Introduction

Nebita 2.5 belongs to a group of medicines called beta-blockers. It is used to treat high blood pressure (hypertension), and heart failure. It also helps to prevent future heart attacks and stroke and to prevent migraine. Nebita 2.5 is also used to relieve the symptoms caused by an overactive thyroid gland. It may be prescribed alone or together with other medications. The dose and frequency depend on what you are taking it for and the severity of your condition. It may be taken empty stomach or with a meal, but take it regularly at the same time each day to get the most benefit. It may take several weeks before you get the full benefit of this medicine and you may need to take it for the rest of your life. However, it is important to continue taking it even if you feel well. Most people with high blood pressure do not feel ill and if you stop taking it, your condition may worsen. The main side effects of this medicine are fatigue, headache, slow heart rate, feeling dizzy, and nausea. These are usually mild and short-lived. It may also cause shortness of breath or low blood pressure in some people. To reduce the risk of side effects your doctor will probably start the medicine at a low dose and gradually increase it. Consult your doctor if the side effects bother you or do not go away. Before taking it, let your doctor know if you have any liver problems. It may also not be suitable for people who have a slow heart rate, severe circulation problems, severe heart failure, or low blood pressure. Pregnant or breastfeeding mothers should also consult their doctor before taking it. You must talk to your doctor to find out whether this medicine is suitable for you to use. You should have your blood pressure checked regularly to make sure that this medicine is working properly. Avoid drinking alcohol as it may increase certain side effects. Lifestyle changes like low fat diet, exercise and no smoking helps to enhance the working of medicine.

Uses of Nebita 2.5

• Hypertension (high blood pressure)

Side effects of Nebita 2.5

• Nausea
• Headache
• Fatigue
• Constipation
• Diarrhea
• Dizziness
• Cold extremities

How to use Nebita 2.5

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Nebita 2.5 may be taken with or without food, but it is better to take it at a fixed time.

How Nebita 2.5 works

Nebita 2.5 is a beta blocker that works specifically on the heart. It works by slowing down the heart rate and makes the heart more efficient at pumping blood around the body.

Indication

Heart failure, Hypertension

Administration

May be taken with or without food.

Adult Dose

Oral Hypertension Adult: Initially, 5 mg once daily. May increase dose at intervals of 2 wk if needed. Max: 40 mg once daily. Elderly: >65 yr Initially, 2.5 mg once daily increased to 5 mg once daily if required. Oral Heart failure Adult: Initially, 1.25 mg once daily. May double dose every 1-2 wk if tolerated. Max: 10 mg once daily. Hepatic impairment 2.5 mg/day PO initially; increased cautiously

Renal Dose

Renal impairment: CrCl <30 mL/min: Initially, 2.5 mg once daily. Maintenance: Increased to 5 mg once daily if required.

Contraindication

Hepatic impairment, sick sinus syndrome, 2nd and 3rd degree heart block (without a pacemaker), history of asthma, metabolic acidosis, severe peripheral arterial disease, severe bradycardia, cardiogenic shock or decompensated heart failure, untreated phaeochromocytoma. Pregnancy and lactation.

Mode of Action

Nebivolol exhibits high selectivity for beta1-adrenergic receptors and has vasodilating activity due to a direct action on the endothelium, involving nitric oxide release. It lacks intrinsic sympathomimetic and membrane-stabilising activity.

Precaution

Patients w/ inadequate cardiac function, well-compensated heart failure, myasthenia gravis. Patients undergoing major surgery involving general anaesth. 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. Monitoring Parameters Monitor ECG, BP and blood glucose in diabetic patients. Lactation: Not known whether drug is excreted into breast milk; use not recommended

Side Effect

1-10% Headache (6-9%),Fatigue (2-5%),Dizziness (2-4%),Diarrhea (2-3%),Nausea (1-3%),Increased triglyceride levels and insulin resistance, decreased high-density lipoprotein (HDL) levels (1%),Insomnia (1%),Peripheral edema (1%),Weakness (1%) <1% Bradycardia.Chest pain,Dyspnea Potentially Fatal: Anaphylaxis.

Interaction

Increased plasma concentrations w/ potent CYP2D6 inhibitors (e.g. paroxetine, fluoxetine, propafenone, thioridazine, quinidine). Concomitant use w/ antiarrhythmic drugs (e.g. amiodarone, disopyramide) or nondihydropyridine Ca channel blockers (e.g. diltiazem, verapamil) may cause conduction disturbance. Additive negative effects on AV conduction and heart rate w/ other beta-adrenergic blocking agents or digoxin. Concurrent admin w/ catecholamine-depleting agents (e.g. reserpine) may result in additive hypotension or bradycardia. Abrupt withdrawal of clonidine may increase risk of rebound HTN.