Instructions for Nebivolol pills
Release Form:
tab. 5 mg:10, 14, 20, 28, 30 or 42 pcs.
Description:
White to white tablets with yellowish color, round, double-pointed, with cross-shaped risk on one side.
1 tab
Nebyvolol hydrochloride 5.45 mg,
which corresponds to the content of Nebyvolol 5 mg
Auxiliary substances: betadex (betacyclodekstrin) - 23 mg, starch corn pregelatinized - 36.4 mg, microcrystalline cellulose - 108.55 mg, crosspov Eid - 1.9 mg, silicon coloid dioxide - 0.9 mg, magnesium stearat - 1.8 mg.
ATX codes
Nebivolol
Pharmacological groups / Group membership:
Beta<SUB>1</SUB>-adrenoblocator III generation with vasodilating properties
Active substance:
non-bivolol
Pharmacy Group
Beta1 adrenderer selective
Pharmaceuticals:
Cardioselic beta1-adrenoblocator III generation with vasodilating properties. An active substance is a racemate consisting of two enantiomers: D-Nebyvolol and L-Nebyvolol. D-non-bivolol is a competitive and highly selective blockage of α1-adrenoreceptors; L-Nebivolol has a soft vasodilating effect by modulating the release of vasodilating factor (NO) from the vascular endothelium.
Nebyvolol reduces the HSS and AD in the state of rest and under load, reduces the final diastolic pressure of the left ventricle, reduces the OPSS, improves the diastolic function of the heart (reduces the pressure of filling), increases the fraction of the discharge; causes anti-anginal effect in IBS patients.
Hypotensive action is also caused by decrease of activity of renin-angiotensin system (not directly correlates with change of activity of renin in plasma blood).
The anti-arrhythmic action is caused by the suppression of pathological automatic heart (including in the pathological area) and the deceleration of AV conductivity.
Sustainable hypotensive action develops in 1-2 weeks of regular drug Nebivolol use, and in some cases - in 4 weeks, stable action is noted in 1-2 months.
Testimonials Nebivolol:
Arterial hypertension.
Stable chronic cardiac failure of mild and moderate severity (in combination therapy) in patients over 70 years of age.
Method of application, course and dosage Nebivolol:
Applied inside. The dosage mode is set individually, depending on the patient's indications, clinical situation and age. Average daily dose - 2.5-5 mg. Maximum daily dose - 10 mg
Drug Interaction:
Contrary to this, simultaneous use with floctaphenin is shown. Nebyvolol can prevent compensatory reactions of the cardiovascular system associated with arterial hypotensis or shock, which can be caused by floctaphenin.
Contrary to the simultaneous application of Nebivolol and sultopride is shown, as when they are simultaneously applied there is an increased risk of the emergence of ventricular arrhythmia, especially polymorphic gastrointestinal tachycardia of the "piruet" type.
When simultaneously used with antiarrhythmic agents of the I class (hyidine, hydrochyidine, phleachinide, cybenzolin, diopyramide, lidokain, mexiletine, prophphenonphenen) it is possible to increase of negative iptroactive effect excitation time line through the AV node.
At the same time, the use of beta-adrenoblocators with slow calcium channel blockers (verapamyl and diltiase) increases the negative effect on myocardial acidification and AV conductivity. Contradicted in/in the introduction of verapamyl against the background of the intake of Nebivolol.
When simultaneously used with hypotensive means of central action (clone, guanfacin, moxonidine, methyldopa, rilmenidine) it is possible to decrease the flow of heart failure due to reduction of symptomatic tone (decrease of HSS and heart discharge, symptoms We are vasodilatsiya). In case of abrupt cancelation of these drugs Nebivolol, especially before the cancelation of Nebivolol, "ricochet" arterial hypertension ("cancel" syndrome) may develop.
When simultaneously used with antiarrhythmic III agents (amiodarone), the influence on the time of conducting through the AV node may increase.
