A. Menarini


Zuellig Pharma
Concise Prescribing Info
Nebivolol HCl
Essential HTN; stable mild & moderate chronic heart failure in addition to standard therapies in elderly ≥70 yr.
Dosage/Direction for Use
HTN Adult 5 mg daily. In combination w/ other hypertensive agents 5 mg + hydrochlorothiazide 12.5-25 mg. Elderly >65 yr & renal impairment Initially 2.5 mg daily, may be increased to 5 mg daily. Chronic heart failure Initially 1.25 mg once daily, increase stepwise at 1-2 wkly intervals depending on patient tolerability to 2.5, 5 & 10 mg once daily. Max: 10 mg once daily.
May be taken with or without food.
Hypersensitivity. Acute heart failure, cardiogenic shock or episodes of heart failure decompensation requiring IV inotropic therapy; sick sinus syndrome including SA block; 2nd- & 3rd-degree heart block w/o pacemaker; bradycardia; hypotension; history of bronchospasm & bronchial asthma; untreated phaeochromocytoma; metabolic acidosis; severe peripheral circulatory disorders. Hepatic insufficiency or impairment.
Special Precautions
Sensitivity to allergens & severe anaphylactic reactions. Not to be used in untreated CHF. Ischaemic heart disease, symptoms suggestive of bradycardia, peripheral circulatory disorders (Raynaud's disease or syndrome, intermittent claudication), 1st degree heart block, Prinzmetal's angina; diabetes; COPD; history of psoriasis. May mask symptoms of hypoglycemia or tachycardic symptoms in hyperthyroidism. Avoid abrupt w/drawal. Not to be taken by patients w/ galactose intolerance, Lapp lactase deficiency, glucose-galactose malabsorption. Not recommended in combination w/ verapamil- & diltiazem-type Ca-channel antagonists, class I antiarrhythmics, centrally-acting antihypertensives. Concomitant use w/ certain anaesth causing myocardial depression eg, cyclopropane, ether or trichloroethylene. May affect ability to drive & use machines. Not recommended in severe renal impairment. Not to be used during pregnancy & lactation. Not recommended in childn. Elderly >75 yr.
Adverse Reactions
Dizziness. HTN: Headache, paraesthesia; dyspnoea; constipation, nausea, diarrhoea; tiredness, oedema. Chronic heart failure: Bradycardia; cardiac failure aggravation; postural hypotension; drug intolerance; 1st-degree AV block; lower limb oedema.
Drug Interactions
Negative effect on contractility & AV conduction w/ verapamil- or diltiazem-type Ca antagonists. Potentiated atrial conduction time & -ve inotropic effect w/ class I antiarrhythmics eg, amiodarone. Reduced heart rate & cardiac output, vasodilation w/ centrally-acting antihypertensives eg, clonidine, guanfacin, moxonidine, methyldopa, rilmenidine. Increased AV conduction time w/ digitalis glycosides. Attenuated reflex tachycardia & increased risk of hypotension by anaesth. Increased fall in BP w/ baclofen, amifostine. Increased risk of hypotension w/ dihydropyridine-type Ca antagonists eg, amlodipine, felodipine, lacidipine, nifedipine, nicardipine, nimodipine, nitrendipine. Counteracted effect w/ sympathicomimetic agents. Unopposed α-adrenergic activity of sympathicomimetic agents. Increased BP-lowering effect w/ TCA, barbiturates, phenothiazines. Serotonin reuptake inhibitors, dextromethorphan, other CYP2D6-metabolised compds.
MIMS Class
ATC Classification
C07AB12 - nebivolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.
Nebilet tab 5 mg
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