Instructions for use
Additional Information
Nebilet is a popular medicine for high blood pressure, coronary heart disease, chronic heart failure. It has a unique property - not only lowers the pulse, but also dilates the blood vessels. This is the original drug, the international name of which is nebivolol. The vasodilating effect, in addition to the hypotensive effect, ensured the adherence of doctors and patients to Nebilet. However, this medicine is not a panacea, it has its own contraindications and side effects. The following is an instruction for use, written in an accessible language. Read the indications for use, dosages for various diseases. Find out how Nebilet affects male potency, whether it is compatible with alcohol, what cheap analogues of this medicine exist.
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Nebilet: instructions for use
| pharmachologic effect | Cardioselective beta-1-blocker. Normalizes blood pressure, improves heart rate, reduces the frequency of angina attacks. It holds pressure well not only at rest, but also during physical exertion and stress. Modulates the release of endothelial nitric oxide (NO), which dilates blood vessels. With hypertension, a stable effect begins to be felt after 1-2 weeks of daily intake, sometimes after 4 weeks. The maximum reduction in blood pressure is achieved after 1-2 months. |
| Pharmacokinetics | Can be taken on an empty stomach or after meals. Eating does not affect the rate of its absorption from the gastrointestinal tract. The drug is excreted by the kidneys (38%) and through the intestines (48%) in the form of metabolic products. No more than 0.5% of the dose taken is excreted unchanged in the urine. |
| Indications for use |
|
Read detailed articles about the treatment of diseases:
Watch also a video about the treatment of coronary artery disease and angina pectoris
Learn how to take control of heart failure
| Dosage | Nebilet is enough to take 1 time per day, on an empty stomach or after a meal, preferably at the same time every day. Most often, a suitable dose in the treatment of arterial hypertension and coronary heart disease is 2.5-5 mg per day, i.e. 1/2-1 tablet. The drug is well suited for combination with other drugs that reduce blood pressure. In chronic heart failure start with a minimum dose of 1.25 mg per day, what is? pills. The dose is slowly increased, no more than once every 1-2 weeks, under the supervision of a physician. The same for patients with renal insufficiency or over the age of 65 years. The maximum dose of Nebilet is 10 mg per day. |
| Side effects | Common side effects (1-10%):
more rare (<1%):
|
| Contraindications |
Intermittent claudication and other circulatory disorders in the legs are considered contraindications. However, Nebilet is prescribed for patients with foot problems, and treatment is often successful. Chronic obstructive pulmonary disease is the same situation. |
| Pregnancy and breastfeeding | During pregnancy, a non-bilet is prescribed in exceptional cases, only for vital indications. The drug is used if doctors believe that the benefit to the mother outweighs the possible risk. At the same time, uteroplacental blood flow and fetal growth are carefully monitored. Possible consequences for the fetus and newborn are too low a pulse, a low concentration of glucose in the blood, arterial hypotension. It is advisable to stop taking non-ticket 48-72 hours before delivery. If this is not possible, then doctors monitor the newborn for 48-72 hours after birth, in case emergency care is needed. Nebivolol passes into breast milk. Therefore, against the background of treatment with Nebilet tablets, breastfeeding should be stopped. |
| drug interaction | The hypotensive effect of nebivolol is enhanced by the simultaneous use of other drugs for pressure or tricyclic antidepressants, as well as barbiturates and phenothiazine derivatives. Increased caution requires simultaneous use with prazosin, diltiazem and verapamil. Many drugs increase the concentration of nebivolol in the blood and slow down its excretion. In particular, these are serotonin reuptake inhibitors and cimetidine. Discuss drug interactions with your doctor! Patients with diabetes should remember that taking Nebilet tablets can mitigate the symptoms of hypoglycemia. |
| Overdose | Overdose symptoms - a pronounced decrease in blood pressure, nausea, vomiting, cyanotic skin color, low pulse. AV blockade, bronchospasm, loss of consciousness, cardiogenic shock, coma, cardiac arrest are also possible. Treatment: gastric lavage, activated charcoal. Call an ambulance! May need resuscitation. To speed up the pulse, the doctor may inject 0.5-2 mg of atropine intravenously and carry out other intensive care measures. |
| Release form | Tablets are almost white, round, biconvex. They have a cross-shaped notch to conveniently divide into two or four parts. |
| Terms and conditions of storage | Keep out of the reach of children at a temperature not exceeding 25°C. Shelf life - 3 years. |
| Compound | One tablet contains micronized nebivolol hydrochloride 5.45 mg, which corresponds to 5 mg of nebivolol. Excipients: lactose monohydrate - 141.75 mg, corn starch - 46 mg, croscarmellose sodium - 13.8 mg, hypromellose - 4.6 mg, polysorbate - 0.46 mg, microcrystalline cellulose - 16.1 mg, colloidal silicon dioxide - 0.69 mg, magnesium stearate - 1.15 mg. |
Prices for Nebilet tablets and their analogues in an online pharmacy with delivery in Moscow and Russia
The use of tablets Nebilet
Nebilet is a popular remedy for:
- arterial hypertension;
- ischemic heart disease;
- heart failure.
