Nebivolol

By Medically reviewed by hellodoktor

Generic Name: Nebivolol Brand Name(s): Nebivolol.

Uses

What is Nebivolol used for?

Nebivolol is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.

This medication belongs to a class of drugs known as beta blockers. It works by blocking the action of certain natural substances in your body, such as epinephrine, on the heart and blood vessels. This effect lowers heart rate, blood pressure, and strain on the heart.

How should I take Nebivolol?

Take this medication by mouth with or without food as directed by your doctor, usually once daily. The dosage is based on your medical condition and response to treatment.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

It may take several weeks before you get the full benefit of this drug. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

Tell your doctor if you do not get better or if you get worse (blood pressure readings remain high or increase).

How do I store Nebivolol?

Nebivolol is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Nebivolol in the bathroom or the freezer. There may be different brands of Nebivolol that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Nebivolol down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Nebivolol?

Before taking nebivolol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain types of heart rhythm problems (such as a slow heartbeat, second- or third-degree atrioventricular block), blood circulation problems (such as Raynaud’s disease, peripheral vascular disease), breathing problems (such as asthma, chronic bronchitis, emphysema), kidney disease, liver disease, mental/mood disorders (such as depression), a certain muscle disease (myasthenia gravis), overactive thyroid disease (hyperthyroidism), serious allergic reactions, including those needing treatment with epinephrine.

This drug may make you dizzy. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

If you have diabetes, this product may mask the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar, such as dizziness and sweating, are unaffected by this drug. This product may also make it harder to control your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

During pregnancy, this medication should be used only when clearly needed. Babies born to mothers taking this drug during pregnancy may have a low birth weight and require monitoring for problems such as low blood pressure, slow heartbeat, low blood sugar, and slow/shallow breathing. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Nebivolol during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Nebivolol. Nebivolol is pregnancy risk category N according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Nebivolol?

Headache, dizziness, lightheadedness, tiredness, nausea, slow heartbeat, or trouble sleeping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: blue fingers/toes, fainting, very slow heartbeat, new or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), mental/mood changes (such as confusion, mood swings, depression).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Nebivolol?

A product that may interact with this drug is: fingolimod.

Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

Nebivolol may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Nebivolol?

Nebivolol may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Nebivolol?

Nebivolol may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Nebivolol.

What is the dose of Nebivolol for an adult?

Usual Adult Dose for Hypertension

Initial dose: 5 mg orally once a day

Dose adjustment: Titrate dose at 2-week intervals up to 40 mg once a day as needed.

Maximum dose: 40 mg per day

Comments:

-Titrating doses more frequently than every 2 weeks is unlikely to be beneficial.

-The dose should be individualized to patient requirements.

Use: For the management of hypertension, alone or with another antihypertensive agent.

Renal Dose Adjustments

CrCl less than 30 mL/min:

-Initial dose: 2.5 mg orally once a day; titrate slowly as needed.

Liver Dose Adjustments

Moderate impairment:

-Initial dose: 2.5 mg orally once a day; titrate slowly as needed.

Severe impairment:

-Not recommended.

Dose Adjustments

Cessation of therapy:

-Abrupt discontinuation should be avoided; taper therapy over approximately 1 to 2 weeks.

-If withdrawal symptoms occur, therapy may be temporarily reinstituted.

Other Comments

Administration advice:

-Take orally once a day at the same time each day with or without food.

-If a dose is missed, take it as soon as remembered; but if it is close to the next dose, skip the missed dose; do not double the dose.

General:

-Transient worsening of heart failure, hypotension, and bradycardia may occur during titration; consider discontinuation for heart failure worsening that persists.

-If discontinuation is necessary, gradually taper over 1 to 2 weeks, monitor for the signs and symptoms of heart failure, and limit exercise.

-This drug interferes with allergic reaction modulation and may increase the risk of anaphylactic reactions; additionally, patients may be refractory to epinephrine in treatment for anaphylactic reactions.

Monitoring:

-Heart rate and blood pressure

-Signs and symptoms of heart failure (e.g., shortness of breath, edema, and weight gain), especially in at risk patients

-Angina in patients with coronary artery disease, especially during withdrawal

Patient advice:

-Warn patients to avoid interruptions or abrupt discontinuation of this drug.

-Instruct the patient to notify his or her healthcare provider upon signs and symptoms of angina, bradycardia, hypotension, or heart failure (e.g., shortness of breath, edema, and weight gain).

-Avoid driving or operating machinery until the full effects are known.

-Advise patient to speak to healthcare provider if pregnant, intend to become pregnant, or are breastfeeding.

-Patients with diabetes should be informed that this drug may mask hypoglycemic reactions.

What is the dose of Nebivolol for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Nebivolol available?

Nebivolol is available in the following dosage forms and strengths:

  • Oral tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Nebivolol, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: April 5, 2018 | Last Modified: September 12, 2019

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