Compare Bystolic vs. hydrochlorothiazide

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

Bystolic
(nebivolol)

Microzide
(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.Removes water from the body, which lowers blood pressure. Microzide (hydrochlorothiazide (HCTZ)) is a well-tolerated water pill that's often the first-choice treatment for mild high blood pressure.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
4.89Bystolic
Reviews for Bystolic
53%
of people (All ages) say Bystolic is worth it
49%
say it works well
18%
say it's a big hassle
154 reviews
Have you used Bystolic (nebivolol)?
Worth itNot sureNot worth it
Reviews for hydrochlorothiazide
47%
+6% better vs. Bystolic
31%
+18% better vs. Bystolic
16%
-2% worse vs. Bystolic
139 reviews
Have you used Microzide (hydrochlorothiazide )?
Worth itNot sureNot worth it
Side effects
Bystolichydrochlorothiazide
  • Headache 3%
  • Fatigue 1%
  • Nausea 3%
More Bystolic side effects »

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

More about hydrochlorothiazide side effects »
How it works
Bystolichydrochlorothiazide
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) that makes you urinate more. It works in the kidneys to remove extra water and certain electrolytes, while lowering blood pressure and reducing swelling.
Type of medication
Bystolichydrochlorothiazide
Prescription onlyPrescription only
Available as
Bystolichydrochlorothiazide
  • Pill
  • Pill
Used for
Bystolichydrochlorothiazide
Risk factors for serious side effects
Bystolichydrochlorothiazide
  • 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
  • Lower kidney function
  • Dehydration
  • History of sulfa allergies
  • History of gout
Detailed Microzide (hydrochlorothiazide ) risks & warnings »
Pregnancy

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.

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

Kidneys and liver
Bystolichydrochlorothiazide
No kidneys and liver related info.
  • Requires routine blood tests to check kidney function.
Upsides and benefits
Bystolichydrochlorothiazide
  • 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.
  • Does a good job getting rid of extra fluids in your body by making you urinate more.
  • A first-choice blood pressure treatment. Works especially well for people of African descent.
  • Lowers the risk of heart attack and stroke.
  • Good option if you have high blood pressure and heart failure.
  • Most people have very few side effects from Microzide (hydrochlorothiazide (HCTZ)).
  • Can be good for patients with osteoporosis since it raises the body's level of calcium.
Downsides and risks
Bystolichydrochlorothiazide
  • 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.
  • Microzide (hydrochlorothiazide (HCTZ)) doesn't work well in people with severe kidney problems.
  • It can increase the risk of gout attacks in people with poor kidney function or a history of gout.
  • People with a sulfa allergy may be allergic to Microzide (hydrochlorothiazide (HCTZ)).
Tips from our pharmacists for people taking the medication
Bystolichydrochlorothiazide
  • Can cause headache, dizziness, or feeling short of breath in the first few days.
  • Check your blood pressure 1 week after starting this medicine, and tell your doctor if it hasn't improved.
  • If side effects don't go away, talk to your doctor about alternatives.
  • Don't stop taking this medicine suddenly.
  • Microzide (hydrochlorothiazide (HCTZ)) starts working in about 2 hours.
  • It makes you urinate more often, so don't take it at bedtime.
  • Can cause dizziness in the first few days.
  • Check your blood pressure 1 week after starting this medicine, and tell your doctor if it hasn't improved.
  • Tell your doctor about any tiredness or muscle weakness that doesn't go away.
  • Requires routine blood tests to check kidney function.
Learn more
More about BystolicSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Bystolic (nebivolol)?
Worth itNot sureNot worth it
More about hydrochlorothiazideSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Microzide (hydrochlorothiazide )?
Worth itNot sureNot worth it