It has been proven that it not only lowers blood pressure, but also reduces the frequency of heart attacks and strokes, prolonging the life of patients. Previous-generation beta-blockers, in particular atenolol, also lower blood pressure, but worse at reducing the incidence of cardiovascular complications and mortality. Source - article “Atenolol in hypertension: is it a wise choice?” by Carlberg B., Samuelsson O., Lindholm L.H. in the British medical journal Lancet, February 19, 2005.
Modern beta-blockers that compete with Nebilet:
Each manufacturer emphasizes that his drug is better than others, but in practice the difference between them is not significant. However, it is advisable to switch from propranolol (obzidan, anaprilin) and atenolol to one of the new generation drugs.
Benefits of Nebilet compared to other beta blockers:
- Not only lowers blood pressure, but also dilates blood vessels.
- It is enough to take 1 tablet per day, it works stably for more than 24 hours, without jumps.
- It lowers blood pressure as well as other beta-blockers, while causing fewer side effects. The tolerability of Nebilet tablets is comparable to placebo.
- In many patients, it restores the normal daily rhythm of blood pressure fluctuations. This is an additional prevention of a heart attack.
- With prolonged use (1 year or more), the effectiveness of the drug does not weaken, addiction does not develop.
- This drug can be prescribed for metabolic syndrome and type 2 diabetes. It does not worsen the results of blood tests for glucose, cholesterol and triglycerides.
- Proven: does not affect male potency. Indirectly even improves it. Read the article "" for more details.
- It can be combined with many other pressure medications if it turns out that the non-ticket alone does little to help.
Disadvantages:
- Less studied than other beta-blockers, in particular bisoprolol (Concor). However, a significant evidence base for effectiveness has been accumulated.
- While taking nebivolol, 11% of patients experience bradycardia - a decrease in heart rate to 50-30 beats per minute. Against the background of placebo - 3% of cases of bradycardia.
- It has a mixed route of excretion from the body - it loads both the liver and the kidneys. Not suitable for patients with liver disease or renal insufficiency.
Nebilet should be used with caution in the following diseases:
- kidney failure;
- diabetes;
- increased thyroid function (hyperthyroidism);
- psoriasis;
- AV block I degree;
- Prinzmetal's angina;
- patients over the age of 75 years.
However, all these are not contraindications. Patients with the comorbidities listed above can be treated with non-ticket and are often successful.
Nebilet or Concor - which is better
What is better to take for hypertension - non-ticket or concor? This question is asked by many patients who have high blood pressure. The answer is that both drugs are good. What the doctor prescribes for you, then take it. And if you feel worse, then consult a doctor to change your medicine. Concor and Nebilet are the original preparations of bisoprolol and nebivolol. They are the most expensive, but also guaranteed quality. If the doctor approves, then you can try their inexpensive counterparts. In particular, the analogue of Nebilet tablets is the drug binelol produced in Croatia.
Nebilet manufacturers claim that their drug is better than bisoprolol (Concor). Producers of concor - respectively, on the contrary. There are many articles published in medical journals about the benefits of one drug over another. However, there is little trust in them, because they are mainly paid by pharmaceutical companies. For example, you can read the article "Comparative efficacy of nebivolol and bisoprolol in terms of effect on central arterial pressure and elastic properties of arteries in patients with mild to moderate arterial hypertension" on the Internet.
This article was published in the journal Arterial Hypertension, No. 1/2013, the authors are Sirenko Yu.N., Rekovets O.L., Kushnir S.N., Mikheeva K.V., Dobrokhod A.S., Torbas E. BUT. In it, based on the results of a small clinical study (40 patients), it is proved that nebilet is better than bisoprolol. The reason is that it lowers central arterial pressure more strongly. There are other articles confirming that the protective properties of nebivolol are more pronounced than those of bisoprolol. Although both drugs lower the pressure with the same force.
Instead of choosing between a concor and a non-ticket, the better question to ask is, do you even need to take beta-blockers? Read . After 3 weeks you will have normal pressure without “chemical” pills. Even the highest quality beta-blockers can cause bradycardia (an excessive decrease in heart rate), fatigue, dry mouth, nausea, and constipation. Unlike them, the natural way to treat hypertension is 100% free of harmful side effects. The same method also helps with heart failure. Eliminate the causes of your health problems, instead of knocking down the pressure with a non-ticket or other pills, trying to "mute" the symptoms.
Analogues
The most famous analogue of Nebilet tablets is the drug binelol produced in Croatia. It costs about 30% less. Its manufacturers are running an advertising campaign in medical journals to prove that binelol is no worse than a non-bilet. See, for example, the article “Modern treatment of cardiovascular diseases with ?-adrenergic blockers, taking into account the range of properties and substantiation of benefits: focus on nebivolol” in the journal Systemic Hypertension, No. 4/2009, authors - A. G. Evdokimova, V. A. Olkhin, V. V. Evdokimov, E. V. Zolotareva, A. B. Khadzegova.
Other analogues:
- Nebivator;
- Nevotens;
- Nebivolol-Chikafarma.
Each doctor, as experience accumulates, develops his own point of view whether inexpensive analogues are inferior in effectiveness to the original drug. As explained above, medical journal articles cannot be relied upon in this regard. Because they are financed by drug manufacturers, and therefore they are not always objective.
Reviews
Reviews about the drug nebilet on Russian-language and English-language sites are approximately 70% positive and no more than 30% abusive. This is a phenomenally good indicator. Because drug reviews are mostly written by people who did not help the pills or caused side effects. Satisfied patients do not leave comments, but go about their business.