When simultaneously using non-bivolol with insulin and hypoglycemic agents for intake, symptoms of hypoglycemia (increased heartbeat, tachycardia) may be masked.
Simultaneous use of Nebivolol and drugs Nebivolol for general anesthesia can cause suppression of reflex tachycardia and increase the risk of development of arterial hypotension.
Simultaneous use of Nebivolol with baclofen, amifostin, with hypotensive preparations can cause a significant fall of AD, therefore correction of doses of hypotensive drugs Nebivolol is required.
If you simultaneously apply non-bivolol with cardiac glycozides, the AV conductivity may slow down. Non-bivolol does not affect pharmacokinetic digoxin parameters.
Simultaneous application of Nebivolol and slow calcium channel blocks of dihydropyridine range (amlodipin, phelodipine, lacidipine, nifedipine, nicardipine, nimodipine Nitrendipine) can increase the risk of development of arterial hypotension. The increased risk of further reduction of myocardial abatement in patients with heart failure cannot be ruled out.
When simultaneously using non-bivolol with hypotensive agents, nitroglycerin can develop a pronounced arterial hypotension (special care is necessary when combined with prasozine).
Simultaneous use of tricyclic antidepressants, barbiturates and phenotiazine derivatives, anxiolitis, sleeping aids can increase the antihypertensive action of Nebivolol.
Clinically significant interaction between Nebyvolol and NPWS is not established. Acethylsalicinic acid as an anti-aggregate may be used simultaneously with Nebivolol. Simatomytic devices can inhibit beta-adrenoblocator activity when simultaneously used.
When using Nebyvolol in combination with preparations that ingibate reverse grafting
Use in pregnancy and breastfeeding:
Application during pregnancy is possible only for life reasons, when the expected benefit for the mother exceeds the potential risk for the fetus (due to the possibility of delay of fetal growth, fetal death, premature birth, as well as development in the newborn bradycardia, arterial hypotension, hypogli kemia and respiratory paralysis).
If necessary during lactation, stop breastfeeding should be decided.
Side Action Nebivolol:
From the immune system: Very rarely - angionevrotic edema, reactions of hypersensitivity.
From the psyche: rarely - depression, "nightmarish" dreams, psychosis; Very rarely - hallucinations, confusion of consciousness.
On the side of the nervous system: very often - dizziness; Often - headaches, dizziness, weakness, pastesthesia; very rarely fainting.
From the viewpoint: infrequently - visual impairment; rarely is the dry eye.
On the side of the cardiovascular system: very often - bradycardia; often - aggravation of the course of chronic heart failure, AV-block I degree, ortostatic hypotension; Infrequently - peripheral swelling, bradycardia, heart failure, AV blockade, pronounced reduction of AD, progression of accompanying "intermittent" chromots; very seldom - Reino syndrome.
From the respiratory system: Often - breathing; Not often - bronchospasm (including in the absence of obstructive lung diseases in anamnesis).
From the digestive system: often - nausea, constipation, diarrhea; Not often - dyspepsia, meteorism, vomiting.
On the skin and subcutaneous tissue side: Infrequently - erythematosis skin rash, itching; very rarely - the aggravation of the flow of psoriasis, the nettle; frequency unknown - alopecia.
Others: often - increased fatigue; not often - photermatosis, hyperhydrosis; erectile dysfunction; Very rarely - cold/cyanosis of limbs.
Application for kidney disorders
Contradicted for use in severe kidney function disorders (CC less than 20 ml/min). Care should be taken in patients with kidney impairment.
Application for liver disorders
Contraindicated to use in the expressed liver function disorders. Carefully apply to patients with liver disorders.
Application of elderly patients
Use with care in patients over 65 years of age. Laboratory indicators of kidney function in elderly patients should be monitored 1 time every 4-5 months.
Application of children
Contradicted to use in children and teenagers up to 18 years.
Nozologiya Nebivolol:
Essential [primary] hypertension
Stagnant heart failure
