Nebivolol is a cardio and vasotropic 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 blood pressure, a decrease in the afterload on the heart and facilitating the work of this organ. The drug can be used for the relief of cardiac arrhythmias.
Sustained hypotensive effect develops after 1 to 2 weeks of regular use of the drug, in some cases may develop in a month. Stable exposure is observed after one to two months.
Cardioselective beta1-adrenoblocker of the third generation with vasodilating properties.
Pharmacy sales terms
It is released on prescription.
How much does Nebivolol cost in pharmacies? The average price is at the level of 220 rubles.
Release form and composition
The drug is produced in the form of tablets, each of which contains 5 mg of the active compound in the form of nebivolol.
Cardioselective beta-1-blocker III generation. Reduces 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 strokes. Improves heart rate. Stimulates the release of nitric oxide (NO) from the vascular endothelium and thus has a mild vasodilator effect.
A sustained effect on reducing blood pressure develops after 1-2 weeks of regular use, sometimes after 4 weeks.
Indications for use
What helps? The main indications for receiving Nebivolol:
- Chronic heart failure - a decrease in the volume of blood emitted by the heart during each contraction.
- Persistent hypertension - a regular increase in pressure of 140/90 or more.
- Prevention of coronary heart disease - is carried out among people who are prone to this pathology, but at the moment they have no clinical manifestations.
Often tablets Nebivolol prescribed as part of complex therapy.
The drug can not be used for:
- cardiogenic shock;
- metabolic acidosis;
- SSSU, including sinoatrial blockade;
- severe obliterating diseases of peripheral vessels (Raynaud's syndrome, intermittent claudication);
- bronchial asthma and bronchospasm in history;
- significant abnormal liver function;
- bradycardia (heart rate less than 60 beats per minute);
- AV blockade of the second and third degree (with no artificial pacemaker);
- significant arterial hypotension (systolic blood pressure less than 90 mmHg);
- chronic heart failure in the stage of decompensation;
- acute heart failure.
Use during pregnancy and lactation
Nebivolol during pregnancy is prescribed only according to strict indications, provided that the benefit to the mother exceeds the risk to the fetus, since drug therapy may contribute to growth retardation and development of the fetus, premature labor, development of a newborn's blood pressure reduction, bradycardia, hypoglycemia, respiratory paralysis, and also fetal death. Taking pills should be stopped 48-72 hours before the onset of labor, and if this is not possible, monitor uteroplacental blood flow, as well as strict monitoring of the newborn during the first 3 days after birth.
During animal experiments, it was revealed that nebivolol passes into breast milk. If it is necessary to take the drug during lactation, breastfeeding is required to stop.
Dosage and method of use
The instructions for use indicate that the standard dosage of Nebivolol for adults is 2.5-5 mg per day for intake in the morning. The effect will be noticeable 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 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.
The frequency of negative side effects according to the WHO (World Health Organization) classification: very often -> 10%, often -> 1% and 0.1% and 0.01% and <0.1%, extremely rarely - <0.01% , including individual cases.
- Gastrointestinal tract: often - nausea, diarrhea, constipation; infrequently - flatulence, dyspepsia, vomiting;
- Respiratory system: often - shortness of breath; infrequently - bronchospasm (including in the absence of anamnestic data on obstructive pulmonary diseases);
- Cardiovascular system: often - peripheral edema; infrequently - heart failure, bradycardia, AV-blockade, orthostatic hypotension, cardiac arrhythmias, Raynaud's syndrome, cardialgia, aggravation of CHF, marked reduction in blood pressure;
- Nervous system: often - dizziness, headache, weakness, fatigue, paresthesia; infrequently - nightmares, insomnia, depression, confusion; extremely rarely - hallucinations, fainting;
- Skin and subcutaneous tissue: rarely - erythematous rash, pruritus; extremely seldom - aggravation of the course of psoriasis; in some cases - alopecia, angioedema;
- Other reactions: infrequently - photosensitivity reactions, blurred vision, impotence, hyperhidrosis; rarely - dryness of the mucous membrane of the eye.
If a patient for any reason does not take the drug correctly, then he may develop an overdose, in which the following symptoms occur:
- critical decrease in blood pressure (below 90/60) and pulse (less than 60 beats per minute);
- dizziness, loss of consciousness;
- acute heart failure;
- Quincke swelling, urticaria.
If these symptoms occur, seek medical attention as soon as possible!
Before you start using the drug, read the specific instructions:
- Use in children is not recommended.
