Nebicard-5 Torrent tablets for hypertension (5 blisters x 10 tablets)

Dosage form Box of 5 blisters x 10 tablets
Specifications Nebivolol

Ingredient

Composition information	Content
Nebivolol	5mg

Uses

Indications

Nebicard 5 mg is indicated for hypertension treatment.

Pharmacokological

Nebivolol is a water -based beta blocker, clinically used in the form of a Racemic mixture of two optical copper D and L in equal ratio. It is a competitive substance, high selective antagonism with the Beta - 1 receptor and has some light effects on the blood vessels, possibly due to the interaction by L - Arginine/Nitric Oxid mechanism. Nebivolol has the effect of protecting the function of the left ventricular heart. The drug tends to reduce the burden and maintain or reduce the burden. The heart rate and pressure at the end of the centrifugal ventricular ventricular are decreasing while the volume of the squeeze increases and the heart amount is maintained.

pharmacokinetic

absorption

After taking Nebivolol tablets, the drug reaches the blood concentration in the blood within 0.5 to 2 hours and this time is not affected by food. Oral bioavailability averages about 12% in people who metabolize good drugs and reach 96% in poor metabolic people.

Distribution

In plasma, both of Nebivolol's optical isomers are associated with albumin. The associated ratio of plasma proteins of SRRR - Nebivolol is 98.1% and of RSSS - Nebivolol is 97.9%.

Metabolism

Nebivolol is strongly metabolized, partly into hydroxyl metabolites. Nebivolol is metabolized through the process of hydroxylation of saturated and aromatic rings, n - dealkylation and glucuronide; The metabolites of hydroxyl forms then are also linked to glucuronid compounds. Nebivolol's aromatic hydroxylation depends on the polymorphism in the gene expression of the enzyme CYP2D6. Due to the difference in metabolic speed, the dose of Nebivolol should always be adjusted depending on the patient: those who metabolize drugs are poor, so they should be used lower doses.

Elimination

In those who metabolize drugs fast, the sale time of optical isomers of Nebivolol is 10 hours on average. For those who metabolize drugs slowly for sale 3-5 times.

Before taking Nebicard-5 Torrent tablets for hypertension (5 blisters x 10 tablets)

How to use

Used by oral.

Dosage

Dosage 5 mg/time/day, drink at a certain time of the day. The drug can be taken at meals.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Treatment:

When overdose, patients need to be closely monitored and actively treated. Need to check blood glucose levels. It is possible to prevent the absorption of the remaining medications in the gastrointestinal tract by gastrointestinal lavage or for patients to take activated carbon and a bleach. Bradycardia or widespread vagus reactions can be treated with atropine and methyl atropin. Hemorrhage and shock should be treated with plasma/plasma substances and if necessary, with catecholamine. In unpopular cases, isoprenalin can be combined with dopamine. If necessary, can be injected within an hour and even needed, glucagon vein can be transmitted at a dose of 70 μg/kg/h. In the most severe cases when the heart rate slow phenomenon does not respond to treatment, the pacemaker can be placed for patients. However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using Nebicard 5 mg , you may experience unwanted effects (ADR).

Common, ADR> 1/100

Systemic: headache, dizziness, fatigue, paresthesia, shortness of breath.

Digestive: diarrhea, constipation, nausea.

Less, rare ADR

Cardiovascular: Slow heart rate, reducing atrial transmission time, atrial bloc, hypotension, heart failure, (increasing) limb.

Neurology: Reduce vision, helplessness, depression, nightmares.

digestive: digestive disorders , flatulence, vomiting.

Respiratory: bronchospasm.

Other: rashes, hallucinations, mental disorders, cold/pale purple, manifestation of raynaud, dry eyes, eye -poisoning - skin - mucous membrane in the style of practolol.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Nebicard 5 mg contraindicated in the following cases:

Patients with Nebivolol. Grade 2 and 3.

