Nebita 2.5

Indications

Nebivolol is used to treat high blood pressure (hypertension). It is also used, together with other medicines, for stable mild to moderate heart failure in people aged 70 years or older. It is also available combined with Hydrochlorothiazide for blood pressure.

How It Works

Nebivolol is a beta blocker that mainly acts on the heart. It slows the heart rate and reduces the force of each beat. It also helps blood vessels relax by increasing nitric oxide, a natural substance in the vessel wall. Together these effects lower blood pressure and reduce the heart's workload.

Dosage and Administration

• High blood pressure, adults: usually 5 mg once a day, at the same time each day.
• Older people (over 65 years) and people with kidney problems: usually start with 2.5 mg once a day; the doctor may increase it to 5 mg.
• Heart failure: started at a very low dose and increased slowly every 1 to 2 weeks, as prescribed.
• Children: not recommended.

Swallow the tablet with water, with or without food. The full effect on blood pressure may take 1 to 2 weeks.

Interactions

• Verapamil and Diltiazem: can slow the heart too much; avoid unless a doctor advises.
• Amiodarone and other heart rhythm medicines, and Digoxin: risk of a very slow heartbeat.
• Clonidine: stopping Clonidine suddenly while on a beta blocker can cause a sharp rise in blood pressure.
• Fluoxetine, Paroxetine and Quinidine: can increase Nebivolol levels.
• Insulin and diabetes tablets: Nebivolol can hide the fast heartbeat of low blood sugar.
• Other blood pressure medicines, some antidepressants and anaesthetics: can lower blood pressure further.
• NSAID painkillers such as Ibuprofen: can reduce the blood pressure-lowering effect.

Contraindications

• Allergy to nebivolol or any ingredient of the product.
• Liver failure or poor liver function.
• Very slow heart rate (under 60 beats a minute before treatment), certain heart block or sick sinus syndrome without a pacemaker.
• Sudden or worsening heart failure, or shock caused by heart failure.
• Very low blood pressure.
• Severe asthma or a history of severe wheezing.
• Untreated phaeochromocytoma (a rare adrenal gland tumour).
• Severe blood circulation problems in the arms or legs.

Side Effects

Common: headache, dizziness, tiredness, tingling, diarrhoea, constipation, nausea, shortness of breath and swollen ankles. Less common: slow heartbeat, low blood pressure, cold hands or feet, sleep problems, nightmares, low mood and reduced sexual ability.

Get urgent medical help if you faint, have a very slow pulse, wheezing or difficulty breathing, chest pain, increasing breathlessness or leg swelling (signs of worsening heart failure), or signs of a serious allergic reaction.

Pregnancy and Lactation

Not recommended during pregnancy unless the doctor decides it is clearly necessary; it may slow the baby's growth and heart rate. Not recommended while breastfeeding.

Precautions and Warnings

Do not stop taking it suddenly, as this can make chest pain or blood pressure worse; the doctor will reduce the dose slowly. Tell the doctor or dentist before surgery that you take a beta blocker. Use with care if you have diabetes, an overactive thyroid, psoriasis, mild asthma or circulation problems. Dizziness and tiredness can affect driving.

Overdose

Too much can cause a very slow heartbeat, very low blood pressure, wheezing, fainting and heart failure. Seek emergency medical help straight away.

Therapeutic Class

Beta blocker (selective beta-1 blocker with vasodilating action).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.