Indications
Nebita serves various purposes including:
- Managing hypertension
- Treating essential hypertension
- Addressing chronic heart failure (CHF)
- Managing stable mild and moderate chronic heart failure in elderly patients alongside standard therapies.
Pharmacology
Nebivolol, a β adrenergic receptor blocking agent, targets both β1 and β1 adrenergic receptors. It lacks intrinsic sympathomimetic and membrane stabilizing activity at therapeutic levels. Nebivolol’s actions include:
- Lowering heart rate
- Reducing myocardial contractility
- Decreasing sympathetic outflow to the periphery
- Suppressing renin activity
- Promoting vasodilation and reducing peripheral vascular resistance
Pharmacokinetics
Nebivolol undergoes metabolism via glucuronidation and hydroxylation by CYP2D6. Its active isomer (d-nebivolol) has a half-life of approximately 12 hours in most individuals, with variations in poor metabolizers. Absorption is similar to an oral solution, with peak plasma concentrations occurring around 1.5 to 4 hours post-dosing. Food does not affect its pharmacokinetics.
Interaction
Caution is advised when Nebita is used with myocardial depressants, AV conduction inhibitors, or antiarrhythmic agents. Combining Nebita with other β-blockers or CYP2D6 inhibitors requires careful monitoring.
Contraindications
Nebivolol is contraindicated in patients with severe bradycardia, heart block, cardiogenic shock, decompensated cardiac failure, sick sinus syndrome, severe hepatic impairment, or hypersensitivity to any component.
Side Effects
Common side effects include headache, nausea, and bradycardia.
Precautions & Warnings
Patients should be cautioned against abrupt discontinuation of Nebita, especially those with coronary artery disease. Special considerations apply to patients with congestive heart failure, angina, bronchospastic diseases, undergoing anesthesia or major surgery, diabetic patients, those with thyrotoxicosis, peripheral vascular disease, and those on non-dihydropyridine calcium channel blockers.
Use in Special Populations
Caution is advised in patients with impaired renal or hepatic function, and in individuals with a history of severe anaphylactic reactions.
Therapeutic Class
Nebita belongs to the class of beta-adrenoceptor blocking drugs, commonly known as beta-blockers.
Storage Conditions
Store Nebita below 30°C, away from light and moisture, and out of the reach of children.
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