For the reasons mentioned above, the effectiveness of drugs on reviews on the Internet looks worse than it actually is. Many people, after reading negative reviews, are afraid to take the medicines prescribed by their doctor. As a result, their condition worsens without treatment. All the more surprising is the many positive reviews about the drug Nebilet, which people take for hypertension and cardiac arrhythmias.
Galina Krasnova
A year ago, I started taking Nebilet for hypertension as prescribed by a doctor at a dosage of 5 mg / day. Recently reduced the dosage to 2.5 mg / day, and the pressure is still normal. A good drug, worth the money, especially if you take only half a tablet a day. Side effects are minor, the body quickly adapts.
Nebilet, like other beta-blockers, does not affect the causes of hypertension, but only muffles the symptoms. This may continue for several years, but sooner or later the situation will get out of hand. Switch to a healthy lifestyle to normalize blood pressure in natural ways.
Dmitry Kruglov
I have been taking non-bilet for a month and a half, 0.5 tablets a day. I feel the effect - the pulse and pressure returned to normal, working capacity improved. The first two weeks I felt somehow unusual, there were dizziness. Now everything is fine, the body is used to it.
In middle age, people knock down pressure with pills and run to work. After retirement, it becomes easier to find time to take care of your health. Ask about natural treatments for hypertension and methods to strengthen the heart, instead of hoping for miracle drugs. Combine "chemical" drugs with a transition to a healthy lifestyle.
Lilia Zubchenko
Nebilet really lowers the pressure, but its price is high, and I'm also worried about side effects. My heart aches every day, there are dizziness, weakness and at the same time insomnia. Now I am looking for what other medicine it can be changed to, so that it costs less and acts softer.
There is no magic drug for hypertension that can help if you eat garbage, lead a sedentary lifestyle, regularly fight with relatives and colleagues. Blood pressure medications, even the most powerful combination pills, are just an adjunct to lifestyle changes.
Frequently Asked Questions and Answers
Below are answers to questions that often arise in people taking Nebilet for high blood pressure and cardiovascular disease.
Are non-tickets and alcohol compatible?
People who take a non-ticket are allowed to consume alcohol in small quantities. Large doses of alcohol can cause hypotension - too low blood pressure. Symptoms: dizziness, weakness, headache. Possible fainting. Drink alcohol only if you are able to consume it in moderation. However, treatment with modern beta-blockers does not require patients to lead a 100% sober lifestyle.
Nebilet or nebivolol: which is better?
Nebilet is the trade name of the drug, and nebivolol is its active ingredient. It cannot be said that nebilet is better than nebivolol, or vice versa, because they are the same thing. Nebilet is an original drug containing nebivolol. It is considered the highest quality among drugs in which the active ingredient is nebivolol. However, pharmacies sell similar drugs - analogues that are produced by other manufacturers. All of them are cheaper than a non-ticket. There is no reliable information which is better: nebilet or its analogues containing nebivolol. There are many articles on this subject in medical journals. But they cannot be trusted, because articles comparing medicines with each other are usually published for money and are not objective.
How does a non-ticket affect male potency?
Is it possible to divide a tablet of a non-ticket into parts?
Yes, you can, and often have to do it. Place the tablet on a hard, flat surface. Then divide it in half along the notch. The halves can also be divided along the second notch to get? tablets - a daily dose of 1.25 mg.
How long can you take? Will there be addiction and weakening of the effect?
The manufacturer promises that there will be no addiction and the effect will not weaken for at least 1 year. In practice, you can take several years in a row. Improve your lifestyle to normalize blood pressure and strengthen your heart, and not just quench symptoms with pills.
Is a non-bilet compatible with ... the name of another drug ...?
Read the instructions and find out which group each of the drugs you are interested in belongs to. Then study. It has a table - which groups are compatible with each other, and which are not. That way you will know the answer to your question. Ask your doctor to prescribe a combination of blood pressure medicines in one tablet. These medications are convenient, effective, and easy to take. In particular, a combination tablet of nebivolol with amlodipine, called nebilong AM, has recently appeared.
What to do if a non-ticket lowers blood pressure or pulse too much?
You need to consult a doctor, reduce the daily dose or stop taking it altogether. It is impossible to give general advice here, because everyone is individual. Read the section on the instructions for treating an overdose of this drug. It can be useful.
What can replace this medicine?
Explore. Perhaps, thanks to magnesium with vitamin B6 and other natural remedies, you will not need beta-blockers at all. The issue of replacing a non-ticket with another “chemical” drug can only be discussed personally with the doctor at the reception, and not in absentia on the Internet.
Read more about the methodology in the article "". How to Order Hypertension Supplements from the USA - . Get your blood pressure back to normal without the harmful side effects that Noliprel and other "chemical" pills cause. Improve heart function. Become calmer, get rid of anxiety, sleep like a baby at night. Magnesium with vitamin B6 works wonders for hypertension. You will have excellent health, to the envy of your peers.
An antihypertensive drug with vasodilating properties is Nebilet. Instructions for use reports that 5 mg tablets reduce heart rate and total peripheral vascular resistance. According to cardiologists, this drug helps in the treatment of hypertension (lowering pressure) and the prevention of angina attacks.
