Indications
Nebiren Tablet is used for:
Heart failure, Hypertension
Adult Dose
Oral
Hypertension
Adult: Initially, 5 mg once daily. May increase dose at intervals of 2 wk if needed. Max: 40 mg once daily.
Elderly: >65 yr Initially, 2.5 mg once daily increased to 5 mg once daily if required.
Oral
Heart failure
Adult: Initially, 1.25 mg once daily. May double dose every 1-2 wk if tolerated. Max: 10 mg once daily.
Hepatic impairment
2.5 mg/day PO initially; increased cautiously
Child Dose
Renal Dose
Renal impairment: CrCl <30 mL/min: Initially, 2.5 mg once daily. Maintenance: Increased to 5 mg once daily if required.
Administration
May be taken with or without food.
Contra Indications
Hepatic impairment, sick sinus syndrome, 2nd and 3rd degree heart block (without a pacemaker), history of asthma, metabolic acidosis, severe peripheral arterial disease, severe bradycardia, cardiogenic shock or decompensated heart failure, untreated phaeochromocytoma. Pregnancy and lactation.
Precautions
Patients w/ inadequate cardiac function, well-compensated heart failure, myasthenia gravis. Patients undergoing major surgery involving general anaesth. May mask signs and symptoms of hypoglycaemia and hyperthyroidism. Abrupt withdrawal may exacerbate angina symptoms and/or precipitate MI and ventricular arrhythmias in patients w/ coronary artery disease. Pregnancy and lactation. Monitoring Parameters Monitor ECG, BP and blood glucose in diabetic patients.
Lactation: Not known whether drug is excreted into breast milk; use not recommended
Pregnancy-Lactation
Pregnancy category: C
Lactation: Not known whether drug is excreted into breast milk; use not recommended
Interactions
Increased plasma concentrations w/ potent CYP2D6 inhibitors (e.g. paroxetine, fluoxetine, propafenone, thioridazine, quinidine). Concomitant use w/ antiarrhythmic drugs (e.g. amiodarone, disopyramide) or nondihydropyridine Ca channel blockers (e.g. diltiazem, verapamil) may cause conduction disturbance. Additive negative effects on AV conduction and heart rate w/ other beta-adrenergic blocking agents or digoxin. Concurrent admin w/ catecholamine-depleting agents (e.g. reserpine) may result in additive hypotension or bradycardia. Abrupt withdrawal of clonidine may increase risk of rebound HTN.
Side Effects
Side effects of Nebivolol :
1-10%
Headache (6-9%), Fatigue (2-5%), Dizziness (2-4%), Diarrhea (2-3%), Nausea (1-3%), Increased triglyceride levels and insulin resistance, decreased high-density lipoprotein (HDL) levels (1%), Insomnia (1%), Peripheral edema (1%), Weakness (1%)
<1%
Bradycardia.Chest pain, Dyspnea
Potentially Fatal: Anaphylaxis.
Mode of Action
Nebivolol exhibits high selectivity for beta1-adrenergic receptors and has vasodilating activity due to a direct action on the endothelium, involving nitric oxide release. It lacks intrinsic sympathomimetic and membrane-stabilising activity.
Note
Nebiren 5 mg Tablet generic name is Nebivolol. Nebiren 5 mg Tablet is manufactured by Renata LimitedNebiren is availble in all over Bangladesh.
Mes BD drug index information on Nebiren Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.