Nebivolol Flashcards

Brand Information

• Brand name: Bystolic
• Generic name: Nebivolol

Indications

• Approved for treating hypertension

Dosing Guidelines

• Starting dose: 5 mg once daily
• Potential dose increase at 2-week intervals, max 40 mg once daily
• Applicable for monotherapy or in combination therapy
• Patients with severe renal or moderate hepatic impairment: starting dose 2.5 mg once daily

Available Strengths and Dosage Forms

• Tablet strengths: 2.5 mg, 5 mg, 10 mg, 20 mg

Medication Class

• Classified as an antihypertensive agent

Pharmacology

• Primarily acts as a β1-adrenergic blocker; acts as both β1 and β2 blocker in poor metabolizers and higher doses
• Results in decreased heart rate, reduced myocardial contractibility, vasodilation, and decreased peripheral resistance
• Suppresses renin activity and diminishes tonic sympathetic outflow

Drug Interactions

• CYP2D6 inhibitors (e.g., paroxetine, fluoxetine): may elevate plasma levels
• CYP2D6 inducers: may lower plasma levels
• Use with digitalis glycosides and non-dihydropyridine calcium channel blockers (e.g., verapamil, diltiazem): risk of excessive bradycardia
• No interactions classified as risk X/D

Side Effects

• Common effects include headache, nausea, fatigue, and dizziness
• None of the side effects exceed a 10% occurrence rate

Contraindications

• Not for use in severe bradycardia, first-degree heart block, cardiogenic shock, decompensated cardiac failure, and sick sinus syndrome (without a pacemaker)
• Avoid in severe hepatic impairment and hypersensitivity to any component
• Sudden discontinuation may worsen angina, myocardial infarction, or ventricular arrhythmias
• Caution advised for bronchospastic patients
• Can mask hypoglycemic symptoms in diabetic patients
• Classified as Pregnancy Category C

Patient Counseling

• Store in a cool, dry place away from light and children
• If a dose is missed, take as soon as possible; skip if it's near next dose time—do not double doses
• Consult a physician for severe or persistent side effects
• Do not stop taking without consulting a physician
• May cause drowsiness; exercise caution in activities requiring alertness
• Diabetic patients should be aware of symptom masking
• Avoid nonprescription cold, cough, and allergy medications unless directed