Nebilet - indications and instructions for use of tablets, reviews from cardiologists and patients about the medicine, analogues. Nebilet: analogues and detailed instructions for use Nebilet tablets instructions for use

Since today's pharmacy shelves are overflowing with a variety of pharmaceuticals, it is sometimes difficult to decide on the purchase of a drug that is suitable both in price and in effect. The medicine Nebilet, analogues of which can be found in any pharmacy, actively fights both the first signs of arrhythmia and serious cases hypertension and heart rhythm disturbances.

A powerful remedy to combat hypertension

The drug Nebilet is a representative of third generation beta 1-blockers and is prescribed to patients with heart rhythm disturbances, arrhythmia varying degrees severity and arterial hypertension. After using this medicine, the frequency of contraction of the heart muscle stabilizes and blood pressure normalizes.

Features of the drug and its composition

The drug has several names: (international generic name) and Nebil (often used synonym for Nebilet). This variety of names was due to the active ingredient included in the drug. substance nebivolol, which contains exactly 5 mg in 1 tablet. As excipients, the drug is supplemented with elements such as hypromellose, lactose, cellulose and corn starch.

Dosage forms

The drug is available in the form of white tablets with a classic round shape. Manufacturers took into account the possible need to divide the tablet into lower dosages by making a cross-shaped notch on each tablet. The package contains from 1 to 4 blisters, each of which contains 7 or 14 tablets.

The price of the medicine depends on the pharmacy chain that sells it and on the manufacturer, this is dictated by such a large gap in price - from 250 rubles to 1200 rubles for a pack of 14 tablets.

Pharmacodynamics

Nebilet tablets are a classic adrenergic blocker, which has antiarrhythmic, hypotensive and antianginal effects. The medicine actively fights unstable blood pressure, gently lowering it both in a state of severe physical activity or stress, and at rest. By modulating the release of endothelial nitric oxide, blood vessels dilate, which immediately improves general state sick.

If the reason for taking Nebilet is hypertension, positive dynamics should occur within a couple of weeks of continuous use of the drug. Greatest effect is achieved on average 1–2 months after the start of treatment.

The medicine helps the patient reduce the frequency and intensity of angina attacks and reduces the need for oxygen in the myocardial muscle.

Pharmacokinetics of the drug

• Suction process. The drug is well absorbed into the blood regardless of food intake, so you can take the tablets at any time of the day. For faster absorption, take the tablets with plenty of water.
• Bioavailability. Studies have revealed about 14% bioavailability in patients with accelerated metabolism and almost complete bioavailability in people with low level metabolism.
• Distribution. Most of these enantiomers are associated with .
• Metabolism the only one active substance Medicine occurs via aromatic and alicyclic hydroxylation.
• Removal of residual substances carried out through the intestines and kidneys, that is, naturally. About 40% of the residues are excreted in the urine and feces more than 45%.

Nebilet: indications for use

The drug is prescribed by the attending physician and must be used in accordance with the instructions in the instructions and the recommendations of a specialist. A drug is prescribed to treat the following series of diseases of cardio-vascular system:

• Angina attacks, coronary artery disease, unstable blood pressure and heart rhythm.
• Arterial hypertension.

The drug is actively used by doctors for both complex and individual treatment diseases of the cardiovascular system:

• IHD, unstable heart rhythm, angina attacks of varying degrees.
• Arterial hypertension.
• CHF included complex therapy, together with ACE inhibitors and other similar drugs.

If we are talking about the use of the drug by women in pregnancy, it should be taken only if it is really necessary and lighter analogues of Nebilet are not suitable for treatment. It is also worth considering the mandatory visit to a doctor to carefully monitor the condition of the patient and the fetus. The specialist managing the pregnancy during treatment must monitor the development and growth of the baby, as well as uteroplacental blood flow. It is advisable to stop taking the medicine 2-3 days before giving birth.

If treatment with Nebilet is necessary during lactation, the child is transferred to artificial feeding, or Nebilet is replaced with suitable analogues that will not affect the baby. According to doctors, the medicine may negatively affect both for bearing a child and for the birth process itself.

