Non-ticket

Nebilet is a popular medicine for hypertension, coronary heart disease, chronic heart failure.

It has a unique property - not only lowers the pulse, but also dilates the blood vessels. This is an original drug, the international name of which is nebivolol.

The vasodilator action in addition to the hypotensive effect provided the drug Nebilet adherence to doctors and patients.

Clinical and pharmacological group

Beta-blocker III generation with vasodilating properties.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does the ticket cost in pharmacies? The average price is at the level of500 rubles.

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Form of issue and composition

Currently, Nebilet is produced in a single dosage form - it is a tablet for oral administration. Tablets have a round biconvex form, are painted white and are provided with a notch on one side for division. The ticket is issued in packages of 7, 14, 28 and 56 pieces.

1. The drug contains the active substance: nebivolol hydrochloride.
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2. Additional components: lactose monohydrate, corn starch, MCC, magnesium stearate, silicon dioxide, polysorbate 80, carboxymethyl cellulose sodium salt, hydroxypropylmethylcellulose.

Pharmacological effect

Cardioselective beta-1-adrenoblocker. Normalizes blood pressure, improves heart rate, reduces the frequency of angina attacks. Well holds pressure not only at rest, but also with physical activity and stress. Modulates the release of endothelial nitric oxide (NO), thereby expanding the blood vessels.

With hypertension, a stable effect begins to be felt after 1-2 weeks of daily intake, sometimes after 4 weeks. The maximum reduction in blood pressure is achieved after 1-2 months.

Indications for use

The ticket has clear indications for use:

1. Essential arterial hypertension.
2. Chronic heart failure.

Contraindications

Absolute:

1. Pheochromocytoma (without combination with alpha-blockers);
2. Severe liver impairment;
3. Metabolic acidosis;
4. Bronchial asthma and bronchospasm in the anamnesis;
5. Severe obliterating lesions of peripheral vessels (Raynaud's syndrome, intermittent claudication);
6. Depression;
7. Myasthenia gravis;
8. Chronic heart failure in the stage of decompensation (if necessary, intravenous administration of drugs that have an inotropic effect);
9. Acute congestive heart failure;
10. Syndrome of weakness of the sinus node (including sinoauric blockade);
11. Severe arterial hypotension (systolic blood pressure below 90 mm Hg);
12. Atrioventricular blockade of II and III degree (without an artificial pacemaker);
13. Cardiogenic shock;
14. Bradycardia (heart rate less than 60 beats per minute);
15. Syndrome of glucose-galactose malabsorption, lactase deficiency and lactose intolerance;
16. Age to 18 years (due to lack of research on the use of funds in children and adolescents);
17. Hypersensitivity to the components of the drug.

Relative (required to be used with extreme caution because of the possible risk of complications):

1. Psoriasis;
2. Chronic obstructive pulmonary disease (possibly strengthening bronchospasm);
3. Atrioventricular block of the 1st degree;
4. Angina of princemetal;
5. Hyperfunction of the thyroid gland (masking the increase in heart rate);
6. Renal failure;
7. Diabetes mellitus (possible masking of symptoms of lowering blood glucose concentration - palpitation, trembling, nervousness);
8. Predisposition to allergies (anaphylactic reactions may worsen);
9. Age over 75 years.

During pregnancy, a Nebilet can be appointed only on strict indications, in the case when the expected benefit of taking the drug exceeds the possible risk of side effects (fetal / newborn hypoglycemia, arterial hypotension, bradycardia). If it is necessary to carry out therapy with the drug, you should monitor uteroplacental blood flow and fetal growth, the course should be interrupted 2-3 days before the birth. In those cases when this is not feasible, it is necessary to establish a careful monitoring of the newborn during 2-3 days after delivery.

Since the drug is excreted in breast milk, if necessary, treatment with lactemia should stop breastfeeding.

Use in pregnancy and lactation

A non-ticket can be taken during pregnancy only as a last resort. If a non-ticket is accepted by a woman who is carrying a child, you should regularly monitor the uteroplacental blood flow and fetal growth.

