Nebivolol and Bupropion: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Nebivolol
Bupropion
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased exposure to nebivolol
Interaction Deep Dive
Nebivolol is partially metabolized by the CYP2D6 isozyme. Concomitant use of nebivolol and a CYP2D6 inhibitor should be avoided1 as it may increase plasma concentrations of nebivolol 12. If coadministration is required, patients should be closely monitored, and dose adjustment may be required 2.
Why it happens (mechanism)
Inhibition of CYP2D6-mediated metabolism of nebivolol
Literature reports
2 reports — tap to read
a) Coadministration of singe dose of nebivolol 5 mg to healthy volunteers (n=23) who received paroxetine 20 to 40 mg/day for 6 days resulted in a 6.1-fold increase in nebivolol exposure and a 5.7-fold increase in the exposure of the nebivolol active metabolite. Significant increases were seen in nebivolol Cmax (1.78 to 4.24 ng/mL), Tmax (1.37 to 3.11 hours), and AUC (17.26 to 106.2 ng x hr/mL) 3.
b) Coadministration of a single 10-mg dose of nebivolol in healthy adults (n=10) who received fluoxetine at a dose of 20 mg/day for 21 days led to an 8-fold increase in AUC and 3-fold increase in Cmax of d-nebivolol (pharmacologically active isomer) 1.
Common questions
Can I take Nebivolol and Bupropion together?
Increased exposure to nebivolol Always confirm with your pharmacist or prescriber before making any change.
How serious is the Nebivolol and Bupropion interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Nebivolol or Bupropion need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: BYVALSON(TM) oral tablets, nebivolol, valsartan oral tablets. Allergan USA Inc (per manufacturer), Irvine, CA, 2016. DailyMed
- Product Information: BYSTOLIC(R) oral tablets, nebivolol oral tablets. Forest Pharmaceuticals, Inc. (per Manufacturer), St. Louis, MO, 2014. DailyMed
- Briciu C, Neag M, Muntean D, et al: A pharmacokinetic drug interaction study between nebivolol and paroxetine in healthy volunteers. J Clin Pharm Ther 2014; 39(5):535-540. PubMed
Keep reading about Nebivolol
Keep reading about Bupropion
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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