Release form and composition
Nebilet is produced in the form of white tablets, convex on both sides with a cross-shaped notch for easy division. Tablets are packed in blisters of 7 or 14 pieces in a cardboard box with detailed instructions for taking.
Each tablet contains 5 mg of the active ingredient - Nebivolol, as well as excipients
pharmachologic effect
Nebivolol has antianginal, antiischemic and hypotensive effects. Due to this, the drug is very effective in lowering blood pressure, reducing heart rate and overall peripheral vascular resistance. Nebilet smoothly reduces systolic and diastolic blood pressure.
Even against the background of long-term use, resistance to the drug does not develop. The effectiveness of the drug does not depend on the sex and age of the patient. With a sharp cessation of the use of Nebilet, there is no withdrawal syndrome. The use of Nebilet has an angioprotective and cardioprotective effect, which manifests itself in the form of normalization of the basal vascular tone, improvement of arterial extensibility, and inhibition of the development of atherosclerosis.
Indications for use
What helps Nebilet? The main indications for the use of tablets:
- ischemia of the heart;
- arterial hypertension;
- chronic heart failure (as part of combination therapy).
Instructions for use
Nebilet tablets are taken orally, 1 time per day, preferably always at the same time of day, regardless of the meal, with a sufficient amount of liquid. The average daily dose for the treatment of arterial hypertension and coronary artery disease is 2.5-5 mg (1/2-1 tablet).
Nebilet can be used as monotherapy or in combination with other blood pressure lowering agents. In patients with renal insufficiency, as well as in patients over the age of 65 years, the initial dose is 2.5 mg (1/2 tablet) per day.
If necessary, the daily dose can be increased to a maximum of 10 mg (2 tablets in 1 dose). Treatment of chronic heart failure should begin with a slow increase in dose until the individual optimal maintenance dose is reached.
Dose selection at the beginning of treatment should be carried out at intervals of 1 to 2 weeks and based on the tolerance of this dose by the patient: the dose of 1.25 mg of nebivolol (1/4 tablet) 1 time per day can be increased initially to 2.5-5 mg (1/2-1 tablet), and then - up to 10 mg (2 tablets) 1 time per day. The maximum recommended dose is 10 mg once daily.
At the beginning of treatment and with each dose increase, the patient should be under the supervision of a physician for at least 2 hours to ensure that the clinical condition remains stable (especially blood pressure, heart rate, conduction disturbances, as well as symptoms of exacerbation of chronic heart failure).
Rules for dividing tablets
To divide, place the tablet on a hard, flat surface with the cross-shaped notch up, press down on the tablet with both index fingers. For 1/4 tablet, repeat the same steps for 1/2 tablet.
Contraindications
Nebilet is contraindicated for:
- Bradycardia.
- Pronounced violations of liver function.
- Bronchospasm and bronchial asthma in history.
- Hypersensitivity to the active substance - nebivolol or other components of the drug.
- Sick sinus syndrome, including sinoatrial block.
- Lactase intolerance or deficiency and galactose malabsorption syndrome.
- Acute heart failure and chronic heart failure in the stage of decompensation.
- Pheochromocytoma, without the simultaneous use of alpha-blockers.
- Myasthenia.
- metabolic acidosis.
- Severe arterial hypotension.
- Severe obliterating diseases of peripheral vessels.
- AV block II and III degree.
- depression.
- Cardiogenic shock.
During pregnancy, Nebilet is used only under strict indications and under the control of uteroplacental blood flow and fetal growth. In this case, the use of the drug must be canceled no later than two days before delivery. For the duration of the use of Nebilet, breastfeeding must be interrupted. According to the instructions, the medication is not used under the age of 18 due to the lack of studies on the effectiveness and safety of the drug.
Nebilet tablets should be used with caution in hyperfunction of the thyroid gland, psoriasis, renal failure, diabetes mellitus, AV blockade of the 1st degree, chronic obstructive pulmonary disease, a history of allergic diseases, Prinzmetal's angina, and also over the age of 75 years.
Side effects
During treatment with the drug in patients, the development of adverse reactions is possible:
- Allergic reactions - skin rash, urticaria, development of angioedema, bronchospasm, exacerbation of atopic dermatitis and psoriasis.
- Against the background of long-term use of this drug, patients wearing contact lenses complained of increased dryness of the eyes.
- From the side of the nervous system - headaches, fatigue and lethargy, weakness, a feeling of crawling on the skin, decreased sensitivity in the limbs, dizziness, depression, impaired sleep, insomnia, in rare cases, patients may faint.
- On the part of the cardiovascular system - the development of heart failure, a sharp drop in blood pressure, up to collapse, bradycardia, the development of Raynaud's syndrome.
- From the gastrointestinal tract - nausea, pain in the epigastric region, vomiting, bloating, increased flatulence, constipation, diarrhea, pain in the right hypochondrium, increased activity of hepatic transaminases.
During pregnancy and lactation
During pregnancy, Nebilet is prescribed only for vital indications, when the benefit to the mother outweighs the possible risk to the fetus or newborn (due to the possible development of bradycardia, arterial hypotension, hypoglycemia in the fetus and newborn).
If treatment with Nebilet is necessary, then uteroplacental blood flow and fetal growth should be monitored. Treatment must be interrupted 48-72 hours before delivery. In cases where this is not possible, it is necessary to establish strict observation of newborns within 48-72 hours after delivery.
