Bystolic vs. Hydrochlorothiazide

Head-to-head comparisons of medication uses, side effects, ratings, and more.

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(Hydrochlorothiazide )

Lowers blood pressure and controls heart rate. Bystolic (Nebivolol) is a good blood pressure-lowering medicine for people with heart conditions, and has fewer side effects than other beta blockers, but it's expensive. You can't miss doses.Lowers blood pressure. Removes extra water from your body. Microzide (Hydrochlorothiazide (Hctz)) is a well-tolerated water pill that's often the first-choice treatment for mild high blood pressure.
How it works
Bystolic (Nebivolol) is a selective beta blocker that works specifically on the heart. It lowers blood pressure by slowing down the heart and making it work less to pump.Microzide (Hydrochlorothiazide (Hctz)) is a thiazide diuretic (water pill). It works in the kidneys to make you urinate more, which removes extra water and certain electrolytes. This lowers blood pressure and swelling.
Type of medication
Beta blocker
Prescription only
Prescription only
Available as
  • Pill
  • Pill
Used for (click to learn more)
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Reviews & ratings
Button Group. All currently active
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Reviews for Bystolic (Nebivolol)
of people say Bystolic (Nebivolol) is worth it
say it works well
say it's a big hassle
Reviews for Microzide (Hydrochlorothiazide (Hctz))
-4% vs. Bystolic (Nebivolol)
-15% vs. Bystolic (Nebivolol)
+3% vs. Bystolic (Nebivolol)
Side effects
  • Fatigue 4%
  • Headache 3%
  • Dizziness 2%
  • Diarrhea 1%
More Bystolic side effects »

The Hydrochlorothiazide FDA package insert doesn’t have numbers about how common side effects are.

More about Hydrochlorothiazide side effects »
Risk factors for serious side effects
  • Sudden discontinuation of medicine
  • History of asthma
  • History of diabetes
  • Age 65 years or older
  • Using other medicine(s) that slows the heart
Detailed Bystolic (Nebivolol) risks & warnings »
  • Current electrolyte imbalance
  • History of sulfa allergies
  • History of gout
  • Current kidney problems
    Detailed Microzide (Hydrochlorothiazide (Hctz)) risks & warnings »
    Pregnancy category
    CFDA pregnancy category (Weigh risks vs. benefits)

    Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

    See the FDA package insert
    BFDA pregnancy category (Probably safe)

    Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

    See the FDA package insert
    No specific alcohol-related info.No specific alcohol-related info.
    No specific food-related info.No specific food-related info.
    Kidneys and liver
    No specific kidneys and liver-related info.
    • Doesn't work well in people with severe kidney problems.
    • Requires routine blood tests to check kidney function.
    No specific sex-related info.No specific sex-related info.
    No specific sleep-related info.No specific sleep-related info.
    No specific weight-related info.No specific weight-related info.
    Upsides and benefits
    • Controls your heart rate to reduce work for your heart.
    • A first-line treatment for heart failure and heart attack.
    • Helps to lower blood pressure if you can't use first-choice treatments or need additional blood pressure control.
    • Many beta blockers can worsen asthma or cause headaches, but Bystolic usually doesn't because it targets the heart more specifically and causes fewer side effects.
    • Works well to get rid of extra fluids in your body through urination.
    • A first-choice blood pressure treatment for many people. Works especially well for African Americans.
    • Lowers the risk of heart attack and stroke.
    • Good option if you have both high blood pressure and heart failure.
    • Raises calcium levels in the body, so it can be good for people with osteoporosis to slow down bone loss and even help with new bone formation.
    • Most people have very few side effects.
    Downsides and risks
    • Not available in less expensive generic form.
    • Taking a beta blocker might make you feel more tired or out of breath during exercise or normal daily routines. This gets better for most people, but for some might not go away.
    • Can hide symptoms of low blood sugar if you're diabetic.
    • You can't miss doses. Stopping Bystolic suddenly can cause your blood pressure to go up suddenly, which raises the risk of heart attack and stroke.
    • Makes you urinate more often.
    • Doesn't work well in people with severe kidney problems.
    Tips from our pharmacists for people taking the medication
    • Can cause headache, dizziness, or feeling short of breath in the first few days.
    • If side effects don't go away, talk to your doctor about alternatives.
    • Don't stop taking this medicine suddenly.
    • Check your blood pressure 1 week after starting this medicine, and tell your doctor if it hasn't improved.
    • Starts working in about 2 hours.
    • Makes you urinate more often, so avoid taking it at bedtime.
    • Can cause dizziness in the first few days.
    • Tell your doctor about any dizziness, fatigue, or muscle weakness that doesn't go away.
    • Requires routine blood tests to check kidney function.
    • Check your blood pressure 1 week after starting this medicine, and tell your doctor if it hasn't improved.
    Learn more
    More about BystolicSide effectsReviews & ratingsAlternativesFDA package insert
    More about HydrochlorothiazideSide effectsReviews & ratingsAlternativesFDA package insert