Nebivolol
Betablocking Agent · Beta-blocker
Indications
Hypertension.
Dosage
Adults: 5 mg once daily. Elderly over 65 yr, or patients with renal insufficiency, initially 2.5 mg once daily, increasing to 5 mg once daily if necessary. Children: Not recommended.
Adverse Effects
Cardiovascular effects including bradycardia, postural hypotension. Rarely, heart failure, increased AV block, cardiac arrhythmias. Raynaud's phenomenon cold extremities, sexual dysfunction. GI, sleep and CNS disturbances. Dyspnoea rarely, bronchospasm. Skin reactions, withdraw if unexplained dry eyes or rash. Fatigue, paraesthesia, peripheral neuropathy, arthralgia, myopathy, altered blood sugar, haematology and lipid levels.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: 2nd or 3rd degree AV block (without pacemaker), severe bradycardia, sick sinus syndrome, uncontrolled heart failure, cardiogenic shock, severe peripheral arterial disease, hypotension, metabolic acidosis, untreated pheochromocytoma, severe asthma or COPD, patients at risk of hypoglycaemia, Prinzmetal's angina, history of bronchospasm. Precautions: 1st degree AV block. Heart failure (avoid if uncontrolled). Peripheral arterial circulatory disorders (avoid if severe), Myasthaenia gravis. Ischaemic heart disease, withdraw gradually. History of bronchospasm. Diabetes, hyperthyroidism, renal or hepatic impairment, psoriasis. Elderly. Consider withdrawal before elective surgery. Anaphylaxis risk due to increased sensitivity to allergens. Always withdraw gradually over period of 1-2 weeks.
Interactions
Ca++ antagonists. Antihypertensives including centrally acting agents (e.g. clonidine), antiarrhythmics, antipsychotics. TCADs, MAOIs, fluvoxamine, barbiturates, cardiac glycosides, sympathomimetics, cimetidine, hydralazine, rifampicin, NSAIDs, ergot derivatives, erythromycin, anaesthetics, diuretics, digoxin, xanthines, insulin/oral hypoglycaemics, antimalarials, moxisylyte, iodinated contrast media, baclofen, levothyroxine, alcohol, corticosteroids, rizatriptan, muscle relaxants, contraceptives, parasympathomimetics, fingolimod, ampicillin.
Advice to Patient
Take with or without meals. Contact prescriber if there is bleeding or bruising, cough at night, dizziness, edema, rash, shortness of breath or slow pulse rate. Do not stop medication abruptly, gradually decrease the dose then stop. If you have diabetes, regularly check blood glucose level. Change position slowly. Weigh yourself daily during nebivolol therapy and inform prescriber if weight gain is more than 2 lb (0.9 kg) in 1 day or 5 lb (2.3 kg) in 1 week.
Pharmacokinetics
Absorption: Oral: Rapid. Metabolism: Hepatic. Bioavailability: Fast metabolizers: 12%. Slow metabolizers: Complete. Half-life elimination: Fast metabolizers: 10 hrs. Hydroxy metabolites: 24 hrs. Excretion: Urine (38%). Faeces (48%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.