Nebivolol is excreted in breast milk. If you need to take the drug Nebilet during lactation, breastfeeding should be stopped.
special instructions
With pheochromocytoma, the use of the drug is possible only in parallel with taking alpha-blockers. At the beginning of the course of therapy, with each dose increase, the patient should be under the supervision of a physician for at least 2 hours. This will allow you to monitor the patient's condition.
When planning a surgical intervention, the anesthesiologist should be warned about taking beta-blockers. Cancellation of the drug should be carried out gradually over 10-14 days.
drug interaction
When Nebilet is combined with anesthetics, a cardiodepressive effect may occur, which increases the risk of arterial hypotension. Simultaneous use with antihypertensive drugs, blockers of "slow" calcium channels, Nitroglycerin contributes to a sharp increase in arterial hypotension.
Taking antiarrhythmic drugs, Reserpine, Alpha-methyldopa, Clonidine, Guanfacine leads to an increase in the severity of bradycardia. Combination treatment with clonidine may exacerbate the "withdrawal" syndrome.
The use of microsomal oxidation inducers (Rifampicin, barbiturates) can reduce, and some inhibitors, for example, Cimetidine, on the contrary, increase its concentration in the blood plasma.
Nebilet's analogs
According to the structure, analogues are determined:
- Nebilong.
- Nebivator.
- Nebivolol.
- Newotens.
- Nebilan Lannacher.
- OD Neb.
- Binelol.
- Nebivolol hydrochloride.
- Nebicor Adifarm.
The group of beta-blockers includes analogues:
- Metocard.
- Cordinorm.
- Xonef.
- Lokren.
- Corbis.
- Kordanum.
- Kuzimolol.
- Okumol.
- Trazikor.
- Whisken.
- Concor.
- Timoptic.
- Betoftan.
- Sotalex.
- Atenosan.
- Prinrm.
- Timolol.
- Atenova.
- Egilok.
- Korgard.
- Propranolol.
- Inderal.
- Arutimol.
- Optimol.
- Betaloc.
- Breviblock.
- Atenobene.
- Coronal.
- Betacard.
- Betoptik.
- Anaprilin.
- Okumed.
- Sektral.
- Atenolol.
- Vasocardin.
- Obzidan.
- Propranobene.
- Corvitol.
- Acecor.
- Egilok Retard.
- Betaxolol.
- Biprol.
- Glaumol.
- Metolol.
- Nebilong.
- Sandonorm.
- Nebivator.
- trimepranol.
- Celiprol.
- Atenol.
- Bisocard.
- Metoprolol.
Holiday conditions and price
The average cost of Nebilet (tablets 5 mg No. 14) in Moscow is 559 rubles. The drug can be bought at a pharmacy with a prescription from a doctor.
Tablets are recommended to be kept away from children in a cool place where direct sunlight does not fall. Subject to the storage conditions of the drug, Nebilet can be stored for 3 years from the date of production, which is indicated on the package. At the end of the expiration date, the medicine should not be taken orally.
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Nebilet is a cardioselective β 1 -blocker with antianginal, hypotensive and antiarrhythmic action, which reduces high blood pressure at rest, during stress and physical exertion.
Release form and composition
Nebilet dosage form - tablets: biconvex, almost white, round, with one-sided cross-shaped notch for dividing (7 or 14 pieces in a blister, in a cardboard box 1, 2 or 4 blisters).
Composition of 1 tablet:
- Active substance: nebivolol hydrochloride - 5.45 mg (equivalent to the content of nebivolol 5 mg);
- Additional components: corn starch, microcrystalline cellulose, colloidal silicon dioxide, lactose monohydrate, sodium croscarmellose, polysorbate 80, magnesium stearate, hypromellose (15 mPa×s).
Indications for use
- Arterial hypertension;
- Chronic heart failure (as part of combination therapy);
- Ischemic heart disease (prevention of angina attacks).
Contraindications
Absolute:
- Chronic heart failure in the stage of decompensation (if necessary, intravenous administration of drugs that have an inotropic effect);
- Acute heart failure;
- Sick sinus syndrome (including sinoauricular block);
- Severe arterial hypotension (systolic blood pressure below 90 mm Hg);
- Atrioventricular block II and III degree (without artificial pacemaker);
- Cardiogenic shock;
- Bradycardia (heart rate less than 60 beats per minute);
- Pheochromocytoma (without combination with alpha-blockers);
- Severe violations of the liver;
- metabolic acidosis;
- Bronchial asthma and bronchospasm in history;
- Severe obliterating lesions of peripheral vessels (Raynaud's syndrome, intermittent claudication);
- Depression;
- myasthenia;
- Glucose-galactose malabsorption syndrome, lactase deficiency and lactose intolerance;
- Age up to 18 years (due to the lack of studies on the use of the drug in children and adolescents);
- Hypersensitivity to the components of the drug.
Relative (required to be used with extreme caution due to the possible risk of complications):
- Hyperfunction of the thyroid gland (masked increase in heart rate);
- kidney failure;
- Diabetes mellitus (it is possible to mask the symptoms of a decrease in the concentration of glucose in the blood - palpitations, trembling, nervousness);
- Predisposition to allergies (anaphylactic reactions may be aggravated);
- Psoriasis;
- Chronic obstructive pulmonary disease (possibly increased bronchospasm);
- Atrioventricular block I degree;
- Prinzmetal's angina;
- Age over 75 years old.
