Ivineb (Nebivolol Hydrochloride)

Nebivolol Hydrochloride is used to manage conditions within the hypertension disease family.

• Hypertension: reduces systolic and diastolic blood pressure in adults with primary hypertension.
• Isolated systolic hypertension: helps achieve target systolic levels in patients with elevated systolic pressure.
• Isolated diastolic hypertension: contributes to lowering diastolic pressure in patients with elevated diastolic pressure.

• Nebivolol Hydrochloride selectively blocks β1‑adrenergic receptors in cardiac tissue, decreasing heart rate and myocardial contractility. In addition, it stimulates endothelial nitric‑oxide synthase, producing nitric oxide–mediated vasodilation, which together lower cardiac output and peripheral vascular resistance, resulting in reduced arterial blood pressure.

Common Side Effects

• Fatigue: feeling of tiredness or lack of energy.
• Headache: mild to moderate pain in the head region.
• Dizziness: sensation of light‑headedness or unsteadiness.
• Bradycardia: slower than normal heart rate.
• Peripheral edema: mild swelling of the ankles or feet.
• Nasal congestion: blocked or runny nose.

Serious or Rare Side Effects

• Severe bradycardia: markedly low heart rate requiring medical attention.
• Symptomatic hypotension: significant drop in blood pressure causing faintness.
• Heart block: impairment of electrical conduction in the heart.
• Bronchospasm: narrowing of airways, especially in patients with asthma.
• Allergic reactions: rash, itching, swelling, or anaphylaxis.
• Hepatic dysfunction: abnormal liver enzyme elevations.

Before initiating therapy, consider the following precautions:

• Blood pressure monitoring: regularly assess to ensure therapeutic targets are met.
• Heart rate assessment: observe for excessive slowing, especially in patients with pre‑existing bradycardia.
• Asthma or COPD: use with caution as β1‑selectivity may still affect bronchial tone.
• Diabetes mellitus: monitor glucose levels as β‑blockade can mask hypoglycaemic symptoms.
• Abrupt discontinuation: taper gradually to avoid rebound hypertension.
• Store at room temperature: keep in the original packaging, protect from moisture and direct sunlight.

Nebivolol Hydrochloride may interact with several medicines.

Major Interactions (Avoid)

• Other β‑blockers: additive bradycardia and hypotension.
• Calcium channel blockers (verapamil, diltiazem): increased risk of AV‑block and severe bradycardia.

Moderate Interactions (Monitor Closely):\n- Clonidine: may cause rebound hypertension if stopped abruptly.

• Insulin or oral hypoglycemics: can mask signs of low blood sugar.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may reduce antihypertensive efficacy.