Nebivolol + hydrochlorothiazide


Full Prescribing Info
Dosage/Direction for Use

Oral
Hypertension
Adult: Per tablet contains nebivolol 5 mg and hydrochlorothiazide 12.5 mg: 1 tablet once daily.
Contraindications
Hypersensitivity, liver impairment, anuria, sulphonamide allergy. Pregnancy, lactation.
Special Precautions
History of allergies, psoriasis, hyperthyroidism, peripheral arterial disease, diabetes, existing electrolyte disturbances, oedema, renal impairment, hyperlipidemia,hyperuricaemia. Elderly.
Adverse Reactions
Nebivolol - Headache, fatigue, parasthesias, dizziness.
Hydrochlorothiazide - Hypotension including orthostatic hypotension, pancreatitis, intrahepatic cholestatic jaundice, diarrhoea, vomiting, sialadenitis, cramping, constipation, gastric irritation, nausea, anorexia, thrombocytopenia, photosensitivity, fever, urticaria, rash, purpura, hyperglycemia, glycosuria, hyperuricemia, restlessness, impotence.
Potentially Fatal: Seizures, may unmask diabetes mellitus. Hyponatraemia and idiosyncratic, hypersensitivity reactions.
Drug Interactions
Symptomatic hyponatraemia when combined with carbamazepine. Predisposes to allopurinol sensitivity reactions and impaired renal function. Potentiates hypotensive effect of beta blockers and ACE inhibitors; these also reduce diuretic-induced hypokalaemia.
Potentially Fatal: Enhance neuromuscular blocking action of competitive muscle relaxants. Cross-allergy with sulphonamides and sulphonylurea hypoglycaemics with resultant acute interstitial nephritis and vasculitis. Potentiates bone-marrow suppression caused by anticancer drugs. Potentiates aminoglycoside nephrotoxicity. Impaired control of diabetes by oral hypoglycaemic agents. May precipitate digitalis toxicity and lithium toxicity. Increased risk of hypokalaemia with corticosteroids. Prolongs paralysis caused by tubocurarine.
Lab Interference
Discontinued before carrying parathyroid function.
Action
Nebivolol exerts its actions by exhibiting a high selectivity for beta-1 adrenergic receptors and also by reducing the peripheral vascular resistance by modulating nitrous oxide release. Hydrochlorothiazide inhibits the reabsorption of Na and chloride at the beginning of distal convoluted tubule. It causes natriuretic effect mainly by decreasing Na and chloride reabsorption in the cortical segment of the ascending limb of the Loop of Henle by inhibition of a specific Na+Cl- co-transporter.
CIMS Class
ATC Classification
C07AB12 - nebivolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.
C03AA03 - hydrochlorothiazide ; Belongs to the class of low-ceiling thiazide diuretics.
Disclaimer: This information is independently developed by CIMS based on nebivolol + hydrochlorothiazide from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 CIMS. All rights reserved. Powered by CIMSAsia.com
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