Instructions for use Nabilet

The dosage of Nebilet tablets, as well as the regimen of use, is prescribed by a cardiologist. The usual schedule includes taking 1 tablet once a day, at any time, regardless of food. It is worth noting that it is important to drink Nebilet every day at the same time of day. It is not recommended to chew the tablet; you should simply drink it with plenty of water.

The dosage of the medication may vary depending on the disease:

• For treatment of ischemic heart disease And arterial hypertension Experts recommend taking up to 1 tablet per day.
• During complex therapy for CHF, the beginning of treatment will consist of a minimum dose (1.25 mg) and its gradual increase. Increasing the dosage and monitoring the patient is carried out exclusively by a doctor.
• In patients suffering renal failure, as well as the elderly (from 65 years old), the minimum dose is half a tablet per day with the possibility of taking a maximum dose of 2 tablets.
• Treatment of ischemic heart disease is characterized by the administration of half or 1 tablet per day, similar to the treatment of arterial hypertension.

Within 2-3 hours after the first dose of the drug, the attending physician is obliged to observe the behavior and condition of his patient in order to monitor the effectiveness of therapy and exclude side effects or cases of overdose. The maximum permissible dose of the drug is 10 mg (2 tablets) per day.

Contraindications

Any drug has its own number of cases of unwanted use, or contraindications:

• CHF in the stage of decompensation;
• AV block of the second and third degrees;
• bradycardia;
• cardiogenic shock;
• presence of bronchial asthma or past bronchospasm;
• if systolic blood pressure is less than 90 mm Hg. pillar;
• myasthenia gravis, impotence;
• pheochromocytoma;
• prolonged depression;
• liver dysfunction, progressive diseases of the organ;
• metabolic acidosis;
• various SSSUs, such as sinoarticular block;
• progressive obliterating diseases of peripheral vessels.

In addition to serious contraindications in which taking Nebilet is strictly prohibited, there are relative contraindications, which can be appealed by the attending physician:

• Age less than 18 years.
• Hypersensitivity to the active substance of the drug, as well as to its auxiliary components.
• Complete or partial lactose intolerance.

• for diabetes mellitus;
• those suffering from psoriasis or allergies;
• patients with variant angina;
• with hyperfunction thyroid gland;
• people with kidney failure;
• with obstructive chronic illness lungs;
• with a diagnosis of first degree AV block;
• Special attention should be paid to patients who have reached or crossed the age of 75 years.

In case of an overdose of a beta-blocker, the patient may experience the following symptoms and ailments:

• hypothnia;
• bradycardia;
• bronchospasms.

If symptoms of overdose occur, you should immediately consult a doctor for symptomatic therapy and eliminating ailments. After this, you should definitely contact your doctor to adjust the dose.

Analogues of the drug Nebilet

Perhaps the most popular is an analogue of Nebilet, Binelol, which is produced in Croatia. The medicine not only copes well with its main function, but also has a much lower price than Nebilet, 30–40% less.

The following drugs have a similar composition and identical effect on the body:

• Nebivolol (direct and completely identical analogue of Nebilet);
• Nebivator.

These medications can be replaced with Nebilet only if prescribed by a doctor.

The drug Nebilet has antianginal, hypotensive effects, as well as a dose-dependent anti-ischemic effect. The use of this drug gradually reduces the size of myocardial infarction.

Pharmacological action and pharmacokinetics

The mechanism of action of the drug on the body consists of two properties:

• Firstly, Nebilet has a mild vasodilator effect,
• Secondly, a competitive and selective adrenergic receptor blocker.

The use of the medicine leads to a decrease in heart rate and a decrease in blood pressure (blood pressure).

The hypotensive effect of Nebilet persists with long-term treatment; the effectiveness of therapy does not depend on the gender and age of the patient and left ventricular ejection parameters.

Taking the drug as an adjuvant drug to the standard treatment complex in patients with chronic form Heart failure significantly improves the prognosis in terms of the frequency of hospitalization due to cardiovascular disease.

A decrease in the number of cases was also recorded sudden death with similar problems among patients using Nebilet.