- Cancellation of beta-blockers should be carried out gradually over 10 days (up to 2 weeks in patients with coronary artery 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 non-smokers.
- Nebivolol may exacerbate the symptoms of impaired peripheral circulation.
- If nebivolol is needed in patients with psoriasis, the expected benefit of therapy and the possible risk of exacerbation of psoriasis should be carefully evaluated.
- Beta-blockers should be used with caution with increased thyroid function due to the fact that under the influence of beta-blockers tachycardia can be leveled.
- Patients wearing contact lenses should take into account that, with the use of beta-blockers, it is possible to reduce the production of tear fluid.
- Nebivolol does not affect glucose levels in patients with diabetes mellitus, however, under the action of nebivolol, certain signs of hypoglycemia (tachycardia, rapid heartbeat) caused by the use of hypoglycemic drugs may be masked.
- When performing surgical interventions, the anesthesiologist should be warned that the patient is taking beta-blockers.
- Control of glucose in the blood plasma should be carried out 1 time in 4-5 months (in patients with diabetes mellitus).
- Monitoring of laboratory parameters of renal function should be carried out 1 time in 4-5 months (in elderly patients).
- Nebivolol should be used with caution in patients with renal insufficiency, diabetes, hyperthyroidism, history of allergies, psoriasis, COPD, AV-grade I blockade, Prinzmetal angina, as well as in patients over 75 years of age.
Nebivolol does not affect the speed of psychomotor reactions. With nebivolol intake, dizziness and tiredness are sometimes possible, so patients taking nebivolol should refrain from practicing potentially hazardous activities.
When using the drug, you must consider the interaction with other drugs:
- With the on / in the introduction of verapamil on the background of receiving nebivolol there is a threat of cardiac arrest (simultaneous use is contraindicated).
- When applied simultaneously with calcium channel blockers (verapamil and diltiazem), the negative inotropic effect and inhibition of AV conduction is enhanced.
- With simultaneous use with class I antiarrhythmic drugs, amiodarone, it is possible to enhance the negative inotropic effect and suppress AV conductivity.
- When applied simultaneously with sympathomimetics, the pharmacological activity of nebivolol is suppressed.
- With the simultaneous use of nebivolol with antihypertensive drugs, nitroglycerin or slow calcium channel blockers, severe arterial hypotension may develop (special caution is necessary when combined with prazosin).
- With simultaneous use with drugs for anesthesia, it is possible to suppress reflex tachycardia and increase the risk of arterial hypotension.
- With simultaneous use with cimetidine may increase the concentration of nebivolol in the blood plasma.
- With simultaneous use with tricyclic antidepressants, barbiturates, phenothiazine derivatives, the antihypertensive effect of nebivolol may be enhanced.
- When combined with nebivolol insulin and hypoglycemic agents for oral administration can mask the symptoms of hypoglycemia (tachycardia).
- With simultaneous use of nebivolol with drugs that inhibit serotonin reuptake, or other means biotransforming with the participation of CYP2D6 isoenzyme, nebivolol concentration in plasma increases, the metabolism of nebivolol slows down, which may increase the risk of bradycardia.
We picked up some reviews of people using the drug Nebivolol:
- Sasha. I believe that the drug is an excellent substitute Nebilet. According to the content, the amount of the active substance Nebivolol and Nebilet are completely interchangeable. But considering the cost - Nebivolol completely wins !!!
- Katerina. A terrible dizziness, depression and fatigue experienced when taking this drug. She was frightened that recently returned cervical chondrosis was treated. She would have drunk him and treated her chondrosis, if one day she had not forgotten to take a pill in the morning. At about three o'clock in the morning, my head cleared up and dizziness disappeared. I realized that it was a sidewalk. I do not advise. Although it seems to whom it acts.
- Irina. Nebivolol from the pressure acts very gently, or someone says "slowly." This is not a minus of the drug, it is his property. And they need to use, if necessary, slightly lower the pressure without jerks.
- Olga After using nebivolol, the level of blood pressure stopped rising, although I was previously diagnosed with hypertension. I heard that kidneys may suffer from prolonged use, but so far everything is in order. In addition to good efficiency, I like the affordable price, which is an important factor for pensioners.
Similar in action with Nebivolol are: Nebival, Nebikard, Nebikor, Nebilet, Nebilong, Nodon.
Before using analogues consult your doctor.
Storage conditions and shelf life
The drug is stored at a temperature of not more than 25 grams in a place remote from small children. The drug is allowed to use within 3 years from the date of its release.