Nebivolol Teva Uk (Nebivolol)

Nebivolol is a selective β1‑adrenergic antagonist used primarily in the management of hypertension.

• Hypertension: reduces systolic and diastolic blood pressure, helping to prevent cardiovascular complications.
• Chronic heart failure (off‑label in some regions): may improve ventricular function and symptoms when used under specialist supervision.
• Elderly patients with isolated systolic hypertension: provides blood‑pressure control with a favorable heart‑rate profile.

• Nebivolol selectively blocks β1‑adrenergic receptors in cardiac tissue, decreasing heart rate and contractility, which lowers cardiac output. Concurrently, it stimulates endothelial nitric‑oxide synthase, leading to nitric‑oxide‑mediated vasodilation and reduced peripheral vascular resistance, together producing an antihypertensive effect.

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

Common Side Effects

• Headache: mild to moderate intensity.
• Dizziness or light‑headedness: especially after the first dose.
• Fatigue: a feeling of reduced energy.
• Nasal congestion: occasional blockage of nasal passages.
• Bradycardia: slower than normal heart rate.
• Gastrointestinal discomfort: nausea or abdominal pain.

Serious or Rare Side Effects

• Severe bradycardia: heart rate markedly below normal.
• Acute heart failure decompensation.
• Bronchospasm: especially in patients with reactive airway disease.
• Hypotension: dangerously low blood pressure.
• Allergic reactions: rash, itching, or swelling.
• Liver enzyme elevations: abnormal liver function tests.

Nebivolol requires careful assessment before initiation and during therapy.

• Cardiovascular assessment: evaluate heart rate, rhythm, and blood pressure before starting.
• Concomitant β‑blockers: avoid combining with other β‑blockers to prevent excessive bradycardia.
• Asthma or COPD: use with caution due to potential bronchospasm.
• Diabetes mellitus: monitor blood glucose as β‑blockade may mask hypoglycaemia symptoms.
• Pregnancy and lactation: safety not established; prescribe only if benefits outweigh risks.
• Store at ambient temperature: keep below 25 °C, in the original container, protected from moisture and light.

Nebivolol can interact with several drug classes, influencing its efficacy and safety.

Major Interactions (Avoid)

• Strong CYP2D6 inhibitors (e.g., paroxetine, quinidine): may increase nebivolol plasma levels.
• Non‑dihydropyridine calcium channel blockers (e.g., verapamil, diltiazem): can cause additive bradycardia.
• Other antihypertensives (e.g., ACE inhibitors, diuretics): may lead to excessive hypotension.

Moderate Interactions (Monitor Closely)

• Antidiabetic agents: β‑blockade may mask hypoglycaemia signs.
• NSAIDs: may reduce antihypertensive effect.
• Antidepressants (e.g., SSRIs): monitor for additive heart‑rate effects.
• Digoxin: increased risk of bradyarrhythmias.
• Alcohol: may enhance central nervous system depression and dizziness.