Nebivolol

Nebivolol is a cardio-and sosudotropic drug belonging to the group of beta-blockers.

This medicine has a vasodilating effect. Due to this effect, beta receptors are blocked, which are located in the vessels. At the same time, there is a decrease in arterial pressure, a decrease in postload on the heart and simplification of the work of this organ. The drug can also be used to stop heart rhythm disturbances.

A stable hypotensive effect develops after 1 to 2 weeks of regular use of the drug, in some cases it may develop in a month. Stable exposure is observed after a lapse of one to two months.

Clinical and pharmacological group

Cardioselective beta-blocker III generation with vasodilating properties.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much is Nebivolol in pharmacies? The average price is at the level of220 rubles.

Form of issue and composition

The medication is produced in the form of tablets, each containing 5 mg of the active compound as nebivolol.

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Pharmacological effect

Cardioselective beta-1-blocker III generation. Reduces the pulse and blood pressure at rest and under load, improves the diastolic function of the heart, increases the fraction of cardiac output. Reduces the frequency of angina attacks. Improves heart rate. Stimulates the release of nitric oxide (NO) from the vascular endothelium and thus has a mild vasodilating effect.

A stable effect on reducing blood pressure develops after 1-2 weeks of regular admission, sometimes after 4 weeks.

Indications for use

What helps? The main indications for taking Nebivolol:

Chronic failure of cardiac activity is a decrease in the volume of blood ejected by the heart at each contraction.
Persistent arterial hypertension is a regular increase in pressure from 140/90 or more.
Prophylaxis of coronary heart disease - is conducted among people prone to this pathology, but at the moment they have no clinical manifestations.

Often Nebivolol tablets are prescribed as part of a complex therapy.

Contraindications

The drug can not be used when:

depression;
myasthenia gravis;
pheochromocytoma;
cardiogenic shock;
metabolic acidosis;
SSSU, including sinoatrial blockade;
severe obliterating diseases of peripheral vessels (Raynaud's syndrome, intermittent claudication);
bronchial asthma and bronchospasm in anamnesis;
significant violations of the liver;
Bradycardia (heart rate less than 60 beats per minute);
AV-blockade of the second and third degree (with the absence of an artificial pacemaker);
significant arterial hypotension (systolic blood pressure less than 90 mm Hg. item);
chronic heart failure in the stage of decompensation;
acute heart failure.

Use in pregnancy and lactation

Nebivolol during pregnancy is prescribed only on strict indications, provided that the benefit to the mother is greater than the risk to the fetus, because the drug therapy may delay growth and development of the fetus, premature labor, the development of a newborn decrease in blood pressure, bradycardia, hypoglycemia, respiratory paralysis, and intrauterine fetal death. The taking of tablets should be stopped 48-72 hours before the onset of labor, and if this is not possible, monitor utero-placental blood flow, as well as strict observation of the newborn during the first 3 days after birth.

During animal experiments, it was found that nebivolol penetrates into breast milk. If you need to take the drug during lactation, breastfeeding should be interrupted.

Dosage and route of administration

The instructions for use indicate that the standard dosage of Nebivolol to adults is 2.5-5 mg per day for taking in the morning. The effect will be visible after 1-2 weeks of treatment, and in some cases - after 4 weeks.

If necessary, increase the dose to 10 mg per day, but not more. Most often, the drug is prescribed as part of a combination therapy. For patients aged 65 years and older, the initial dose is 2.5 mg per day. If necessary, it can later be increased to 5 mg per day.

Side effects

The frequency of adverse side effects by the WHO classification (World Health Organization): very often -> 10%, often -> 1% and <10%, infrequently -> 0.1% and <1%, rarely -> 0.01% and <0.1%, very rarely - <0.01%, including individual cases.

Gastrointestinal tract: often - nausea, diarrhea, constipation; infrequently - flatulence, indigestion, vomiting;
Respiratory system: often - shortness of breath; infrequently - bronchospasm (incl. in the absence of anamnestic data on obstructive pulmonary diseases);
Cardiovascular system: often - peripheral edema; infrequently - heart failure, bradycardia, AV-blockade, orthostatic hypotension, cardiac rhythm disturbances, Raynaud's syndrome, cardialgia, worsening of CHF flow, marked decrease in blood pressure;
Nervous system: often - dizziness, headache, weakness, increased fatigue, paresthesia; infrequently - nightmarish dreams, insomnia, depression, confusion; extremely rarely - hallucinations, fainting;
Skin and subcutaneous tissue: infrequently - erythematous rashes, itchy skin; extremely rare - aggravation of the course of psoriasis; in some cases - alopecia, angioedema;
Other reactions: infrequently - photosensitization reactions, visual impairment, impotence, hyperhidrosis; rarely dryness of the mucous membrane of the eye.

