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    3. Nebivolol-Teva 5mg 28 tablets — Made in Czech Republic — Free Delivery

    Nebivolol-Teva 5mg 28 tablets — Made in Czech Republic — Free Delivery


    Brand: TEVA
    Product Code: Nebivolol-Teva
    Availability: In Stock
    $26.50
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    Product description

    Nebivolol-Teva tablets are used for the following indications:
    • essential arterial hypertension;
    • stable chronic heart failure of mild to moderate degree, as an addition to standard therapy for patients over the age of 70 years.

    Structure

    The active ingredient is nebivolol (one tablet contains 5.45 mg of nebivolol hydrochloride, which is equivalent to 5 mg of nebivolol).
    Excipients: colloidal anhydrous silicon dioxide, magnesium stearate, croscarmellose sodium, macrogol 6000, lactose monohydrate.

    Contraindications

    • hypersensitivity to the active substance or other components of the preparation;
    • liver failure or limited liver function;
    • acute heart failure, cardiogenic shock or episodes of decompensation of heart failure, requiring the administration of active substances with a positive inotropic effect;
    • sick sinus syndrome, including sinoauricular block, II-III degree AV block (without an artificial pacemaker);
    • history of bronchospasm and bronchial asthma;
    • untreated pheochromocytoma;
    • metabolic acidosis;
    • bradycardia (before starting treatment, the heart rate is less than 60 beats / minute);
    • arterial hypotension (systolic blood pressure less than 90 mm Hg);
    • severe peripheral circulatory disorders;
    • combined use with floktaphenin and sultopride.

    Mode of application

    Used internally. The tablets or part of the tablet are swallowed with a sufficient amount of liquid (for example, one glass of water). The preparation is taken regardless of food intake.
    Essential arterial hypertension
    For adult patients, take one tablet (5 mg) of Nebivolol-Teva per day, if possible, at the same time. The antihypertensive effect becomes apparent after 1-2 weeks of treatment, but sometimes the optimal effect is observed only after 4 weeks.
    Combination with other antihypertensive preparations. Nebivolol-Teva can be used both as monotherapy and in combination with other antihypertensive preparations.
    By this time, an additional hypotensive effect was observed only when the preparation was combined with 12.5-25 mg of hydrochlorothiazide.
    Chronic heart failure
    Treatment of chronic heart failure should begin with slow titration of the dose until the individual's optimal maintenance dose is reached. Such patients should be prescribed the preparation if chronic heart failure is observed without episodes of its acute decompensation during the last 6 weeks. The doctor should be experienced in the treatment of heart failure.
    Patients using other cardiovascular preparations (diuretics, digoxin, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists) should have an adjusted dose of this medication for the last 2 weeks before starting their treatment with nebivolol. The initial dose titration should be carried out according to the following scheme, while maintaining intervals from 1-1 to 2 weeks and focusing on the patient's dose tolerance: 1.25 mg of nebivolol per day can be increased to 5 mg per day, and in the future - up to 10 mg once a day. The maximum recommended dose is 10 mg per day.
    At the beginning of treatment and with each increase in the dose, the patient should be under the supervision of an experienced physician for at least 2 hours to make sure that the clinical condition remains stable (especially with regard to blood pressure, heart rate, myocardial conduction disturbances, as well as symptoms of heart failure).
    The occurrence of adverse reactions can lead to the fact that not all patients can be treated with the high recommended doses. If necessary, the dose already reached can be gradually reduced again or returned to it.
    If symptoms of heart failure intensify or if the preparation is intolerant during the titration phase, it is recommended to first reduce the dose of nebivolol or, if necessary, immediately discontinue the preparation (if severe hypotension occurs, symptoms of heart failure with acute pulmonary edema intensify, cardiogenic shock, symptomatic bradycardia or AV blockade).
    Nebivolol treatment should not be stopped abruptly, as this may worsen the symptoms of heart failure. If preparation withdrawal is necessary, then the dose should be reduced in stages, reducing it by half a week. As a rule, treatment of chronic heart failure with nebivolol is long-term.

    Application features

    Pregnant
    The pharmacological effects of nebivolol can adversely affect the course of pregnancy, the fetus and the infant, so it should be used only when the benefits outweigh the potential risk to the fetus. If nebivolol treatment is necessary, monitoring of uteroplacental circulation and fetal growth should be carried out. If negative effects are confirmed, treatment with alternative preparations should be considered.The baby must be carefully monitored and keep in mind that symptoms such as hypoglycemia and bradycardia can be expected within the first 3 days.
    Breastfeeding is not recommended during treatment with nebivolol.
    Children
    Studies on the use of the preparation in children under 18 years of age have not been conducted, therefore, the use of the preparation is not recommended for this age group.
    Drivers
    No relevant studies have been carried out. Pharmacokinetic studies have shown that nebivolol does not affect psychomotor function. However, it should be borne in mind that sometimes dizziness and a feeling of fatigue are possible.
    The likelihood of these effects is higher at the beginning of treatment or after increasing the dose.

    Overdose

    There is no data available on nebivolol overdose.
    Symptoms In case of an overdose of β-blockers, the following are observed: bradycardia, arterial hypotension, bronchospasm, acute heart failure.
    Overdose treatment: gastric lavage, intake of activated charcoal and laxatives. Artificial ventilation may also be required. Monitoring blood glucose levels is recommended. If necessary, intensive therapy is carried out in a hospital: with bradycardia and increased vagotonia - the introduction of atropine or methylatropine, with hypotension and shock - the introduction of plasma substitutes and catecholamines. The beta-blocking effect can be discontinued by slow administration of isoprenaline hydrochloride starting at 5 μg / minute, or dobutamine starting at 2.5 μg / minute until the expected effect is achieved. In refractory cases, isoprenaline can be combined with dopamine. If the above measures do not help, glucagon should be prescribed at the rate of 50-100 μg / kg, if necessary, the injection can be repeated within an hour and, if necessary, an infusion of glucagon at the rate of 70 μg / kg / hour. In extreme cases, when bradycardia does not respond to treatment, an artificial pacemaker may be required.

    Side effects

    Essential arterial hypertension
    From the nervous system: often (≥ 1/100 and <1/10) - headache, dizziness, paresthesia.
    From the respiratory system: often (≥ 1/100 and <1/10) - shortness of breath.
    From the digestive system: often (≥ 1/100 and <1/10) - constipation, nausea, diarrhea.
    Chronic heart failure
    The most common adverse reactions reported by patients receiving nebivolol were bradycardia and dizziness.

    Storage conditions

    Store in its original packaging at a temperature not exceeding 25 ° C, out of the reach of children.
    Shelf life is 3 years.

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