Nebilet Hct (Hydrochlorothiazide, Nebivolol)

Nebilet Hct combines nebivolol and hydrochlorothiazide to treat hypertension by targeting cardiovascular and renal mechanisms.

• Essential hypertension: lowers systolic and diastolic blood pressure in patients with primary high blood pressure.
• Hypertension with fluid retention: reduces plasma volume while providing beta‑blockade to improve blood pressure control.
• Hypertension requiring beta‑blockade: offers heart‑rate control together with diuretic action for comprehensive management.

• Nebivolol selectively blocks β1‑adrenergic receptors, decreasing heart rate and contractility, and simultaneously stimulates endothelial nitric‑oxide synthase, causing vasodilation. Hydrochlorothiazide inhibits Na⁺/Cl⁻ reabsorption in the distal convoluted tubule, promoting diuresis, reducing extracellular fluid volume, and contributing to a fall in systemic vascular resistance.

Common Side Effects

• Dizziness or light‑headedness.
• Headache.
• Increased urinary frequency.
• Fatigue.
• Electrolyte disturbances such as mild hypokalemia.
• Erectile dysfunction.

Serious or Rare Side Effects

• Severe hypotension leading to syncope.
• Bronchospasm, especially in patients with asthma or COPD.
• Significant electrolyte imbalances (severe hyponatremia or hypokalemia).
• Acute kidney injury.
• Pancreatitis.
• Allergic reactions such as rash or angioedema.

Nebilet Hct should be used with clinical monitoring and patient education.

• Blood pressure monitoring: check regularly to avoid excessive lowering.
• Renal function assessment: evaluate creatinine and eGFR before and during therapy.
• Electrolyte surveillance: monitor serum potassium and sodium levels.
• Caution in asthma/COPD: β1‑selectivity reduces risk but bronchospasm can still occur.
• Do not discontinue abruptly: taper to prevent rebound hypertension.
• Store at room temperature: keep in the original container, protect from moisture and light.

Nebilet Hct may interact with several medicines; clinicians should review patient medication lists.

Major Interactions (Avoid)

• Other antihypertensives (e.g., ACE inhibitors, ARBs) may cause additive hypotension.
• Potassium‑sparing diuretics can lead to hyperkalemia.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs) may reduce diuretic efficacy.
• Strong CYP2D6 inhibitors (e.g., paroxetine) increase nebivolol plasma levels.
• Lithium: concurrent use can raise lithium concentrations.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: monitor renal function and potassium.
• Additional beta‑blockers: risk of excessive bradycardia.
• Antidiabetic agents: beta‑blockade may mask hypoglycaemia symptoms.
• Digoxin: diuretic‑induced electrolyte shifts can alter digoxin levels.
• Alcohol: may enhance dizziness and hypotensive effects.