Since Nebilet infiltrates into milk, during breastfeeding, the drug should also be discarded. If it is necessary to take Nebilet, the child will have to be transferred to artificial mixtures and refuse to breast-feed.

Dosage and route of administration

The instructions for use indicate that Nebilet tablets are taken orally, 1 time / day, preferably always at the same time of the day, regardless of food intake, with a sufficient amount of liquid.

For division, place the tablet on a firm, level surface with a cross-shaped notch up, press the tablet with both index fingers. To obtain 1/4 tablets, repeat the same procedure with 1/2 tablet.

1. The average daily dose for the treatment of hypertension and arterial hypertension is 2.5-5 mg (1 / 2-1 tab.). A non-ticket can be used in monotherapy or in combination with other means that reduce blood pressure.
2. Treatment of chronic heart failure should begin with a slow increase in the dose until an individual optimal maintenance dose is reached. Selection of the dose at the beginning of treatment should be carried out according to the following scheme, while maintaining intervals from 1 up to 2 weeks and based on the tolerability of this dose by the patient: a dose of 1.25 mg nebivolol (1/4 tab. 5 mg) 1 time / day can be increased first to 2.5-5 mg (1/2 table. 5 mg or 1 tab. 5 mg), and then - up to 10 mg (2 tablets). 5 mg) 1 time / day.

In patients with renal insufficiency, as well as in patients older than 65 years, the recommended initial dose is 2.5 mg (1/2 tab.) / Day. If necessary, the daily dose can be increased to a maximum of 10 mg (2 tablets). 5 mg in 1 dose).

• The maximum daily dose is 10 mg 1 time / day.

At the beginning of treatment and at each dose increase, the patient should be under the supervision of a doctor for at least 2 hours to ensure that the clinical the condition remains stable (especially, blood pressure, heart rate, conduction disorders, as well as symptoms of worsening of the course of chronic cardiac insufficiency).

Side effects

Against the background of drug treatment, patients may develop adverse reactions:

• Allergic reactions - a rash on the skin, urticaria, the development of angioedema, bronchospasm, exacerbation of atopic dermatitis and psoriasis.
• From the gastrointestinal tract - nausea, pain in the epigastric region, vomiting, bloating, increased gassing, constipation, diarrhea, pain in the right hypochondrium, an increase in hepatic activity transmnase.
• On the part of the nervous system - headaches, fatigue and lethargy, weakness, a feeling of creeping crawling on the skin, a decrease sensitivity in the extremities, dizziness, depression, disturbance of the process of falling asleep, insomnia, in rare cases, patients are possible fainting.
• From the cardiovascular system - the development of heart failure, a sharp drop in blood pressure, including collapse, bradycardia, the development of Raynaud's syndrome.

Against the background of long-term use of this drug, patients wearing contact lenses complained of excessive dry eyes.

Overdose

When using the drug above the specified rate in the patient, the following reactions can occur:

• vomiting and nausea (in 10% of patients),
• arterial hypotension (y,% of patients),
• disorders of the heart rate (y,% of patients),
• loss of consciousness and cardiac arrest (y,% of patients).

When signs of an overdose, the patient should immediately rinse the stomach and take enterosorbents. With a strong and sharp decrease in pressure, the development of heart failure or bradycardia, injection of adrenomimetics is indicated. With extrasystole - shows the introduction of lidocaine, and with convulsions - an urgent intravenous dose of diazepam.

special instructions

Before you start using the drug, read the special instructions:

