Included in the formulation
АТХ:C.07.A.B.12 Nebivolol
Pharmacodynamics:Competitive, reversible, relatively selective blockade of β1-adrenoreceptors, modulation of endothelial vasodilating factor (NO) release. It has antihypertensive, anti-anginal and antiarrhythmic effects.
Pharmacokinetics:The connection with plasma proteins is 98%. Biotransformation in the liver. The half-life of "fast" metabolizers is 10 hours (nebivolol) and 24 hours (hydroxymetabolites), "slow" metabolizers - 30-50 hours (nebivolol) and 48 hours (hydroxymetabolites). Elimination by the kidneys (35%) and with feces (48%) in the form of metabolites.
Indications:Arterial hypertension, hypertensive crisis.Stenocardia of tension.
Unstable angina.
Myocardial infarction (acute phase, secondary prevention).
Arrhythmias.
IX.I10-I15.I15 Secondary Hypertension
IX.I10-I15.I10 Essential [primary] hypertension
IX.I20-I25.I20 Angina pectoris [angina pectoris]
Contraindications:Sinus bradycardia (less than 45-50 beats per minute).Arterial hypotension.
Cardiogenic shock.
Syndrome of weakness of the sinus node.
AV-blockade II-III degree, sinoatrial blockade.
Refractory to treatment severe heart failure.
Violation of peripheral circulation.
Dysfunction of the liver.
Bronchial asthma.
Bronchospasm.
Pregnancy, breast-feeding.
Childhood.
Carefully:Propensity to bradycardia. Diabetes.
Hyperfunction of the thyroid gland.
Psoriasis, a burdened allergic anamnesis.
Elderly age (over 75 years).
Pregnancy and lactation:The action category for the fetus is FDA-C. It can be used during pregnancy according to strict indications. Abolish breastfeeding during the use of the drug.
Dosing and Administration:Inside for 5-10 mg per day (at the same time, regardless of food intake, without chewing and drinking with a sufficient amount of liquid). In chronic renal failure and in patients older than 65 years, the initial dose of 2.5 mg per day.
Side effects:Nervous system: headache and dizziness, paresthesia, weakness, rarely - depression, nightmares and transient visual impairment. Digestive system: nausea, vomiting, constipation or diarrhea, bloating.
The cardiovascular system: symptomatic bradycardia, AV-blockade, hypotension, heart failure, exacerbation of intermittent claudication.
Others: skin reactions, bronchospasm.
Overdose:When an overdose develops bradycardia, arterial hypotension, bronchospasm, acute heart failure. Treatment: gastric lavage, enterosorbents and laxatives, preparations for stopping beta-adrenergic blocking action.
Interaction:Calcium channel blockers increase the blockade of AV conduction when used in conjunction with nebivolol. Antiarrhythmics I class and amiodarone prolong the time of excitation of the atria with simultaneous appointment.
Anesthetic agents (cyclopropane, diethyl ether, trichloroethylene), tricyclic antidepressants, barbiturates, phenothiazine derivatives potentiate hypotension, cimetidine and nicardipine increase the concentration in the plasma, sympathomimetics neutralize the activity.
Special instructions:It is necessary to monitor the parameters of peripheral blood, glucose concentration (in people with diabetes mellitus), heart function, kidneys, functional liver tests, blood pressure, ECG and heart rate (with intravenous administration).