During pregnancy, Nebilet can be prescribed only under strict indications, in the case when the expected benefit of taking the drug outweighs the possible risk of side effects (the appearance of hypoglycemia in the fetus / newborn, arterial hypotension, bradycardia). If it is necessary to carry out therapy with the drug, uteroplacental blood flow and fetal growth should be monitored, the course must be interrupted 2-3 days before delivery. In cases where this is not feasible, it is necessary to establish careful monitoring of the newborn for 2-3 days after delivery.
Since the drug is excreted in breast milk, if it is necessary to treat the drug during lactation, breastfeeding should be abandoned.
Method of application and dosage
Tablets are taken orally 1 time per day, washed down with a sufficient amount of liquid, regardless of the meal, preferably at the same time of day.
In the treatment of coronary heart disease and arterial hypertension, the average dose per day is ½-1 tablet (2.5-5 mg). Nebilet can be used alone or in combination with other antihypertensive drugs. Patients over 65 years of age, as well as persons with renal insufficiency, are prescribed an initial daily dose of ½ tablet (2.5 mg). If necessary, the dose can be increased to a maximum of 2 tablets (10 mg) per day at a time.
For the treatment of chronic heart failure, it is recommended to increase the initial dose gradually to the optimal maintenance dose, which allows to achieve the desired therapeutic effect. At intervals of 1-2 weeks, with good tolerability of the drug, the initial daily dose of ¼ tablet (1.25 mg) can be increased initially to ½-1 tablet (2.5-5 mg), and later, if necessary, up to 2 tablets (10 mg) in one dose. The maximum dose per day should not exceed 10 mg.
At the beginning of the course of treatment, as well as with each dose increase, the patient needs to be under medical supervision for at least 2 hours to prevent the development of adverse reactions (cardiac arrhythmia and conduction disturbances, worsening of chronic heart failure, etc.).
To divide a tablet into two halves, you need to place it with a cross-shaped notch up on a hard, even surface and press on the tablet with both index fingers. To obtain a ¼ tablet, similar actions should be carried out with half a tablet.
Side effects
- Digestive system: often - constipation, nausea, diarrhea; infrequently - flatulence, dyspepsia, vomiting;
- Cardiovascular system: infrequently - atrioventricular blockade, acute heart failure, bradycardia, Raynaud's syndrome, orthostatic hypotension;
- Nervous system: often - increased fatigue, dizziness, weakness, headache, paresthesia; infrequently - nightmares, depression, confusion; extremely rarely - hallucinations, fainting;
- Skin and subcutaneous tissues: infrequently - itching, erythematous skin rash; very rarely - exacerbation of the course of psoriasis; in some cases - angioedema;
- Other: infrequently - bronchospasm; rarely - dry eyes.
Symptoms of an overdose of Nebilet include: cyanosis, vomiting, nausea, a pronounced decrease in blood pressure, atrioventricular blockade, sinus bradycardia, heart failure, loss of consciousness, bronchospasm, coma, cardiogenic shock, cardiac arrest.
In such cases, gastric lavage, activated charcoal are prescribed, with heart failure, bradycardia, severe hypotension - the introduction of β-agonists. In the absence of an adequate response, norepinephrine, dobutamine, dopamine are recommended, further - 1-10 mg of glucagon and the setting of a transvenous intracardiac stimulator. For the treatment of ventricular extrasystole, lidocaine is prescribed, for bronchospasm - stimulants of β 2 -adrenergic receptors (intravenously), and for convulsions - intravenous injections of diazepam.
special instructions
Cancellation of the drug is required to be carried out gradually over 10 days (in patients with coronary heart disease up to 14 days).
At the beginning of the course, daily monitoring of blood pressure and heart rate is necessary.
Elderly people should monitor kidney activity once every 4-5 months, and patients with diabetes mellitus should monitor plasma glucose levels.
Smoking reduces the effectiveness of the drug.
In the presence of psoriasis, admission is possible only after a careful balance of risks and benefits from the use of the remedy.
Patients wearing contact lenses should be aware that when using beta-blockers, there may be a decrease in the production of lacrimal fluid.
If it is necessary to carry out surgical intervention, the anesthesiologist should be informed about the drug intake.
During the course of therapy, due to the possible occurrence of undesirable effects, it is recommended to be careful when driving vehicles and other complex mechanisms.
drug interaction
It should be borne in mind that when used simultaneously with Nebilet:
- Blockers of slow calcium channels (diltiazem, verapamil) - increase the negative effect on atrioventricular conduction and myocardial contractility;
- Cardiac glycosides - contribute to the summation of the chrono- and dromotropic effect;
- Clonidine - leads to an increase in the "withdrawal syndrome";
- Nitroglycerin, antihypertensives, slow calcium channel blockers - contribute to the development of severe arterial hypotension (especially caution should be exercised when combined with prazosin);
- Barbiturates, tricyclic antidepressants, phenothiazine derivatives - increase the hypotensive effect of nebivolol;
- Antiarrhythmic drugs, alpha-methyldopa, reserpine, guanfacine, clonidine - aggravate the severity of bradycardia;
- Preparations for general anesthesia - cause a cardiodepressive effect and increase the risk of arterial hypotension;
- Inhibitors of microsomal oxidation (cimetidine) - increase the level of nebivolol in the blood plasma; and inducers (barbiturates, rifampicin) - reduce.