1. Control of blood pressure and heart rate at the beginning of the drug should be daily.
2. Older patients need control of kidney function (1 time in 4-5 months).
3. The abolition of beta-blockers should be carried out gradually within 10 days (up to 2 weeks in patients with ischemic heart disease).
4. Beta-adrenoblockers can cause bradycardia: the dose should be reduced if the heart rate is less than 50-55 bpm.
5. When conducting surgical interventions, an anesthesiologist should be warned that the patient is taking beta-blockers.
6. With hyperthyroidism, beta-adrenoblockers can mask tachycardia.
7. Beta-adrenoblockers can increase sensitivity to allergens and the severity of anaphylactic reactions.
8. Beta-adrenoblockers should be used with caution in patients with chronic obstructive pulmonary disease, as bronchospasm may increase.
9. Patients using contact lenses should take into account that the use of beta-blockers may reduce the production of tear fluid.
10. With angina pectoris, the dose of the drug should provide a heart rate at rest within 55-60 beats / min, with a load - no more than 110 beats per minute.
11. When deciding on the use of Nebilet in patients with psoriasis, the expected benefits of using the drug and the possible risk of exacerbation of psoriasis should be carefully correlated.
12. Nebivolol does not affect the concentration of glucose in the blood plasma in patients with diabetes mellitus. Nevertheless, care should be taken in the treatment of these patients, since the drug Nebilet can mask certain symptoms of hypoglycemia (eg, tachycardia) caused by the use of hypoglycemic agents for oral administration and insulin. Controlling the concentration of glucose in the blood plasma should be done 1 time in 4-5 months (in patients with diabetes mellitus).

Drug Interactions

When using the drug, it is necessary to take into account the interaction with other drugs:

1. The drug Clonidine develops the syndrome of canceling Nebilet.
2. When drug Nebilet interacts with narcotics, his cardio-depressive effect is greatly enhanced.
3. Medications that depress the central nervous system (CNS), including antidepressants, barbiturates, derivatives of phenothiazide significantly increase the hypotensive effect of Nebilet - nebivolol.
4. A non-ticket reduces the effectiveness of oral agents against diabetes, but increases the hypoglycemic effect of insulin.
5. NSAIDs (non-steroidal anti-inflammatory drugs) are able to reduce the hypotensive effect of Nebilet.
6. Application together with ergot alkaloids increases the risk of violation of the peripheral circulatory system.
7. Nicardipine and cimetidine, when taken together with the drug under consideration, increase the concentration of nebivolol in the blood plasma.
8. Parallel administration of the drug with calcium channel blockers, with antihypertensive agents, antiarrhythmics, with nitroglycerin and methyldopa there is a high risk of developing hypotension (low blood pressure), bradycardia (a decrease in the frequency of cardiac abbreviations). It is also not recommended to combine Nebilet and Prazorin.

It is also necessary to know that when smoking, the effectiveness of the medication is reduced.

Reviews

We picked up some reviews of people who used the drug Nebilet:

1. Sasha. For 6 years I have been taking a non-ticket under the supervision of a therapist. Very satisfied! There are no hypertensive crises, the pressure does not jump above 130, there are no headaches. I work quietly, but before I was tortured with crises. Any special side effects during the application of this nebilet have not been observed.
2. Svetlana. There was angina, I wanted to fall and die, weighed 90kg. I took a non-ticket and lost weight with a nutritionist, lost 30 kg of weight and began to feel good and decided not to take the pill, after 3 months of pain began to return. I went to the cardiologist, I do not experiment anymore.
3. Anna. My mother's vegetative-vascular dystonia, constantly jumping pressure. We tried a lot of drugs, but the effect was either not at all or it was short-term. Reception Nebileta normalized her condition, he has a mild vasodilating effect. This drug almost returned my mother to a normal life.

Analogues

On the basis of nebivolol, other drugs are produced that differ from Nebilet by quality, price and manufacturer. The most popular analogs are:

• Non-bicardium. Recipe nebivolol middle price category. Indian drug in dosages of 2.5 or 5 mg. Contains lactose as an auxiliary. Appoints only for the treatment of hypertension.
• Nebitens. The drug is available at a price. The package contains 30 tablets (for a monthly course of treatment). Country of origin - Malta.
• Nebivolol. Preparations with this name are produced by different pharmaceutical companies. As a rule, their Nebivolol is affordable. In the package can be 20, 28, 30 and other number of tablets.
• Nebivall. Ukrainian analogue of Nebilet. It is very popular due to low cost and high quality. Composition and therapeutic effects correspond to the Nebilet.

Before using analogues, consult your doctor.

Storage conditions and shelf life

The storage of this medication does not require special conditions. Enough space at room temperature, unavailable to children.

Shelf life 3 years.

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