Nabulex
Generic Name
Nebivolol
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nabulex 20 mg injection | ৳ 100.30 | N/A |
Description
Overview of the medicine
Nabulex is a highly selective beta1-adrenergic receptor blocker with vasodilating properties. It is primarily used for the management of essential hypertension and chronic stable heart failure.
Uses & Indications
Dosage
Adults
For Hypertension: 5 mg once daily. For Heart Failure: Initial dose 1.25 mg once daily, titrated up to a maximum of 10 mg once daily.
Elderly
For Hypertension: Initial dose 2.5 mg once daily. For Heart Failure: Same as adults, but titration should be done cautiously.
Renal_impairment
Initial dose 2.5 mg once daily for patients with severe renal impairment (CrCl <30 mL/min). Dose titration should be done carefully.
How to Take
Take orally with or without food, preferably at the same time each day.
Mechanism of Action
Nebivolol selectively blocks beta1-adrenergic receptors, leading to a decrease in heart rate, cardiac output, and renin release. It also induces vasodilation by enhancing nitric oxide release from the vascular endothelium, contributing to its antihypertensive effect.
Pharmacokinetics
Onset
Antihypertensive effect begins within 1-2 hours; full effect usually seen after 1-2 weeks.
Excretion
Excreted in urine (approx. 38%) and feces (approx. 48%) as metabolites.
Half life
Approx. 10-12 hours for extensive metabolizers; 30-50 hours for poor metabolizers.
Absorption
Well absorbed after oral administration. Bioavailability is approximately 12% in extensive metabolizers and up to 96% in poor metabolizers.
Metabolism
Extensively metabolized in the liver, primarily via CYP2D6, to active hydroxyl metabolites.
Side Effects
Contraindications
- Hypersensitivity to nebivolol or any excipient.
- Liver impairment or liver function abnormality.
- Acute heart failure, cardiogenic shock or decompensated heart failure.
- Sick sinus syndrome, including sino-atrial block (unless a permanent pacemaker is in situ).
- Second and third degree heart block (without a pacemaker).
- Severe bradycardia (heart rate <60 bpm prior to start of therapy).
- Severe peripheral arterial occlusive disease.
- Severe asthma or severe chronic obstructive pulmonary disease.
Drug Interactions
0
CYP2D6 inhibitors (e.g., fluoxetine, paroxetine): May increase nebivolol plasma levels.
1
Calcium channel blockers (e.g., verapamil, diltiazem): May potentiate effects, leading to severe bradycardia or heart block.
2
Antiarrhythmics (e.g., amiodarone, quinidine): Increased risk of bradycardia and AV block.
3
Digitalis glycosides: Concomitant use may increase AV conduction time.
4
NSAIDs: May reduce the antihypertensive effect of nebivolol.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms include bradycardia, hypotension, bronchospasm, and acute cardiac insufficiency. Treatment involves symptomatic and supportive measures. Atropine, vasopressors, bronchodilators, and diuretics may be used.
Pregnancy & Lactation
Pregnancy Category C. Nebivolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Excreted in breast milk, so caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Hypersensitivity to nebivolol or any excipient.
- Liver impairment or liver function abnormality.
- Acute heart failure, cardiogenic shock or decompensated heart failure.
- Sick sinus syndrome, including sino-atrial block (unless a permanent pacemaker is in situ).
- Second and third degree heart block (without a pacemaker).
- Severe bradycardia (heart rate <60 bpm prior to start of therapy).
- Severe peripheral arterial occlusive disease.
- Severe asthma or severe chronic obstructive pulmonary disease.
Drug Interactions
0
CYP2D6 inhibitors (e.g., fluoxetine, paroxetine): May increase nebivolol plasma levels.
1
Calcium channel blockers (e.g., verapamil, diltiazem): May potentiate effects, leading to severe bradycardia or heart block.
2
Antiarrhythmics (e.g., amiodarone, quinidine): Increased risk of bradycardia and AV block.
3
Digitalis glycosides: Concomitant use may increase AV conduction time.
4
NSAIDs: May reduce the antihypertensive effect of nebivolol.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms include bradycardia, hypotension, bronchospasm, and acute cardiac insufficiency. Treatment involves symptomatic and supportive measures. Atropine, vasopressors, bronchodilators, and diuretics may be used.
Pregnancy & Lactation
Pregnancy Category C. Nebivolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Excreted in breast milk, so caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Available in pharmacies nationwide
Approval Status
Approved for use in Bangladesh and internationally
Patent Status
Patent expired, generic versions available
Clinical Trials
Extensive clinical trials have demonstrated nebivolol's efficacy in reducing blood pressure and improving outcomes in chronic heart failure patients.
Doctor Notes
- Initiate Nabulex therapy with caution, especially in elderly patients and those with renal impairment.
- Monitor blood pressure and heart rate regularly.
- Educate patients on the importance of not discontinuing the drug abruptly.
Patient Guidelines
- Do not stop Nabulex abruptly without consulting your doctor.
- Take the medicine consistently at the same time each day.
- Report any unusual side effects to your healthcare provider.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Nabulex may cause dizziness or fatigue, especially at the start of treatment or when the dose is changed. Exercise caution when driving or operating machinery.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
Other Medicines in Nabulex Brand
Other medicines available under the same brand name