The use of the medicine affects the body as follows:

• is able to lower blood pressure both at rest and during intense physical activity, in stressful and depressive situations,
• selectively and competitively blocks adrenergic receptors,
• the hypotensive effect develops after 3-6 days, stability of the patient’s condition is noted after 1-2 months,
• the number and severity of angina attacks when taking Nebilet is significantly reduced,
• tolerance increases physical activity,
• the medicine has an antiarrhythmic effect.

After direct oral administration, the drug is relatively quickly absorbed from gastrointestinal tract, food intake does not have a particular effect on absorption). Bioavailability is observed in 12% of patients with accelerated metabolism, complete bioavailability is observed in all patients with slow metabolism. Excreted by the intestines (with feces) - 48%, by the kidneys (with urine) - 38%.

Video

Get acquainted with appearance the drug can be seen on video:

Indications for use

This drug is actively used in the treatment of patients with disorders of the cardiovascular system, such as:

• severe arterial hypertension,
• angina pectoris,

This drug is also widely used in combination for the treatment of chronic heart failure.

Contraindications for use

• in the presence of the disease "acute heart failure",
• those suffering from a chronic form of heart failure in the stage of decompensation (this stage requires intravenous administration of drugs that have an inotropic effect),
• with severe arterial hypotension (with systolic pressure below 90),
• with bradycardia, in which the heart rate is not more than 60 beats per minute,
• with cardiogenic shock,
• With metabolic acidosis,
• with severe liver dysfunction,
• having bronchial asthma and a history of bronchospasms,
• who have been diagnosed with Raynaud's syndrome,
• with myasthenia gravis and depressive states,
• with lactase deficiency and lactose intolerance.

Use the medicine with caution when:

• renal failure,
• hyperfunction of the thyroid gland,
• diabetes mellitus,
• psoriasis,
• Prinzmetal's angina,
• aged over 70 years.

Side effects

When using the medicine, the following reactions are possible:

• state of depression,
• headache,
• paresthesia,
• nightmares, hallucinations,
• visual impairment,
• bradycardia,
• atrioventricular block,
• dyspnea,
• severe intermittent claudication,
• diarrhea, constipation,
• dyspepsia,
• flatulence,
• vomit,
• erythematous rashes,
• swelling,
• hyperhidrosis ( increased sweating),
• impotence,
• excessive fatigue, etc.

Drug interactions

1. When the drug Nebilet interacts with drugs its cardiodepressive effect is significantly enhanced.
2. Medicines that depress the central nervous system nervous system), including antidepressants, barbiturates, phenothiazide derivatives, significantly enhance the hypotensive effect of the substance Nebilet - nebivolol.
3. Parallel use of the drug with calcium channel blockers, with antihypertensive substances, antiarrhythmic drugs, with nitroglycerin and methyldopa, there is a high risk of developing hypotension (low blood pressure), bradycardia (decreased heart rate). It is also not recommended to combine the drugs Nebilet and Prazorin.
4. The drug Clonidine develops Nebilet withdrawal syndrome.
5. Use together with ergot alkaloids increases the risk of disruption of the peripheral circulatory system.
6. Nebilet reduces the effectiveness of oral antidiabetic agents, but increases the hypoglycemic effect of insulins.
7. NSAIDs (non-steroidal anti-inflammatory drugs) can reduce the hypotensive effect of Nebilet.
8. Nicardipine and Cimetidine for joint reception with the one in question medicine increase the concentration of nebivolol in the blood plasma.

You should also know that smoking reduces the effectiveness of the medicine.

Overdose

When using the medicine above the norm specified in the instructions, patients may experience the following reactions:

• vomiting and nausea (in 10% of patients),
• arterial hypotension (in 5.5% of patients),
• heart rhythm disturbances (in 2.5% of patients),
• loss of consciousness and cardiac arrest (in 0.2% of patients).

If there are signs of an overdose, the patient must urgently rinse the stomach and take enterosorbents. With strong and sharp decline pressure, development of heart failure or bradycardia, injection of adrenergic agonists is indicated. In case of extrasystole, the administration of lidocaine is indicated, and in case of convulsions, urgent intravenous administration diazepam doses.

Dosage and method of administration

Tablets are taken orally, once a day and at the same time (recommended to achieve effect). You need to take the tablets with plenty of liquid (preferably water, at least 150 grams).

