Nivoloc
Generic Name
Nebivolol
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nivoloc 500 mg tablet | ৳ 15.00 | ৳ 60.00 |
Description
Overview of the medicine
Nivoloc is a brand of Nebivolol, a beta-blocker primarily used for the management of essential hypertension and chronic heart failure. It works by relaxing blood vessels and slowing heart rate, improving blood flow and reducing blood pressure.
Uses & Indications
Dosage
Adults
Initial: 5 mg once daily. May be increased to 10 mg after 2 weeks if necessary. Max: 40 mg/day.
Elderly
For patients >70 years with heart failure, initial dose 1.25 mg once daily, titrated slowly.
Renal_impairment
Initial 2.5 mg once daily for severe renal impairment (CrCl <30 mL/min).
How to Take
Take orally with or without food, at the same time each day.
Mechanism of Action
Nebivolol is a highly selective beta1-adrenergic receptor antagonist with vasodilatory properties, possibly mediated by nitric oxide release. It reduces heart rate and myocardial contractility, leading to decreased cardiac output and blood pressure.
Pharmacokinetics
Onset
Within 1-2 hours
Excretion
Approximately 38% in urine and 48% in feces.
Half life
Approximately 10-12 hours for extensive metabolizers, 24-30 hours for poor metabolizers
Absorption
Rapidly absorbed after oral administration. Bioavailability averages 12% in extensive metabolizers and 96% in poor metabolizers.
Metabolism
Extensively metabolized in the liver via direct glucuronidation and hydroxylation, primarily by CYP2D6.
Side Effects
Contraindications
- Hypersensitivity to nebivolol or any excipients
- Acute heart failure, cardiogenic shock
- Severe bradycardia (<60 bpm)
- Sick sinus syndrome, second- or third-degree AV block (without a pacemaker)
- Severe liver impairment
- Severe peripheral arterial obstructive disease
- Asthma or severe COPD
Drug Interactions
Digitalis glycosides
Increased risk of bradycardia.
Other antihypertensives
Additive hypotensive effects.
Antiarrhythmics (e.g., amiodarone, diltiazem)
Increased risk of bradycardia and heart block.
CYP2D6 inhibitors (e.g., quinidine, fluoxetine)
May increase nebivolol plasma levels, increasing risk of adverse effects.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms include bradycardia, hypotension, bronchospasm, acute cardiac insufficiency. Management involves symptomatic and supportive treatment, e.g., atropine for bradycardia, IV fluids/vasopressors for hypotension.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Not recommended during breastfeeding as it is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Available in pharmacies
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic versions available, original patent expired
Clinical Trials
Numerous clinical trials have established the efficacy and safety of nebivolol in hypertension and heart failure, including the SENIORS trial for elderly heart failure patients.
Lab Monitoring
- Blood pressure
- Heart rate
- Renal function (CrCl)
- Liver function tests
Doctor Notes
- Counsel patients on abrupt discontinuation risk.
- Titrate dose carefully, especially in elderly and renal impaired patients.
- Monitor for signs of heart failure exacerbation or bradycardia.
Patient Guidelines
- Take as directed by your doctor. Do not stop taking this medicine suddenly without consulting your doctor.
- Monitor your blood pressure regularly.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it's almost time for the next dose, skip the missed dose and resume your regular schedule. Do not double dose.
Driving Precautions
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
- Adopt a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity.
- Avoid smoking and limit alcohol intake.
- Manage stress.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.