Nebyvolol

When ATH:
C07AB12

Characteristic.

Nebivolol hydrochloride - White or almost white powder. Soluble in methanol, dimethylsulfoxide and N,N-dimethylformamide; sparingly soluble in ethanol, propylene glycol and polyethylene glycol; very slightly soluble in hexane, dichloromethane and methylbenzene.

Pharmacological action.
Gipotenzivnoe, antianginalnoe, antiarrhythmic.

Application.

Arterial hypertension (monotherapy or in combination with other antihypertensives), CHD, angina.

Contraindications.

Hypersensitivity, sinusovaya bradycardia (less than 45-50 beats. / min), hypotension, cardiogenic shock, sick sinus syndrome; AV block II-III degrees, refractory to the treatment of severe heart failure; the peripheral blood circulation, sinoatrialynaya blockade, abnormal liver function, bronchial asthma, bronchospasm, pregnancy, lactation, childhood.

Restrictions apply.

The tendency to bradycardia, diabetes, hyperthyroidism, psoriasis, otyahoschennыy allerholohycheskyy history, advanced age (senior 75 years).

Pregnancy and breast-feeding.

When pregnancy is possible only under strict conditions.

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

At the time of treatment should stop breastfeeding.

Side effects.

From the nervous system and sensory organs: 1-10% of cases - headache, dizziness, fatigue (weakness), paraesthesia; less than 1% cases of depression, nightmares; transient blurred vision.

From the digestive tract: in 1% cases or more - nausea, vomiting, constipation; flatulence, diarrhea.

Cardio-vascular system and blood (hematopoiesis, hemostasis): simptomaticheskaya bradycardia, OF блокада, gipotenziya, heart failure, exacerbation of intermittent claudication.

Other: skin reactions, bronchospasm.

Cooperation.

Calcium channel blockers increase AV conduction blockade, antiarrhythmics class I and amiodarone lengthen the time of the excitation of the atria. Anaesthetic agents (cyclopropane, diethyl ether, trichlorethylene), tricyclic antidepressants, barbiturates, phenothiazines potentiate hypotension, cimetidine and increase nicardipine plasma concentration, sympathomimetic negate Activity.

Overdose.

Symptoms: bradycardia, hypotension, bronchospasm, acute heart failure.

Treatment: gastric lavage, administration of activated charcoal, appointment of laxatives; possible mechanical ventilation and administration of atropine (bradycardia and increased vagotonia), plasma or plasma substitutes, if necessary - catecholamines. For relief of beta-blocking action - isoprenaline hydrochloride (slowly, I /, at an initial dose 5 mcg / min until the desired effect is achieved), doʙutamin (at the initial dose 2,5 mcg / min), in the absence of effect - glucagon (IV 50–100 mcg/kg, cherez again 1 h — 70 mcg/kg/h by infusion). With AV blockade - transvenous stimulation.

Dosing and Administration.

Inside, at the same time of the day, without chewing, drinking plenty of water, during or after a meal is on 5 mg 1 once a day. Patients with renal insufficiency or in patients older 65 years - 2,5 mg / day. The maximum daily dose - 10 mg.

Precautions.

Discontinue therapy should be gradual (for 1-2 weeks). Slowing heart rate to 55 u. / min require dose reduction. Against the background of diabetes can disguise signs of hypoglycemia, with hyperfunction of the thyroid gland - tachycardia. May enhance the reaction to pollen or other allergens. Should be abolished for 24 hours before surgery using general anesthesia (including surgical dentistry) or select an anesthetic with the least negative inotropic effects. If necessary, simultaneous administration of antacids Nebivolol is taken with meals, and antacids between meals. Be wary of during the drivers of vehicles and people, skills relate to the high concentration of attention. At the time of treatment is recommended to eliminate the use of alcohol.

Cooperation