Nebilet is taken both in monotherapy and in combination with other medications that reduce blood pressure.

Treatment of patients with this drug should begin with a gradual increase in dose to the maximum optimal.

The treatment regimen is prescribed by the doctor, but at the beginning of therapy (about 2-3 hours), the patient remains under the careful supervision of the doctor, who monitors the patient’s condition and regulates the dosage of the drug.

The tablet can be divided, for which it is placed on a flat and hard surface with the notch facing up. Both index fingers you should press on the tablet.

Storage conditions and periods

The storage conditions for the drug are similar to most drugs - a dry and warm place, temperature from 10 to 28 degrees, but the shelf life is extended and is 3 years.

Nebilet ‒ medicinal product new generation, which leads to normal blood pressure (blood pressure) in patients suffering from heart disease vascular diseases and hypertension different types. Treats angina pectoris.

The active ingredient is , so the question is: “nebilet or nebivolol - which is better?” - rhetorical. Both of these medicines consist of the same active substance, therefore their effect is the same. Nebivolol is a substance that belongs to the group of beta1-blockers of the 3rd generation (latest).

Compound

In addition to nebivolol, this medicine contains additional substances: polysorbate, corn starch, colloidal silicon, sodium, hypromellose, lactose.

Properties of Nebilet

Lowers blood pressure

The medicine Nebilet has a hypotensive effect, that is, it reduces the blood pressure of a patient in any state (stressed, at rest, during physical activity) to normal parameters.

Nebilet cannot be used to instantly reduce high blood pressure during a hypertensive crisis, since the effect of the drug starts only 7 days after ingestion.

The drug Nebilet stabilizes blood pressure and is used for prophylactic purposes against conditions characteristic of hypertensive crises. The effect also appears seven days after the start of taking the medicine. Max. The benefits of the drug are achieved after a couple of months of permanent use.

Normalizes the frequency of contractions of the heart muscle

The antiarrhythmic effect of the described drug normalizes the contraction rhythms of the heart muscle and reduces their frequency to normal parameters. Improves the quality of heart function.

Dilates blood vessels

As part of the antianginal effect, Nebilet tablets dilate blood vessels and reduce the heart's need for oxygen. Painful sensations during angina pectoris decrease, the incidence of heart attacks goes away.

The medicine increases exercise tolerance, reducing the risk of heart attack and stroke.

Advantages over drugs of similar action

An important reason to buy Nebilet, and not some other drug with a similar effect, is that this particular medicine does not provoke metabolic disorders, increasing the amount of glucose in the blood. Nebilet can be taken by patients suffering from diabetes mellitus 2 types.

Another reason to use this particular medicine is that it does not just expand blood vessels, but also relaxes their walls.

The prolonged effect of this drug is one day. This makes it possible to lower blood pressure without sudden jumps.

When using the drug long time(more than 12 months), its effectiveness does not decrease, and the body does not get used to the drug, addiction does not occur.

Does not provide negative impact on men in terms of potency.

What does Nebilet help with?

Based on the instructions for use, Nebilet is indicated for the following ailments:

• Ischemia;
• Hypertension;
• Angina;
• Post-infarction state;
• Cardiac arrhythmia;
• Chron. heart failure;
• Hypertension.

This drug should be taken only after consulting a doctor, according to the indications for the use of Nebilet indicated by him. He will write out the right dosage, taking into account contraindications, existing diseases and the relationship with other medications taken by the patient.

Side effects

Along with the undoubted benefits, the drug Nebilet also has side effects:

1. Insomnia (or, in contrast, drowsiness);
2. Muscle pain;
3. Dizziness;
4. Apathy;
5. High degree of fatigue;
6. Intestinal disorders (constipation or diarrhea).

Judging by the instructions for use for Nebilet tablets, they also have a lot side effects, but they are all very rare.

If you still experience them, inform your doctor, he will pass this information to Rospotrebnadzor, and he will select another medicine for you or reduce the dose.

Who should not take Nebilet

There are a number of contraindications for taking this drug, namely:

• A sharp decrease in blood pressure;
• Bronchospasms;
• Asthma;
• Intolerance to the components of the drug;
• Acute heart failure;
• Children's age (up to 18 years).
• Pheochromocytoma;
• Chronic heart failure;
• Myasthenia;
• Lactose intolerance;
• Apathy;
• Insufficient amount of lactase.

