Nebivolol Unifarma (Nebivolol)

Nebivolol is a selective β1‑adrenergic blocker used in cardiovascular disease management.

• Hypertension: lowers systolic and diastolic blood pressure to reduce cardiovascular risk.
• Heart failure: improves left‑ventricular ejection fraction and reduces symptoms of fluid overload.
• Left ventricular systolic dysfunction: decreases mortality and hospitalisation rates in patients with reduced ejection fraction.

• Nebivolol selectively antagonises β1‑adrenergic receptors in cardiac tissue, reducing heart rate and contractility. In addition, it stimulates endothelial nitric oxide synthase, leading to nitric‑oxide‑mediated vasodilation, which further contributes to blood‑pressure reduction without significant β2‑blockade.

Nebivolol may cause a range of adverse reactions.

Common Side Effects

• Headache: mild to moderate intensity.
• Dizziness or light‑headedness, especially on standing.
• Fatigue or tiredness.
• Nasal congestion or rhinorrhoea.
• Bradycardia: heart rate below 60 bpm.
• Nausea or mild gastrointestinal upset.

Serious or Rare Side Effects

• Severe bradycardia or heart block requiring medical attention.
• Marked hypotension with syncope.
• Acute bronchospasm in patients with reactive airway disease.
• Allergic reactions such as rash, pruritus, or angio‑edema.
• Hepatic enzyme elevations.
• Cardiogenic shock in severe heart failure.

Nebivolol should be used with careful clinical monitoring.

• Blood pressure monitoring: check regularly to avoid excessive hypotension.
• Heart rate assessment: observe for bradycardia, especially in patients with conduction disorders.
• Asthma or COPD: use with caution due to potential bronchoconstriction.
• Discontinuation: avoid abrupt cessation; taper under physician guidance to prevent rebound hypertension.
• Renal/hepatic impairment: dose adjustment may be required based on organ function.
• Pregnancy and lactation: safety not established; weigh benefits against risks.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Nebivolol can interact with several drug classes, requiring vigilance.

Major Interactions (Avoid)

• Co‑administration with other beta‑blockers: may cause excessive bradycardia or AV block.
• Calcium‑channel blockers (verapamil, diltiazem): increase risk of severe bradycardia and hypotension.
• Potent CYP2D6 inhibitors (paroxetine, fluoxetine): raise nebivolol plasma concentrations.

Moderate Interactions (Monitor Closely):\n- Non‑selective beta‑agonists (albuterol): may reduce bronchodilator efficacy.

• Diuretics (thiazides, loop diuretics): additive hypotensive effect, monitor electrolytes.
• ACE inhibitors or ARBs: combined effect on blood pressure may require dose titration.