Nebivolol is a third-generation selective beta 1 receptor blocker that combines nitric oxide mediated vasodilation. It is mainly used to treat cardiovascular diseases such as hypertension, angina pectoris, and chronic heart failure.

1、 Drug name

Common name: Nebivolol

Product Name: BYSTOLIC ® (Best)

English name: Nebivolol Tablets

2、 Indications

Used to treat hypertension, it can be used alone or in combination with other antihypertensive drugs to lower blood pressure, thereby reducing the risk of fatal and non fatal cardiovascular events such as stroke and myocardial infarction.

3、 Specifications

5mg、 Tablets.

4、 Main components

Active ingredient: Nebivolol hydrochloride.

5、 Usage and dosage

The recommended starting dose is 5mg once daily, which can be taken with or without food. If further blood pressure reduction is required, the dosage can be increased every 2 weeks, up to a maximum of 40mg per day. It can be administered once a day.

6、 Dose adjustment

Renal dysfunction: The initial dose for patients with severe renal insufficiency (creatinine clearance rate<30mL/min) is 2.5mg once daily, and if needed, it should be slowly adjusted. Not studied in dialysis patients.

Liver function impairment: The initial dose for patients with moderate liver dysfunction is 2.5mg once daily, slowly adjusted; Patients with severe liver dysfunction are prohibited from using it.

Elderly: No need to adjust dosage.

CYP2D6 metabolic disorders: No need to adjust dosage.

7、 Medication precautions

Medication time: can be taken with food or on an empty stomach.

Missed dose: If missed, it should be taken as soon as possible when remembered. However, if it is close to the next dose, the missed dose should be skipped and the next dose should be taken according to the original plan. Do not take double the dose at once.

Discontinuation of medication: Do not abruptly discontinue medication, especially for patients with coronary heart disease, as it may worsen angina, myocardial infarction, or ventricular arrhythmia. If medication needs to be discontinued, it should be gradually reduced under the guidance of a doctor (usually taking 1-2 weeks).

Vomiting/Fasting: Use during fasting or vomiting periods may increase the risk of hypoglycemia, and blood glucose symptoms should be monitored.

Surgery/Anesthesia: If surgery is required, the doctor should be informed that the medication is being taken; Whether to continue medication during the perioperative period needs to be evaluated by a doctor.

8、 Medication for special populations

Pregnant women: Due to limited data, gestational hypertension should be managed under the guidance of a doctor.

Breastfeeding women: It is not recommended to breastfeed as it may result in adverse reactions (such as bradycardia) to the baby through milk secretion.

Children: The safety and efficacy of patients under 18 years old have not been established.

Elderly patients: There is no significant difference in efficacy and adverse reactions compared to younger patients.

9、 Adverse reactions

Common adverse reactions include headache, fatigue, dizziness, diarrhea, nausea, bradycardia, peripheral edema, dyspnea, rash, etc.

Rare but serious adverse reactions: including severe bradycardia, hypotension, heart failure, bronchospasm, allergic reaction, abnormal liver function, hypoglycemia (especially in diabetes patients may cover up symptoms), etc.

10、 Contraindications

Individuals who are allergic to any ingredient of this product; Severe bradycardia; Greater than one degree atrioventricular block; Cardiogenic shock; Decompensated heart failure; Sick sinus syndrome (unless a permanent pacemaker has been installed); Severe liver dysfunction (Child Pugh>Grade B).

11、 Drug interactions

CYP2D6 inhibitors (such as quinidine, fluoxetine, paroxetine) may increase the blood concentration of nebivolol and require monitoring of blood pressure and consideration of reducing dosage.

Avoid co administration with other beta blockers.

The combination of digoxin and other digitalis drugs may increase the risk of bradycardia.

The combination of verapamil and diltiazem calcium channel blockers may lead to excessive decrease in heart rate and blood pressure.

The combination with reserpine or clonidine may excessively inhibit sympathetic nervous system activity.

Combined use with insulin or oral hypoglycemic drugs may mask symptoms of hypoglycemia, such as tachycardia.

12、 Storage method

Store in a room temperature environment of 20 ° C to 25 ° C (68 ° F to 77 ° F), in a sealed, dark container, and avoid contact with children.

Nebivololinformation