Important information

If you or your doctor decide to stop taking this medication and you have angina, you should reduce your dose gradually over about two weeks. Otherwise, an exacerbation of angina pectoris is possible.

If you smoke, be aware that the effectiveness of Nebilet will be reduced, because nicotine constricts blood vessels.

When taking the described drug, you should constantly monitor your blood pressure and heart rate, and check your kidney function a little less often.

Nebilet and pregnancy

During pregnancy, this drug is prescribed only as a last resort (threat to the life and health of the woman). The reason is the negative effect of the drug on the developing fetus. It should not be taken in the second and third trimester.

Non-ticket and alcohol

There is no compatibility between Nebilet and alcohol. These two words are incompatible, because both dilate blood vessels. If you drink alcohol and take Nebilet at the same time, it is possible death. If you are being treated with this drug, you should completely avoid alcohol.

For Nebilet, the price depends on the manufacturer. The domestic drug can be purchased at a price of 53 rubles. per package. A German-made non-ticket costs more – from 400 to 1400 rubles. The cost of the Nebilet depends on the country of origin.

Method of use

As mentioned above, the dosage of the medicine is determined by the doctor. But more often it does not exceed one tablet per day. One Nebilet tablet contains 5 mg of active ingredient, the price is set for a package that includes 1, 2 or 4 blisters of 7 tablets each. To lower blood pressure, they often take half a tablet a day, i.e. 2.5 mg.

Nebilet: reviews from cardiologists

When using Nebilet in accordance with the instructions for use, reviews from cardiologists indicate a positive effect of the drug on the functional abilities of the patient’s heart muscle. Judging by reviews from cardiologists and other doctors, Nebilet effectively, although slowly, lowers blood pressure.

Nebilet: analogues of this medicine

Analogs of the drug Nebilet are:

• Binelol (Croatia);
• Nebivolol (RF);
• Nebil (Ukraine);
• Nebivalol-orion (Greece and Finland);
• Nebivalol-Sandoz (Türkiye and Germany);
• Nebivalol-Stada (Germany);
• Nebivalol-Actavis (Bulgaria, Malta, Iceland)
• Nebivalol-Zentiva (Greece);
• Nebicard (India);
• Nebilong (India);
• Nebitens (Malta);
• Nebitrent-Reva (Hungary);
• Nebitrix (India).

Nebilet Plus

The latest analogue (Nebilet Plus) is characterized by the fact that in its composition, in addition to the active substance nebivolol, there is a drug

Nebilet is a cardioselective β 1 -blocker with antianginal, hypotensive and antiarrhythmic action, reducing high blood pressure at rest, during stress and physical exertion.

Release form and composition

The dosage form of Nebilet is tablets: biconvex, almost white, round, with a one-sided cross-shaped notch for division (7 or 14 pieces in a blister, in cardboard box 1, 2 or 4 blisters).

Composition of 1 tablet:

• Active substance: nebivolol hydrochloride – 5.45 mg (equivalent to the content of nebivolol 5 mg);
• Additional components: corn starch, microcrystalline cellulose, colloidal silicon dioxide, lactose monohydrate, croscarmellose sodium, polysorbate 80, magnesium stearate, hypromellose (15 mPa×s).

Indications for use

• Arterial hypertension;
• Chronic heart failure (as part of combination therapy);
• Coronary heart disease (prevention of angina attacks).

Contraindications

Absolute:

• Chronic heart failure in the stage of decompensation (if intravenous administration of drugs that have an inotropic effect is necessary);
• Acute heart failure;
• Sick sinus syndrome (including sinoauricular block);
• Severe arterial hypotension (systolic blood pressure below 90 mmHg);
• Atrioventricular block II and III degree(without artificial pacemaker);
• Cardiogenic shock;
• Bradycardia (heart rate less than 60 beats per minute);
• Pheochromocytoma (without combination with alpha-blockers);
• Severe liver dysfunction;
• Metabolic acidosis;
• History of bronchial asthma and bronchospasm;
• Severe obliterating lesions of peripheral vessels (Raynaud's syndrome, intermittent claudication);
• Depression;
• Myasthenia;
• Glucose-galactose malabsorption syndrome, lactase deficiency and lactose intolerance;
• Age under 18 years (due to the lack of studies on the use of the product in children and adolescents);
• Hypersensitivity to the components of the drug.

