Nebivolol Arrow Lab (Nebivolol)

Nebivolol acts on the cardiovascular system to control blood pressure and support heart function.

• Hypertension: lowers systolic and diastolic blood pressure in patients with elevated arterial pressure.
• Chronic heart failure: improves left‑ventricular ejection fraction and reduces symptoms in adults with NYHA class II‑III heart failure.
• Left ventricular dysfunction: helps restore cardiac output in patients with reduced ventricular performance.

• Nebivolol selectively antagonizes β1‑adrenergic receptors, reducing heart rate and myocardial contractility, while simultaneously stimulating endothelial nitric‑oxide synthase. The increased nitric‑oxide release causes vasodilation, decreasing peripheral vascular resistance and contributing to overall blood‑pressure reduction without significant β2‑mediated bronchoconstriction.

Nebivolol may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Headache: mild to moderate pain often occurring early in therapy.
• Dizziness or light‑headedness: related to blood‑pressure lowering.
• Fatigue: general tiredness, especially during dose titration.
• Bradycardia: slower than normal heart rate.
• Nausea: occasional gastrointestinal upset.

Serious or Rare Side Effects

• Severe bradycardia or heart block: may require medical attention.
• Bronchospasm: especially in patients with underlying asthma or COPD.
• Allergic reactions: rash, itching, or angioedema.
• Hepatic dysfunction: elevated liver enzymes.
• Acute heart failure decompensation: worsening symptoms in susceptible individuals.

Before initiating nebivolol, clinicians should evaluate patient‑specific factors and monitor for potential risks.

• Renal impairment: adjust dose in patients with reduced kidney function.
• Hepatic disease: use cautiously and monitor liver enzymes.
• Asthma or COPD: avoid in severe bronchospastic disease due to possible β2 effects.
• Diabetes mellitus: monitor blood‑glucose as β‑blockade may mask hypoglycaemia symptoms.
• Abrupt discontinuation: taper gradually to prevent rebound hypertension.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, and protect from moisture.

Nebivolol can interact with several drug classes, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Other β‑blockers: additive bradycardia and hypotension.
• Calcium‑channel blockers (verapamil, diltiazem): increased plasma levels and risk of heart block.
• Strong CYP2D6 inhibitors (paroxetine, quinidine): may raise nebivolol concentrations.

Moderate Interactions (Monitor Closely):\n- ACE inhibitors or ARBs: enhanced antihypertensive effect, monitor blood pressure.

• Diuretics: risk of excessive volume depletion, watch electrolytes.
• Antidiabetic agents: possible masking of hypoglycaemia signs, check glucose regularly.