even if you only take Bystolic for high blood pressure. Heart disease is common and you may not know you have it. Limit physical activity while you are lowering your dose. If new or worsened chest pain or other heart problems occur, contact your doctor right away. You may need to start taking Bystolic again.
• Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
• Tell your doctor or dentist that you take Bystolic before you receive any medical or dental care, emergency care, or surgery.
• If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk for an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are using Bystolic.
• Bystolic may lower your blood sugar levels. This is most likely to happen in infants and children, or in patients who have diabetes or kidney problems. It may also occur after prolonged physical activity or during fasting. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens.
• Diabetes patients - Bystolic may hide signs of low blood sugar, such as a rapid heartbeat. Be sure to watch for other signs of low blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
• Bystolic may interfere with certain lab tests, including the glaucoma screening test and dobutamine stress echocardiography. Be sure your doctor and lab personnel know you are taking Bystolic.
• Lab tests, including blood pressure, heart function, kidney function, and blood cholesterol levels, may be performed while you use Bystolic. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Bystolic with caution in the elderly; they may be more sensitive to its effects.
• Bystolic should be used with extreme caution in children; safety and effectiveness in children have not been confirmed.
• Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Bystolic while you are pregnant. It is not known if Bystolic is found in breast milk. Do not breastfeed while taking Bystolic.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Dizziness; fatigue; headache; nausea; stomach pain; trouble sleeping.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain or tightness; fainting; mental or mood changes; numbness or tingling of the hands; persistent or severe vision changes; red, swollen, blistered, or peeling skin; severe dizziness; shortness of breath or wheezing; sudden, unusual weight gain; swelling of the hands, ankles, or feet; unusual bruising or bleeding; unusual tiredness or weakness; unusually slow or irregular heartbeat; very cold or blue fingers or toes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.