Relative (must be used with extreme caution due to the possible risk of complications):

• Hyperfunction of the thyroid gland (masks an increase in heart rate);
• Kidney failure;
• Diabetes mellitus (it is possible to mask the symptoms of a decrease in blood glucose concentration - palpitations, trembling, nervousness);
• Predisposition to allergies (anaphylactic reactions may worsen);
• Psoriasis;
• Chronic obstructive pulmonary disease (possible increased bronchospasm);
• First degree atrioventricular block;
• Prinzmetal's angina;
• Age over 75 years.

During pregnancy, Nebilet can be prescribed only for strict indications, in cases where the expected benefit from taking the drug outweighs the possible risk of developing side effects(appearance of hypoglycemia in the fetus/newborn, arterial hypotension, bradycardia). If it is necessary to carry out drug therapy, uteroplacental blood flow and fetal growth should be monitored; the course must be interrupted 2-3 days before birth. In cases where this is not feasible, it is necessary to establish careful monitoring of the newborn for 2-3 days after delivery.

Since the drug is excreted in breast milk, if treatment with the drug during lactation is necessary, breastfeeding should be avoided.

Directions for use and dosage

The tablets are taken orally 1 time per day with a sufficient volume of liquid, regardless of meals, preferably at the same time of day.

In the treatment of coronary heart disease and arterial hypertension, the average dose per day is ½-1 tablet (2.5-5 mg). Nebilet can be used in monotherapy or in combination with other antihypertensive drugs. Patients over 65 years of age, as well as persons with renal failure, are prescribed an initial daily dose of ½ tablet (2.5 mg). If necessary, the dose can be increased to a maximum of 2 tablets (10 mg) per day at a time.

For the treatment of chronic heart failure, it is recommended to increase the initial dose gradually to the optimal maintenance dose to achieve the desired therapeutic effect. At intervals of 1-2 weeks, if the drug is well tolerated, the initial daily dose of ¼ tablet (1.25 mg) can be increased initially to ½-1 tablet (2.5-5 mg), and then, if necessary, to 2 tablets (10 mg) in one dose. Maximum dose per day should not exceed 10 mg.

At the beginning of the course of treatment, as well as with each dose increase, the patient is required to remain under medical supervision for at least 2 hours to prevent the development of undesirable reactions (disturbances in heart rhythm and conduction, worsening the course of chronic heart failure, etc.).

To divide the tablet into two halves, you need to place it with a cross-shaped notch up on a hard, flat surface and press on the tablet with both index fingers. To get ¼ tablet similar actions should be done with half a tablet.

Side effects

• Digestive system: often – constipation, nausea, diarrhea; infrequently – flatulence, dyspepsia, vomiting;
• Cardiovascular system: uncommon - atrioventricular block, acute heart failure, bradycardia, Raynaud's syndrome, orthostatic hypotension;
• Nervous system: often – increased fatigue, dizziness, weakness, headache, paresthesia; infrequently – nightmares, depression, confusion; extremely rarely – hallucinations, fainting;
• Skin and subcutaneous tissues: uncommon – itching, skin rash erythematous in nature; very rarely - exacerbation of psoriasis; in some cases – angioedema;
• Other: infrequently – bronchospasm; rarely – dry eyes.

Symptoms of an overdose of Nebilet include: cyanosis, vomiting, nausea, marked decrease in blood pressure, atrioventricular block, sinus bradycardia, heart failure, loss of consciousness, bronchospasm, coma, cardiogenic shock, cardiac arrest.

In such cases, gastric lavage is prescribed, taking activated carbon, in case of heart failure, bradycardia, severe hypotension - administration of β-adrenergic stimulants. In the absence of an adequate response, norepinephrine, dobutamine, dopamine are recommended, followed by 1-10 mg of glucagon and the placement of a transvenous intracardial stimulator. For the treatment of ventricular extrasystole, lidocaine is prescribed, for bronchospasm - β 2 -adrenergic receptor stimulants (intravenously), and for convulsions - intravenous injections diazepam.

special instructions

Cancellation of the drug must be carried out gradually over 10 days (in patients with coronary disease hearts up to 14 days).

