Nebita 5

Nebita 55mg

Type:10 Tablets

Generic Name:Nebivolol

Manufacturer:Square Pharmaceuticals PLC.

Price:120.00

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Indication

Heart failure, Hypertension

Administration

May be taken with or without food.

Adult Dose

Oral Hypertension Adult: Initially, 5 mg once daily. May increase dose at intervals of 2 wk if needed. Max: 40 mg once daily. Elderly: >65 yr Initially, 2.5 mg once daily increased to 5 mg once daily if required. Oral Heart failure Adult: Initially, 1.25 mg once daily. May double dose every 1-2 wk if tolerated. Max: 10 mg once daily. Hepatic impairment 2.5 mg/day PO initially; increased cautiously

Renal Dose

Renal impairment: CrCl <30 mL/min: Initially, 2.5 mg once daily. Maintenance: Increased to 5 mg once daily if required.

Contraindication

Hepatic impairment, sick sinus syndrome, 2nd and 3rd degree heart block (without a pacemaker), history of asthma, metabolic acidosis, severe peripheral arterial disease, severe bradycardia, cardiogenic shock or decompensated heart failure, untreated phaeochromocytoma. Pregnancy and lactation.

Mode of Action

Nebivolol exhibits high selectivity for beta1-adrenergic receptors and has vasodilating activity due to a direct action on the endothelium, involving nitric oxide release. It lacks intrinsic sympathomimetic and membrane-stabilising activity.

Precaution

Patients w/ inadequate cardiac function, well-compensated heart failure, myasthenia gravis. Patients undergoing major surgery involving general anaesth. May mask signs and symptoms of hypoglycaemia and hyperthyroidism. Abrupt withdrawal may exacerbate angina symptoms and/or precipitate MI and ventricular arrhythmias in patients w/ coronary artery disease. Pregnancy and lactation. Monitoring Parameters Monitor ECG, BP and blood glucose in diabetic patients. Lactation: Not known whether drug is excreted into breast milk; use not recommended

Side Effect

1-10% Headache (6-9%),Fatigue (2-5%),Dizziness (2-4%),Diarrhea (2-3%),Nausea (1-3%),Increased triglyceride levels and insulin resistance, decreased high-density lipoprotein (HDL) levels (1%),Insomnia (1%),Peripheral edema (1%),Weakness (1%) <1% Bradycardia.Chest pain,Dyspnea Potentially Fatal: Anaphylaxis.

Interaction

Increased plasma concentrations w/ potent CYP2D6 inhibitors (e.g. paroxetine, fluoxetine, propafenone, thioridazine, quinidine). Concomitant use w/ antiarrhythmic drugs (e.g. amiodarone, disopyramide) or nondihydropyridine Ca channel blockers (e.g. diltiazem, verapamil) may cause conduction disturbance. Additive negative effects on AV conduction and heart rate w/ other beta-adrenergic blocking agents or digoxin. Concurrent admin w/ catecholamine-depleting agents (e.g. reserpine) may result in additive hypotension or bradycardia. Abrupt withdrawal of clonidine may increase risk of rebound HTN.

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