Nebivolol

Registered South African indications:

• Hypertension

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Liver insufficiency or liver function impairment
• Acute heart failure, cardiogenic shock or episodes of heart failure decompensation requiring IV inotropic therapy
• Pregnancy
• Breastfeeding
• Cardiogenic shock
• Uncontrolled heart failure
• Sick sinus syndrome, including sino-atrial block
• Second- and third-degree heart block (without a pacemaker)
• History of bronchospasm and bronchial asthma
• Untreated phaeochromocytoma
• Metabolic acidosis
• Bradycardia (heart rate <60bpm prior to start of therapy)
• Hypotension (systolic blood pressure <90mm Hg)
• Severe peripheral circulatory disturbances
• In combination with verapamil therapy

Cautions

• Severe renal impairment
• Elderly
• Unstable congestive cardiac failure
• Ischaemic heart disease
• First degree heart block
• Vasospastic (Prinzmetal's) angina
• Diabetes mellitus
• Hyperthyroidism
• Chronic obstructive pulmonary disease
• Psoriasis
• History of allergic reactions
• Abruption cessation
• Galactose intolerance
• Lapp lactase deficiency 
• Glucose-galactose malabsorption

Forms avail. in SA and covered in this monograph: tab

Hypertension - mild, moderate

• Oral (tab): 5mg, dly

Cardiac failure

• Oral (tab): 1.25mg, dly; Titrate by doubling dose at 1-2 week intervals; Maintenance: 10mg, dly; Max dose: 10mg/24hrs

Not established for use in children below 18 years

Pregnancy

• Contraindicated

Breastfeeding

• Contraindicated

Renal Impairment

• Severe: Caution; no information available

Hepatic Impairment

• Contraindicated 
  Contraindicated for liver insufficiency or liver function impairment

Elderly

• Caution; dose adjustment recommended

Central Nervous System Disorders

• Nightmares
• Depression
• Headache
• Dizziness 
• Paraesthesia 
• Syncope

Cardiovascular Disorders

• Bradycardia 
• Heart failure
• Slowed atrioventricular conduction
• Atrioventricular block
• Hypotension 
• Intermittent claudication

Respiratory Disorders

• Dyspnoea
• Bronchospasm

Gastrointestinal Disorders

• Constipation 
• Nausea and vomiting
• Diarrhoea
• Dyspepsia 
• Flatulence

Genitourinary Disorders

• Impotence

Skin and Subcutaneous Tissue Disorders

• Pruritus 
• Rash
• Psoriasis
• Urticaria

Immune, Blood and Lymphatic System Disorders

• Angioneurotic oedema
• Hypersensitivity

• Class I antiarrythmics
• Calcium channel blockers
• Verapamil
• Centrally-acting antihypertensives
• Amioderone
• Halogenated anaesthetics
• Insulin
• Antidiabetic agents
• Baclofen
• Amifostine
• Digoxin
• Antipsychotics
• Antidepressants
• Non-steroidal anti-inflammatory drugs
• Sympathomimetics
• Cimetidine
• Nicardipine 

None routine. Specific cases may require

• Blood glucose
• ECG

Nebivolol is a competitive and selective beta-receptor antagonist which has mild vasodilating properties.

Tablet 5mg

• Lovispes (Akacia) originator
• Nebilet (Adcock) originator