When Nebilet is combined with oral hypoglycemic drugs and insulin, there may be a masking of signs of hypoglycemia (tachycardia).
During the period of use of nebivolol, intravenous administration of verapamil is contraindicated.
Terms and conditions of storage
Keep out of the reach of children at a temperature not exceeding 25 °C.
Shelf life - 3 years.
The composition of the drug contains the active substance: nebivolol hydrochloride .
Additional ingredients: lactose monohydrate, corn starch, MCC, magnesium stearate, silicon dioxide, polysorbate 80, carboxymethylcellulose sodium salt, hydroxypropyl methylcellulose.
Release form
Nebilet is produced in tablets packed in blisters of 7 or 14 pieces, 1, 2 or 4 blisters in a pack.
pharmachologic effect
The medicine has antiarrhythmic, hypotensive and antianginal action.
Pharmacodynamics and pharmacokinetics
Nebilet tablets contribute to lowering, both at rest and during periods of physical exertion or stress. There is a competitive and selective blocking of synaptic and extrasynaptic beta1-adrenergic receptors, making them inaccessible to catecholamines, and the release of endothelial vasodilator factor or NO is also modulated. The hypotensive effect of this drug is due to a decrease in the activity of the renin-angiotensin system, but the change in activity in the composition is not directly correlated.
At the beginning of treatment, an increase in OPSS is not excluded, but gradually it normalizes and even decreases. The development of the hypotensive effect is noted after 2-5 days, the lasting effect persists for 1-2 months. At the same time, myocardial demand for oxygen is reduced, the number and severity of seizures are reduced, and exercise tolerance increases. The antiarrhythmic effect is due to the influence on the pathological automatism of the heart and a noticeable slowdown in AV conduction.
Inside the body, the drug undergoes rapid absorption from the gastrointestinal tract. At the same time, eating food does not affect its absorption. The drug fully binds to proteins. occurs predominantly in the liver, resulting in the formation of active. The drug is excreted from the body with the help of the kidneys and intestines.
Indications for use
The main indications for the use of Nebilet:
- arterial hypertension;
- hearts.
Contraindications
- hypersensitivity ;
- heart failure;
- severe violations of the liver;
- arterial hypotension;
- cardiogenic shock;
- severe bradycardia;
- sick sinus syndrome;
- pheochromocytoma;
- obliterating diseases of peripheral vessels;
- myasthenia gravis;
- muscle weakness;
- under the age of 18.
Take the medicine Nebilet with and should be done with extreme caution, strictly according to the indications and under the supervision of a specialist.
Side effects of Nebilet
When taking the drug, side effects may occur in the form of: , fatigue, paresthesia, nausea, , dry mouth.
Tablets Nebilet, instructions for use (Method and dosage)
Detailed instructions for the use of Nebilet recommends taking the drug orally at the same time of day, regardless of eating food, with water.
In this case, the average daily dosage is 2-5 mg. You need to take the medicine once a day. During the treatment of patients over 65 years of age, the initial daily dosage is 2.5 mg. If necessary, the dosage is increased to 10 mg.
Overdose
In cases of overdose, symptoms such as: hypotension, nausea, cyanosis, sinus bradycardia, vomiting, heart failure, bronchospasm, coma and .
In this case, treatment is carried out, including gastric lavage, application, administration of appropriate drugs, which can only be performed by medical personnel.
Interaction
When Nebilet is combined with anesthetics, a cardiodepressive effect may occur, which increases the risk of arterial hypotension. Simultaneous use with antihypertensive drugs, blockers of "slow" calcium channels, contributes to a sharp increase in arterial hypotension.
Taking antiarrhythmic drugs , Alpha-methyldopa, ,Guanfacina leads to an increase in the severity of bradycardia. Combination treatment with may exacerbate the "withdrawal" syndrome.
Use with inducers of microsomal oxidation (, barbiturates) can lower, and some inhibitors, for example, on the contrary, increase its concentration in the plasma.
special instructions
Patients who use contact lenses should be aware that taking Nebilet Plus tablets can cause a decrease in tear fluid production.
This drug can also be taken by patients suffering from stage I hypertension who have been admitted to flight practice.
Terms of sale
On prescription.
Storage conditions
No special conditions are required for the storage of this medicine. There will be enough space at room temperature, inaccessible to children.
Shelf life
Analogues of Nebilet
Coincidence in the ATX code of the 4th level:Main analogues: Nebivator, Nevotenz, Nebikor, and Bivotens . At the same time, the price of Nebilet analogues may be higher or lower.
Reviews about Nebilet
A large number of reviews about Nebilet are found on forums where ways to treat diseases such as angina pectoris or hypertension are discussed. In this case, you should be aware that the causes of the development of such conditions can be very different and the effectiveness of this drug for all patients extends in different ways.
The opinion of patients about this drug is also very ambiguous, so some of them leave positive reviews, and some - negative. However, this medicine is suitable for many patients who report a significant improvement in health.
Unfortunately, the effect of this drug does not apply to everyone, so you have to prescribe an adequate replacement. If this is done in a timely manner, then an excellent result of treatment comes quickly enough.