Overdose

If the patient, for whatever reason, mistakes the drug, he may develop an overdose that causes the following symptoms:

a critical reduction in blood pressure (below 90/60) and heart rate (less than 60 beats per minute);
dizziness, loss of consciousness;
acute heart failure;
bronchospasm;
Edema Quincke, urticaria.

If these symptoms occur, seek medical attention as soon as possible!

special instructions

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

Use in children is not recommended.
The abolition of beta-blockers should be carried out gradually, within 10 days (up to 2 weeks in patients with ischemic heart disease).
At the beginning of treatment, blood pressure and heart rate should be monitored daily.
The effectiveness of beta-blockers in smokers is lower than that of non-smokers.
Nebivolol can enhance the symptoms of peripheral circulatory disorders.
If nebivolol is necessary in patients with psoriasis, the expected benefit of therapy and the possible risk of exacerbation of psoriasis should be carefully evaluated.
Beta-adrenoblockers should be used with caution in the increased function of the thyroid gland due to the fact that under the influence of beta-adrenoblockers tachycardia can be leveled.
Patients wearing contact lenses should take into account that the use of beta-blockers may reduce the production of tear fluid.
Nebivolol does not affect the level of glucose in patients with diabetes, but under the influence of nebivolol may be disguised certain signs of hypoglycemia (tachycardia, heart palpitations), caused by the use of hypoglycemic drugs.
When conducting surgical interventions an anesthetist should be warned that the patient is taking beta-blockers.
Control of glucose in the blood plasma should be done 1 time in 4-5 months (in patients with diabetes mellitus).
Control of laboratory indicators of kidney function should be performed once every 4-5 months (in elderly patients).
Caution should be used nebivolol in patients with renal insufficiency, diabetes, thyroid hyperthyroidism, allergic psoriasis, COPD, grade I AV blockade, prinzmetal angina, and patients aged over 75 years.

Nebivolol does not affect the rate of psychomotor reactions. With nebivolol, sometimes dizziness and fatigue are possible, so patients taking nebivolol should refrain from engaging in potentially hazardous activities.

Drug Interactions

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

With iv administration of verapamil against the background of nebivolol, there is a threat of cardiac arrest (concomitant use is contraindicated).
With the simultaneous use of calcium channel blockers (verapamil and diltiazem), the negative inotropic effect and inhibition of AV conduction are enhanced.
With simultaneous use with antiarrhythmic drugs of the first class, amiodarone, an increase in the negative inotropic effect and inhibition of AV conduction are possible.
With simultaneous use with sympathomimetics, the pharmacological activity of nebivolol is suppressed.
With the simultaneous use of nebivolol with antihypertensive drugs, nitroglycerin or blockers of slow calcium can cause severe arterial hypotension (special caution is necessary when combined with prazosin).
With simultaneous use with funds for anesthesia, it is possible to suppress reflex tachycardia and increase the risk of developing arterial hypotension.
With simultaneous use with cimetidine, nebivolol concentration in the blood plasma can be increased.
With simultaneous use with tricyclic antidepressants, barbiturates, phenothiazine derivatives, the antihypertensive effect of nebivolol is possible.
When joint use of nebivolol with insulin and hypoglycemic agents for oral administration may mask symptoms of hypoglycemia (tachycardia).
With the simultaneous use of nebivolol with drugs that inhibit serotonin reuptake, or other means, biotransforming with participation isoenzyme CYP2D6, the concentration of nebivolol in the blood plasma increases, the metabolism of nebivolol slows down, which can increase the risk of bradycardia.

Reviews

We picked up some reviews of people who used Nebivolol:

Sasha. I think that the given drug is an excellent substitute for Nebilet. In terms of content, amount of active substance Nebivolol and Nebilet are completely interchangeable. But considering the cost - Nebivolol completely prevails !!!
Katerina. Scary dizziness, depression and a sense of fatigue was experienced when taking this drug. I was afraid that I returned recently treated cervical chondrosis. So I would drink it and treat my chondrosis, if I had once forgotten to take a pill in the morning. For about three hours my head cleared and my head went dizzy. I realized that it was a pimple. I do not advise. Although apparently to someone like it works.
Irina. Nebivolol from the pressure acts very gently, or someone says "slowly." This is not a minus of the drug, it is its property. And they need to use if necessary to lower the pressure a little without jerking.
Olga. After using nebivolol, the blood pressure level ceased to increase, although I was previously diagnosed with hypertension. I heard that kidneys can suffer from prolonged use, but so far everything is in order. In addition to good efficiency, I like the affordable cost, which is an important factor for pensioners.

Analogues

Similar drugs with Nebivolol are Nebival, Nebikard, Nebikor, Nebilet, Nebilong, Nodon.

Before using analogues, consult your doctor.

Storage conditions and shelf life

The medicament is stored at a temperature of not more than 25 gr C in a place remote from small children. The medicine is allowed to be used within 3 years from the moment of its release.