Nebivolol and Hydrochlorothiazide

Betablocking Agent · Beta-blocker/Thiazide diuretic

Indications

Essential hypertension.

Dosage

Adults: 1 tab daily, preferably at the same time of the day. Children: Not recommended.

Adverse Effects

Headache, dizziness, paraesthesia, dyspnoea, nausea, constipation, diarrhoea, oedema, tiredness.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Severe renal impairment. Hepatic impairment. Acute heart failure, cardiogenic shock or episodes of heart failure decompensation requiring IV inotropic therapy. Sick sinus syndrome, including sino-atrial block. 2nd and 3rd degree AV block (without a pacemaker). Bradycardia (heart rate < 60 bpm prior to start therapy). Hypotension (systolic blood pressure < 90 mmHg). Severe peripheral circulatory disturbances. History of bronchospasm and bronchial asthma. Untreated phaeochromocytoma. Metabolic acidosis. Refractory hypokalaemia, hypercalcaemia, hyponatraemia and symptomatic hyperuricaemia. Precautions: Elderly. COPD. Untreated CHF. Psoriasis. Hyperthyroidism. SLE. Check serum electrolytes level before starting treatment.

Interactions

Class-1 antiarrhythmics, calcium channel blockers, centrally-acting antihypertensives, lithium (avoid). Class-3 antiarrhythmics, anaesthetics, insulin, antidiabetics, calcium antagonists of the dihydropyridine type, antipsychotics, antidepressants, NSAIDs, sympathomimetics, calcium salts, digitalis glycosides, non-depolarizing skeletal muscle relaxants, pressor amines, anti-gout drugs, amantadine, salicylates, antipsychotics, barbiturates, narcotics (use caution).

Advice to Patient

Take with meals.

Pharmacokinetics

NEBIVOLOL: 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%). HYDROCHLOROTHIAZIDE: Onset of action: Diuresis: Infants: 2-6 hrs. Adults: Approx. 2 hrs. Peak effect: 4-6 hrs. Duration: Infants: 8 hrs. Adults: 6-12 hrs. Absorption: Well absorbed, absorption is decreased in patients with CHF. Metabolism: Not metabolized. Bioavailability: 65%-75%. Half-life elimination: Approx. 6-15 hrs. Time to peak: Approx. 1-5 hrs. Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.