Carnovas 1010mg
Type:10 Tablets
Generic Name:Nebivolol
Manufacturer:Beximco Pharmaceuticals Ltd.
Price:৳150.00
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.
