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Nebivolol

Nebivolol

It is a lipophilic b1-blocker. It exerts its actions by exhibiting a high selectivity for b-adrenergic receptors and also by reducing the peripheral vascular resistance by modulating nitric oxide release. It is devoid of intrinsic sympathomimetic or membrane stabilising activity but appears to have nitric oxide-mediated vasodilatory effects.

Indications

Nebivolol is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It may be used alone or in combination with other antihypertensive agents.


Dosage

5mg once daily taken with or without food, preferably at a fixed time in a day. A reduced starting dose of 2.5mg (with upward titration where necessary) is recommended in the elderly and in patients with renal insufficiency.


Contra-Indications

Use of the drug in children and patients with hepatic insufficiency is not recommended.


Special Precautions

Patients undergoing major surgery involving general anesthesia. 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.


Side Effects

Fatigue Headache Dizziness Bradycardia (slow heart rate) Hypotension (low blood pressure) Shortness of breath Edema (fluid retention) Nausea Severe side effects are rare but can include: Allergic reactions (rash, itching, swelling, severe dizziness) Unusual weight gain Fainting Mental/mood changes (e.g., depression) Symptoms of a serious allergic reaction, including difficulty breathing and swelling of the face/tongue


Drug Interactions

Nebivolol may interact with other medications, potentially affecting their effectiveness or increasing the risk of side effects. Some examples of drug interactions include: Other beta-blockers Calcium channel blockers Antiarrhythmic drugs Digoxin Nonsteroidal anti-inflammatory drugs (NSAIDs) Clonidine Insulin and oral hypoglycemic agents (may mask signs of hypoglycemia)


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