Caution when using

Patients with renal failure: The plasma concentration of optical isomers and hydroxylation metabolites significantly increases in patients with renal disease. Therefore, the reduction of the dose is recommended for these patients. In patients with renal failure, the starting dose is recommended for 2.5 mg daily. If necessary, daily dose can be increased to 5 mg.

Patients with liver failure: Data on drug use for patients with liver failure or impaired liver function is limited. Therefore, the use of Nebivolol for these patients is contraindicated.

Elderly: Due to the limited experience of using drugs for patients over 75 years old, when using the drug should be cautious and need to closely monitor these patients.

Children: There is no data on the safety and effectiveness of Nebivolol for children. Therefore, the use of drugs for children is not recommended.

The ability to drive and operate machinery

There is no research on the effects of drugs on driving and operating machinery.

Pregnancy

data on Nebivolol's use of pregnant women is incomplete to clearly define the possible effects of the drug with this object.

Beta blockers that reduce the flow of fetal vegetables can lead to fetal death, miscarriage or premature birth. Moreover, adverse effects (hypoglycemia and slow heart rate) can appear in fetus and infant. Babies in the early stages after birth are still at high risk of heart and lung complications. Therefore, Nebivolol should not be used for women during pregnancy.

Breastfeeding period

Most beta blockers, especially water -body compounds such as Nebivolol and its metabolites, can enter breast milk to different degrees. In humans, whether Nebivolol is excreted in breast milk or not is still unknown, so the use of Nebivolol for women during breastfeeding is contraindicated. Animal studies show that Nebivolol is excreted in milk.

Medicinal interaction

Calcium channel blockers: Be careful when using Beta - Adrenergic antagonists simultaneously with calcium channel blockers like Verapamil or Diltiazem because of their adverse effects on heart contractions and atrial transmission. Verapamil intravenous injection is contraindicated for patients taking Nebivolol.

Anti -arrhythmic drugs: Pay attention when using beta - adrenergic antagonists combined with anti -arrhythmia groups I and Amiodarone because of their impact on the transmission time in the atria and the ability to reduce myocardial contraction.

Clonidine: Beta - adrenergic antagonists increases the risk of hypertension response after suddenly stopping using clonidine.

Digitalis: Digitalis cardiac glycosides when combined with beta - adrenergic antagonistic drugs may cause atrial -ventricular turbulence time. Nebivolol does not affect Digoxin's dynamics.

insulin and oral anti -diabetic drugs: Although Nebivolol does not affect blood sugar levels, some symptoms of hypoglycemia (chest drum, tachycardia) can be hidden when taking the drug.

Anesthesia: Concomitance of beta - adrenergic antagonists with anesthesia with anesthetic can reduce fast heart rate reflexes and increase the risk of hypotension.

Concentrated use with cimetidine increases the plasma concentrations of nebivolol but does not change the clinical effect, simultaneously used with ranitidin does not change the pharmacokinetics of Nebivolol. Can be prescribed Nebivolol to drink when eating and an antacids (antacid) used between meals.

Combining nebivolol with nicardipine increases the plasma concentration of both drugs but does not change the clinical effect. Simultaneous use with alcohol, Furosemid or hydrochlorothiazid does not affect the dynamics of Nebivolol.

Sympathetic drugs may lose the effect of beta - adrenergic antagonism. Beta - adrenergic antagonists can increase the effects of Adrenergic enhancement of sympathetic drugs that act on both alpha and beta adrenergic systems (leading to the risk of hypertension, bradycardia and cardiac bloc).

Concomitance of 3 -round antidepressants, barbiturat and phenothiazine sleeping pills may increase the effectiveness of nebivolol's hypotension.

Due to the metabolism of Nebivolol related to CYP2D6 enzyme, simultaneous use of serotonin reabsorption inhibitors or other compounds are metabolized mainly by this enzyme that will reduce Nebivolol's metabolism.

Storage

In a dry place, the temperature does not exceed 30 ° C.

Other drugs

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.