Nebivolol/Hct Stada Arzneimittel Ag (Hydrochlorothiazide, Nebivolol)

Nebivolol/Hydrochlorothiazide is indicated for the management of high blood pressure within the antihypertensive drug class.

• Essential hypertension: reduces systolic and diastolic blood pressure to target levels.
• Secondary hypertension: assists in controlling blood pressure when caused by other conditions.
• Isolated systolic hypertension: helps lower elevated systolic pressure in older adults.

• Nebivolol selectively blocks β1‑adrenergic receptors, decreasing heart rate and myocardial contractility, while also enhancing nitric‑oxide mediated vasodilation. Hydrochlorothiazide inhibits Na⁺/Cl⁻ reabsorption in the distal convoluted tubule, increasing urinary excretion of sodium and water, thereby reducing plasma volume. The combined actions produce additive blood‑pressure‑lowering effects.

Common Side Effects

• Dizziness: sensation of light‑headedness, especially after standing.
• Headache: mild to moderate pain in the head region.
• Fatigue: feeling unusually tired or weak.
• Increased urination: more frequent need to void.
• Nausea: upset stomach or urge to vomit.
• Dry mouth: reduced salivation.

Serious or Rare Side Effects

• Severe hypotension: dangerously low blood pressure requiring medical attention.
• Electrolyte imbalance: abnormal potassium or sodium levels.
• Acute kidney injury: sudden reduction in kidney function.
• Allergic reactions: rash, itching, swelling, or difficulty breathing.
• Pancreatitis: inflammation of the pancreas presenting with abdominal pain.
• Bradycardia: abnormally slow heart rate.

Before initiating therapy, consider the following precautions:

• Monitor blood pressure: check regularly to ensure therapeutic response.
• Assess renal function: evaluate kidney performance, especially in patients with pre‑existing disease.
• Check electrolytes: watch for potassium or sodium disturbances.
• Use caution in diabetes: beta‑blockade may mask hypoglycaemia symptoms.
• Avoid abrupt discontinuation: taper gradually to prevent rebound hypertension.
• Store at ambient temperature: keep in the original pack, protect from moisture and direct sunlight.

Nebivolol/Hydrochlorothiazide may interact with several medicines.

Major Interactions (Avoid)

• Other beta‑blockers: additive cardiac depression.
• Potent CYP2D6 inhibitors (e.g., paroxetine, quinidine): increase nebivolol plasma levels.
• Loop diuretics: excessive diuresis and electrolyte loss.
• NSAIDs: may reduce antihypertensive efficacy.
• Lithium: increased lithium concentrations.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: risk of hyperkalaemia and renal impairment.
• Calcium channel blockers: possible additive blood‑pressure effect.
• Antidiabetic agents: may require dose adjustment due to masked hypoglycaemia.
• Antidepressants (SSRIs): monitor for bradycardia.
• Antimicrobials (e.g., macrolides): observe for QT prolongation.