Nebivolol - Darnitsa
Selective β-adrenoceptor antagonists
Nebivolol is a racemic mixture of two enantiomers: SRRR-nebivolol (D˗nebivolol) and RSSS˗nebivolol (L˗nebivolol). It combines two pharmacological properties: – due to the D-enantiomer, nebivolol is a competitive and selective β1-adrenoceptor antagonist; – due to the L-enantiomer, it has mild vasodilating properties due to its metabolic interaction with L-arginine/nitric oxide (NO).
Chronic heart failure of mild or moderate severity, as an adjunct to standard treatments for patients over 70 years of age.
Administered orally. The tablets should be swallowed with a sufficient amount of liquid (e.g. 1 glass of water). Taken regardless of food intake.
Adult patients should take 1 tablet (5 mg nebivolol) per day, at the same time, if possible. The medicine can be taken with food. The antihypertensive effect becomes apparent after 1–2 weeks of treatment, but sometimes the optimal effect is observed only after 4 weeks.
Combination with other antihypertensive agents.
Nebivolol can be used as monotherapy or in combination with other antihypertensive agents. So far, an additional antihypertensive effect has been observed only in combination with 12.5–25 mg of hydrochlorothiazide.
Patients with renal failure.
The recommended initial dose is 2.5 mg per day. If necessary, the daily dose can be increased to 5 mg.
Patients with hepatic failure.
Experience with the use of the medicine in such patients is limited, so nebivolol is contraindicated.
Elderly patients (age from 65 years).
For this group of patients, the recommended initial dose is 2.5 mg per day, it can be increased to 5 mg if required. Due to the lack of experience with the use of the medicine in patients over 75 years of age, its administration requires caution and close supervision of such patients.
Studies of the efficacy and safety of nebivolol have not been performed in children, so its administration is not recommended in this age group.