Nebivolol tabs 5mg #28

User manual for Nebivolol

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Composition

In 1 tablet of the drug contains 5 milligrams of nebivolol.

Form of issue

The given preparation is issued in tablets, on 30 tablets in a blister.

pharmachologic effect

The drug is a racemate that consists of two enantiomers: L-nebivolol and D-nebivolol.
Single use of the drug:
    reduces the heart rate and blood pressure during exercise and at rest;
    causes an antianginal effect in people with IHD;
    increases the ejection fraction;
    reduces filling pressure and OPSS, reduces the end-diastolic pressure of the left ventricle.
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.
Antiarrhythmic effect of the drug is due to the suppression of pathological automatism of the heart and slowing AV-conduction. The hypotensive effect is due to a decrease in the activity of the renin-antigotensin system.

Pharmacodynamics and pharmacokinetics

Both enantiomers of nebivolol are very rapidly absorbed from the gastrointestinal tract. Food for absorption of the drug is not affected. In people with fast metabolism, bioavailability averages 12 percent, in people with slow metabolism is almost complete. Therefore, depending on the metabolism, the dose of the drug is determined individually. In the blood plasma nebivolol binds mainly to albumin.
It is deduced by 48 percent through the intestine and by 38 percent by the kidneys.

Indications for use

Indications for the use of this medication are:
    chronic heart failure;
    IHD (prevention);
    arterial hypertension.

Contraindications

The drug can not be used when:
    increased sensitivity to nebivolol;
    children and adolescents under 18;
    depression;
    myasthenia gravis;
    severe obliterating diseases of peripheral vessels (Raynaud's syndrome, intermittent claudication);
    bronchial asthma and bronchospasm in anamnesis;
    significant violations of the liver;
    metabolic acidosis;
    pheochromocytoma;
    cardiogenic shock;
    Bradycardia (heart rate less than 60 beats per minute);
    AV-blockade of the second and third degree (with the absence of an artificial pacemaker);
    SSSU, including sinoatrial blockade;
    significant arterial hypotension (systolic blood pressure less than 90 mm Hg);
    chronic heart failure in the stage of decompensation;
    acute heart failure.

Side effects

There may be the following side effects when using the drug:
    With chronic heart failure: often enough - dizziness and bradycardia, as well as swelling of the legs, blockade of the first degree, orthostatic hypotension, increased signs of the disease.
    From the side of the reproductive system: in rare cases - impotence.
    From the skin: sometimes erythematous rash and itching; in very rare cases, hypersensitivity reactions and an increase in psoriasis symptoms.
    From the gastrointestinal tract: often enough - diarrhea, nausea, constipation, and sometimes - dyspeptic syndrome.
    From the respiratory system: often enough - shortness of breath, sometimes - bronchospasm.
    From the cardiovascular system: sometimes - increased intermittent claudication, arterial hypotension, cardialgia, heart rhythm disturbances, AV blockade / conduction slowing, heart failure, bradycardia.
    On the part of the organs of vision: in some cases, visual impairment.
    From the side of the peripheral and central nervous systems: in some cases - nightmares, insomnia, drowsiness, decreased concentration, depression, paresthesia, fatigue, dizziness, headache.

Instructions for use Nebivolol (Method and dosage)

According to the instructions for the use of Nebivolol, adults are advised to take inwards from 2.5 to 5 milligrams of the drug per day (in the morning). If necessary, the daily dose may increase to 10 milligrams. Stable effect is observed after 1 to 2 weeks with regular admission, in some cases - after a month.
For the elderly, the initial dose of the drug is 2.5 milligrams per day (maximum - 5 milligrams).

Overdose

In case of an overdose of this medication, the following symptoms can be observed: acute heart failure, bronchospasm, arterial hypotension and bradycardia.
Treatment consists in washing the stomach and prescribing laxatives and activated charcoal. If necessary, intensive care is provided in the hospital.

Interaction

If you simultaneously take this medicine with hypoglycemic agents and insulin, signs of hypoglycemia (tachycardia) may be masked.
Simultaneous reception of this drug with drugs that inhibit serotonin reuptake may increase the concentration of nebivolol in the blood plasma and slow the metabolism, which increases the risk of developing bradycardia.
Simultaneous reception with cimetidine increases the concentration of nebivolol in the blood plasma.
Simultaneous reception with tricyclic antidepressants, phenothiazine derivatives, barbiturates enhances the antihypertensive effect of nebivolol.
Simultaneous reception with drugs for anesthesia increases the risk of developing arterial hypotension and suppresses reflex tachycardia.
Simultaneous reception with sympathomimetics inhibits the pharmacological activity of nebivolol.
Simultaneous reception with antihypertensive drugs, slow calcium channel blockers or Nitroglycerin causes the development of significant arterial hypotension.
The simultaneous administration of verapamil and the use of nebivolol can cause cardiac arrest.
Simultaneous reception with antiarrhythmic drugs of the first class can enhance the negative inotropic effect and inhibits AV-conduction.

Terms of sale

You don' need a prescription to buy Nebivolol.

Storage conditions

Keep the drug at a temperature of no higher than 25 degrees.
Shelf life Nebivolol is 3 years.

Reviews of Nebivolol

According to reviews of many people, this drug is highly effective, but has many side effects that often manifest.