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NebiletProduct code SKU17235

Brand Name(s) : Hypoloc, Nebilet


NEBIVOLOL USES

What is it used for?

 Nebivolol is used to treat high blood pressure of unknown cause (essential hypertension) and chronic heart failure (the heart is unable to properly pump blood around the body) in people aged 70 years or over.
 It is a type of beta-adrenergic blocking agent, sometimes known as beta-blockers.
 It is used to relax and widen your blood vessels so that it is easier for your heart to pump blood around your body and your blood pressure is reduced.
 In general this drug is used to reduce high blood pressure (hypertension) and is an additional drug, along with other medicines, for chronic heart failure in people aged 70 years or over only.

Listed below are the typical uses of nebivolol:

 High blood pressure of unknown cause (essential hypertension)
 Chronic heart failure in patients aged 70 years or over

HOW TO USE/TAKE

How often do I take it?

 Always take nebivolol exactly as your doctor has told you. Nebivolol can be taken with food or on an empty stomach, and is best taken with some water.
 Use this medication for the duration of the prescription in order to get the most benefit from it.
 Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
 Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

 Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

 Nebivolol may cause dizziness or fatigue. If this happens, do not drive or operate machinery. Consult your doctor or pharmacist for more details.

When can I stop?

 It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop. When treatment with this medicine is stopped it should be done gradually following the instructions given by your doctor.

Details

NEBIVOLOL INTERACTIONS

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:

 Drugs for controlling blood pressure or other heart problems (amiodarone, amlodipine, cibenzoline, clonidine, digoxin, diltiazem, disopyramide, felodipine, flecainide, guanfacin, hydroquinidine, lacidipine, lidocaine, methyldopa, mexiletine, moxonidine, nicardipine, nifedipine, nimodipine, nitrendipine, propafenone, quinidine, rilmenidine and verapamil)
 Drugs used for mental illness, such as barbiturates (also used for epilepsy), phenothiazine (also used for feeling and being sick) and thioridazine
 Drugs used for depression, such as amitriptyline, paroxetine and fluoxetine
 Drugs used for asthma
 Drugs used for a blocked nose
 Drugs use for certain eye disorders, such as glaucoma (increased pressure in the eye) and widening the pupil in the eye (dilation)
 A drug used for stomach problems called cimetidine
 Drugs used to treat diabetes, such as insulin and metformin
 Drugs used for pain relief and inflammation called non-steroidal anti-inflammatory agents (NSAIDs)
 A drug used to treat and prevent malaria called mefloquine

If you are currently using any of these medications, tell your doctor or pharmacist before starting nebivolol.

Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use.

This information does not contain all possible interactions. Therefore, before using nebivolol, tell your doctor or pharmacist of all the products you use.


NEBIVOLOL SIDE EFFECTS

 Headache is common
 Dizziness is common
 Tiredness is common
 Diarrhoea is common
 Feeling sick is common
 Shortness of breath is common
 Swollen hands or feet is common
 Slow heart beat (bradycardia) or other heart problems are uncommon
 Low blood pressure (hypotension) is uncommon
 Depression is uncommon
 Difficulty getting an erection (impotence) is uncommon
 Being sick is uncommon
 Tightening of the chest, difficulty breathing or wheezing is uncommon
 Nightmares are uncommon
 Indigestion and gas are uncommon
 Skin rash or itchiness are uncommon
 Problems with sight are uncommon
 Worsening of heart failure is common in those being treated for the condition
 Swelling of legs and ankles is common in those being treated for heart failure
 Dizziness and light-headedness when going from lying down to sitting or standing (postural hypotension) in those treated for heart failure

If any of these persist or you consider them severe then inform your doctor or pharmacist.

