Nexovas
Generic Name
Nebivolol
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nexovas 5 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Nexovas 5 mg Tablet contains Nebivolol, a beta-blocker primarily used to treat essential hypertension (high blood pressure) and stable mild to moderate chronic heart failure in elderly patients.
Uses & Indications
Dosage
Adults
Hypertension: 5 mg once daily. For chronic heart failure: start with 1.25 mg once daily, titrate gradually up to a maximum of 10 mg once daily.
Elderly
No specific dose adjustment for elderly patients with hypertension. For CHF, recommended starting dose is 1.25 mg daily.
Renal_impairment
For severe renal impairment (CrCl < 30 ml/min), initial dose should be 2.5 mg once daily.
How to Take
Take orally, once daily, preferably at the same time each day, with or without food.
Mechanism of Action
Nebivolol is a highly selective beta-1 adrenergic receptor antagonist. It selectively blocks beta-1 receptors in the heart, leading to a decrease in heart rate and myocardial contractility. Additionally, it causes vasodilation due to the release of nitric oxide from the endothelium, contributing to its antihypertensive effect.
Pharmacokinetics
Onset
Within 1-2 hours; maximum effect seen after 1-2 weeks of treatment.
Excretion
Approximately 38% excreted in urine and 48% in feces over a week.
Half life
Approximately 10-12 hours for extensive metabolizers and 30-50 hours for poor metabolizers.
Absorption
Rapidly absorbed after oral administration. Bioavailability varies due to extensive first-pass metabolism, influenced by CYP2D6 metabolizer status.
Metabolism
Extensively metabolized in the liver, primarily by CYP2D6, into active hydroxyl metabolites.
Side Effects
Contraindications
- •Hypersensitivity to nebivolol or any excipient.
- •Liver insufficiency or severe hepatic impairment.
- •Acute heart failure, cardiogenic shock or episodes of cardiac decompensation requiring intravenous inotropic therapy.
- •Sick sinus syndrome, including sino-atrial block.
- •Second and third degree heart block (without a pacemaker).
- •Severe bradycardia (heart rate < 60 bpm prior to start of therapy).
- •Hypotension (systolic blood pressure < 90 mmHg).
- •Severe peripheral circulatory disturbances.
- •History of bronchospasm and bronchial asthma.
- •Untreated phaeochromocytoma.
- •Metabolic acidosis.
Drug Interactions
Clonidine
Beta-blockers may exacerbate rebound hypertension after abrupt withdrawal of clonidine.
Digitalis glycosides
Increased risk of bradycardia and AV block.
Insulin and oral antidiabetics
Beta-blockers may mask symptoms of hypoglycemia and increase blood glucose levels.
Fluoxetine, Paroxetine, Thioridazine, Quinidine
CYP2D6 inhibitors can increase nebivolol plasma levels.
Calcium channel blockers (e.g., verapamil, diltiazem)
Negative effect on contractility and AV-conduction.
Class I antiarrhythmics (e.g., quinidine, disopyramide)
May potentiate the effect on atrio-ventricular conduction time and increase negative inotropic effect.
Storage
Store below 30°C, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include bradycardia, hypotension, bronchospasm, and acute cardiac insufficiency. Management involves symptomatic and supportive care, e.g., atropine for bradycardia, IV fluids/vasopressors for hypotension.
Pregnancy & Lactation
Not recommended during pregnancy unless clearly necessary, as it may cause fetal growth retardation, bradycardia, or hypoglycemia. Avoid during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Varies by manufacturer, typically 24-36 months.
Availability
Available in pharmacies nationwide
Approval Status
Approved (local regulatory bodies like DGDA)
Patent Status
Generic available
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Global Brand Names
International brand names for this medicine
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