At the beginning of the course, daily monitoring of blood pressure and heart rate is necessary.

Elderly people should monitor kidney activity once every 4-5 months, and patients with diabetes should monitor plasma glucose levels.

Smoking reduces the effectiveness of the drug.

If you have psoriasis, use is possible only after carefully weighing the risks and benefits of using the product.

For patients wearing contact lenses, it should be remembered that when using beta-blockers, there may be a decrease in the production of tear fluid.

If surgical intervention is necessary, the anesthesiologist must be informed about the drug intake.

During the course of therapy, due to possible appearance side effects, it is recommended to exercise caution when driving vehicles and other complex machinery.

Drug interactions

It should be taken into account that when used simultaneously with Nebilet:

• Slow calcium channel blockers (diltiazem, verapamil) – enhance negative action on atrioventricular conductivity and myocardial contractility;
• Cardiac glycosides – contribute to the summation of the chrono- and dromotropic effect;
• Clonidine – leads to increased “withdrawal syndrome”;
• Nitroglycerine, antihypertensive drugs, blockers of slow calcium channels - contribute to the development of severe arterial hypotension (especially caution should be exercised when combined with prazosin);
• Barbiturates, tricyclic antidepressants, phenothiazine derivatives – increase the hypotensive effect of nebivolol;
• Antiarrhythmic drugs, alpha-methyldopa, reserpine, guanfacine, clonidine - aggravate the severity of bradycardia;
• Medicines for general anesthesia– cause a cardiodepressive effect and increase the risk of arterial hypotension;
• Microsomal oxidation inhibitors (cimetidine) – increase the level of nebivolol in the blood plasma; and inducers (barbiturates, rifampicin) reduce it.

When Nebilet is combined with oral hypoglycemic drugs and insulin, masking of signs of hypoglycemia (tachycardia) may be observed.

During the period of use of nebivolol, intravenous administration of verapamil is contraindicated.

Terms and conditions of storage

Store out of reach of children, at a temperature not exceeding 25 °C.

Shelf life – 3 years.

A popular drug for the treatment of arterial hypertension. Should only be prescribed by a doctor, since the group of antihypertensive drugs is selected individually for each patient. The drug is of European quality and is produced in pharmaceutical factories in strict compliance with GMP standards.

Dosage form

Nebilet is issued in the form oral tablets 14 or 28 pieces per package. The tablet is white and has a cross-shaped notch, which allows you to divide it to obtain the desired dose.

Description and composition

The active ingredient of Nebilet is . Its mechanism of action is based on two pharmacological properties:

1. Selective blocking of β 1 -adrenergic receptors, which are located in the myocardium and kidneys.
2. Vasodilation after interaction with nitric oxide.

The combined action leads to several important effects that are used in cardiology:

1. Effective reduction of blood pressure.
2. A decrease in heart rate without a decrease in cardiac output.
3. Slowing down the conduction of impulses in the heart system.
4. Reducing the risk of arrhythmia.

In addition, the antianginal effect of the drug is important. It consists in reducing the myocardial oxygen demand and increasing the supply of oxygen to the heart. Thanks to this, the effect of Nebilet is successfully used in complex therapy of heart failure, where, along with other drugs, it improves the effectiveness of treatment and reduces the frequency of hospitalizations.

The pharmacological effect of the drug manifests itself regardless of the gender and age of the patient, which makes it possible to widely use it in cardiology. The practice of using Nebilet shows a decrease in cases of sudden coronary death.

Patients with liver failure another cardiac drug should be selected, since experience with such groups of people is limited.

If the patient's age is over 65 years, the initial dose is reduced to 2.5 mg. In case of insufficient clinical effect, the doctor may increase it to the standard 5 mg.