Tell your doctor immediately if you develop any of the following symptoms:

 Swelling of ankles or feet
 Severe tiredness
 Unexplained or sudden weight gain
 Symptoms of asthma, such as a tight feeling in the chest, shortness of breath, cough and wheezing

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the UK you may report side-effects to the MHRA


NEBIVOLOL OVERDOSE

If you take more nebivolol tablets than you should, tell your doctor or contact your nearest hospital casualty department immediately. Signs of an overdose include a slow heart beat, heart problems, difficulty in breathing or wheezing.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of nebivolol or intentional overdose is suspected, contact your local hospital, GP or if in the UK call NHS Direct on 0845 4647.

MISSED DOSE

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.


NEBIVOLOL PRECAUTIONS

Before taking nebivolol, tell your doctor or pharmacist if you are allergic to it; or to other beta-blockers; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have:

 Allergy (hypersensitivity) to nebivolol or any of the ingredients in the tablets or to other beta-blockers
 Liver problems
 Asthma, wheezing or other breathing problems
 A type of irregular heart beat called sick sinus syndrome
 A severe circulation disorder called cardiogenic shock
 Severe blood circulation problems in the arms and legs (peripheral vascular disease)
 Increased acid levels in the blood (metabolic acidosis)
 Very low blood pressure (severe hypotension)
 Tumour of the adrenal gland (phaeochromocytoma)
 Very slow heart rate (severe bradycardia)
 A type of heart rhythm problem that blocks the electrical messages in the heart, unless an artificial pacemaker has been fitted (2nd or 3rd degree atrioventricular heart block)
 Pregnancy
 Breastfeeding

Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following:

 Kidney problems
 Diabetes
 A condition called Raynaud's phenomenon that causes painful, pale, cold fingers and toes
 History of allergies
 Overactive thyroid (hyperthyroidism)
 A type of chest pain called Prinzmetal's angina
 A muscle disease that causes abnormal weakness called myasthenia gravis
 A skin condition called psoriasis
 A chronic lung condition called chronic obstructive pulmonary disease (COPD)

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

 Alcohol dose not affect this drug.

The elderly: nebivolol should be used with caution in the elderly as they are more likely to have kidney problems.

Diabetes. Nebivolol should be used with caution in people with diabetes as it may mask the symptoms of low blood sugar.

Psoriasis: Nebivolol should be used with caution in people with the skin condition known as psoriasis as it may worsen the condition.

Allergy: Nebivolol should be used with caution in people with allergies as it may make them worse.

Pregnancy and breastfeeding - please ensure you read the detailed information below

PREGNANCY

Nebivolol is not safe to take if you are, or are planning to become, pregnant.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

Nebivolol is not safe to take if you are breastfeeding.

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.


NEBIVOLOL WARNINGS

Nebivolol should be used with caution in:

 Kidney problems
 Liver problems
 Heart problems
 Elderly
 Diabetes
 A condition called Raynaud's phenomenon that causes painful, pale, cold fingers and toes
 History of allergies
 Overactive thyroid (hyperthyroidism)
 A type of chest pain called Prinzmetal's angina
 A muscle disease that causes abnormal weakness called myasthenia gravis
 A skin condition called psoriasis
 A chronic lung condition called chronic obstructive pulmonary disease (COPD)
 A type of heart rhythm problem that blocks the electrical messages in the heart (1st degree atrioventricular block)

It should not be used in:

 Allergy (hypersensitivity) to nebivolol or any of the ingredients in the tablets or to other beta-blockers
 Liver problems
 Asthma, wheezing or other breathing problems
 A type of irregular heart beat called sick sinus syndrome
 A severe circulation disorder called cardiogenic shock
 Severe blood circulation problems in the arms and legs (peripheral vascular disease)
 Increased acid levels in the blood (metabolic acidosis)
 Very low blood pressure (severe hypotension)
 Tumour of the adrenal gland (phaeochromocytoma)
 Very slow heart rate (severe bradycardia)
 A type of heart rhythm problem that blocks the electrical messages in the heart, unless an artificial pacemaker has been fitted (2nd or 3rd degree atrioventricular heart block)
 Pregnancy
 Breastfeeding

Also see list of precautions and interactions

STORAGE

Store nebivolol tablets below 30C in their original package to protect them from light and moisture.

Nebilet

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