For the treatment of chronic heart failure, individual dose selection is necessary. Therapy begins with taking 1.25 mg of Nebilet. If this is not enough, after a week the dose is doubled. The doctor must take into account the patient’s tolerability of the drug and the dynamics of improvement during treatment. Maximum daily dose, up to which an increase is possible is 10 mg. It should be taken at one time. Be sure to observe the interval when switching to increased amount drug in 1-2 weeks. Higher permissible doses are not suitable for all patients, as they may cause side effects.

If necessary, discontinuation of the drug occurs gradually to avoid exacerbation of heart failure. The dose should be reduced twice a week and then the medication should be stopped completely.

If treatment gives the desired result and ensures blood pressure stability within normal limits, it is carried out for a long time (several years).

Side effects

Nebilet may cause the following side effects:

1. Depression, night terrors.
2. Dizziness, paresthesia.
3. Bradycardia, decreased blood pressure.
4. Bronchospasm.
5. Shortness of breath, flatulence, dyspepsia.
6. Skin rashes, itching.
7. Increased fatigue, swelling of the lower extremities.
8. Dry eyes.
9. Orthostatic hypotension.

The likelihood of occurrence and severity of side effects varies from person to person. If strange symptoms appear during treatment with Nebilet, you should report them to your doctor.

Interaction with other drugs

The therapeutic effect of Nebilet can be modified by drugs from other groups. Concomitant use with:

1. Antiarrhythmic drugs (quinidine,).
2. Calcium antagonists based on diltiazem.
3. Centrally acting antihypertensives (clonidine, methyldopa).
4. Anesthetics (increases the risk of severe hypotension).
5. Antipsychotic drugs (potentiation of effects occurs and a sharp decrease in blood pressure is possible).
6. Symatomimetics (an antagonistic effect is observed).

Nebilet can be combined with non-steroidal anti-inflammatory drugs, which is important for patients with joint diseases who are on long-term treatment with drugs from both groups. Combination therapy with or hydrochlorothiazide is also allowed.

special instructions

Beta-blocker drugs are discontinued one day before planned surgical interventions.

Planned cancellation of Nebilet should occur gradually over 1-2 weeks. At the same time, you can start taking another drug to avoid exacerbation of the condition.

The patient should inform the doctor about all medications he is taking, especially cardiac medications, in order to determine the correct treatment regimen and avoid unexpected complications.

The tablet contains lactose, which should be taken into account by people with intolerance to this component or impaired metabolism.

At the beginning of treatment, the doctor must constantly monitor the patient's condition to determine the body's response to the drug.

May cause exacerbation of psoriasis, so treatment should begin after the onset of remission. Medicines of the beta-blocker group can also increase the body's sensitivity to allergens and increase the risk of developing anaphylactic reactions.

Nebilet does not affect psychomotor function, however, drivers should be aware of the possibility of developing individual side effects, including dizziness and increased fatigue.

Overdose

1. Bradycardia.
2. A sharp decrease in blood pressure.
3. Bronchospasm.
4. Acute heart failure.

Such conditions require immediate medical care. To eliminate the increased content in the blood, gastric lavage, sorbents and laxatives are used. Mechanical ventilation may be required. In emergency situations, intensive therapy is carried out in a hospital setting, which includes intravenous administration of drugs. At the same time, the doctor should monitor the patient's blood glucose level, since Nebilet may mask the symptoms of hypoglycemia.

Storage conditions

No special storage conditions are required. Should be adhered to temperature regime within 25 degrees.

Analogs

Other drugs are produced on this basis, which differ from Nebilet in quality, price and manufacturer. The most popular analogues include:

1. Nebicard. Prescription in the middle price category. Indian drug in dosages of 2.5 or 5 mg. Contains lactose as excipient. Prescribed only for the treatment of arterial hypertension.
2. Nebitenz. The drug is affordable. The package contains 30 tablets (for a monthly course of treatment). Country of origin: Malta.
3. . Drugs with this name are produced by different pharmaceutical companies. They are usually affordable. The package may contain 20, 28, 30 or another number of tablets.
4. Nebil. Ukrainian analogue of Nebilet. It is very popular due to its low cost and high quality. The composition and therapeutic effects correspond to Nebilet.

Price

The cost of a Nebilet is on average 749 rubles. Prices range from 402 to 1350 rubles.