You can also find messages from patients who are interested in what pills help best of all and whether they can be taken during pregnancy and lactation. In any case, you can take this medicine only as directed by your doctor, carefully studying the description of the tablets.
An important role in the treatment of hypertension, as well as cardiac pathologies, is given to the competent choice of drugs and the therapeutic regimen. Of course, only a doctor who is able to assess the course of the disease and the characteristics of the patient, and therefore prescribe the correct treatment, can do this.
Ne-ticket price, where to buy
The price of Nebilet 5mg tablets varies between 480-950 rubles, depending on their number in a pack.
- Internet pharmacies in Russia Russia
- Internet pharmacies of Ukraine Ukraine
- Internet pharmacies in Kazakhstan Kazakhstan
A healthy person often does not understand how big a gift has been given to him from above. After all, every day he can live exactly the way he wants, regardless of weather conditions, atmospheric pressure and other factors. But people suffering from certain diseases, look at the world differently. For them, the coming morning is sometimes already a real happiness. This is especially true for those who have heart problems and hypertension. Many underestimate the seriousness of high blood pressure, but doctors around the world claim that it is progressive hypertension that causes diseases of various organs. In the future, human carelessness can lead to a stroke and sudden death in a dream. To date, a large number of drugs have been developed that are very effective in combating arrhythmia, high blood pressure and other problems of the cardiovascular system. One of the most common means in Russia is "Nebilet". Reviews of cardiologists about him are overwhelmingly positive. Therefore, it is often prescribed to patients in different clinics. However, this medicine should not be considered a panacea, it has a lot of side effects and contraindications. Therefore, you need to be very careful about the independent use of "Nebilet". Indications for treatment with the drug should be determined only by a cardiologist. He will be able to compare the need for taking pills with the diagnosis. Today we will tell you what Nebilet is, how long to take it and which groups of patients really need this drug.
a brief description of
From the reviews of cardiologists about "Nebilet" you can form a general idea of \u200b\u200bthis remedy. It belongs to a large group of beta-blockers. Such drugs have been used for a very long time, and today several generations of them have been released. "Nebilet" is the latest generation of tablets, combining efficiency and maximum safety for the patient.
The drug quickly lowers blood pressure, dilates blood vessels, eliminates oxygen starvation and normalizes the heart rhythm. Also, from the reviews of cardiologists about Nebilet, it becomes clear that the drug significantly reduces the risk of death from stroke and coronary disease. It is also often prescribed in order to avoid repeated heart attacks. The tool can be used as a personal therapy or in combination with other medicines prescribed by a doctor.
Release form, active and excipients
The manufacturer of "Nebilet" is the Belgian company Berlin-Chemie AG / Menarini Group. It has been supplying the drug to Russia for several years. In pharmacies, the drug is sold only in the form of tablets, so if you are offered to buy medicine in the form of drops, then keep in mind that this is a clear fake. It can cost you not only health, but also life.
The instructions for "Nebilet" indicate that the tablets are available in blisters of seven, fourteen, twenty-eight and fifty-six pieces. Each tablet is painted white and has a convex shape on both sides. On the one hand, a notch is applied to it, with its help it is convenient to divide.
Often, cardiologists, prescribing this drug to a patient, say such a mysterious phrase as “Nebilet”, 5 mg. lowering blood pressure.For those who are confused by the dosage indicated on the package of Nebilet tablets, we will tell you that the main active ingredient of the drug in the tablet is in connection with hydrochloride.Once in the body, nebivolol is released, and in its pure form its dosage is exactly five milligrams Therefore, pharmacists have decided to indicate the amount of pure active substance on the drug packaging.
Among the auxiliary components of the drug, the following can be distinguished:
- polysorbate;
- corn starch;
- microcrystalline cellulose and other similar substances.
Cardiologists in reviews of "Nebilet" write that the drug is very quickly absorbed into the body, so you do not have to wait more than ten minutes for its action. All patients note that within minutes after taking one tablet, relief comes.
"Nebilet" and "Nebilet Plus": similarities and differences
Often, patients who are prescribed this remedy are interested in whether they can purchase Nebilet Plus instead, which is also very common. Doctors usually warn against such a replacement, because, despite the similarity of drugs, they also have significant differences.
"Nebilet Plus" has two active components instead of one, and the second has a pronounced diuretic effect. This contributes to a rapid decrease in blood pressure, but at the same time, such a side effect can aggravate the patient's condition in some cardiovascular diseases. Therefore, the drug that we are describing today differs significantly in its therapeutic effect from Nebilet Plus, and they are by no means interchangeable.
Therapeutic effect of the drug
Reception "Nebilet" is prescribed by cardiologists to people suffering from diseases of the cardiovascular system and in the treatment of hypertension. It has shown itself to be very effective in complex therapy, so doctors often combine it with other drugs, which ultimately enhances the effect of Nebilet. However, it is strictly forbidden to experiment with various means on your own.
It is believed that this drug in its group has the maximum therapeutic effect:
- Decreased blood pressure. It is noteworthy that the medicine helps to normalize pressure in various physical and mental states of a person. You can take Nebilet tablets (the price will be indicated by us in one of the sections of the article) when you are relaxing, doing physical labor or are in a stressful situation. In any case, the desired result will be achieved quickly. Sometimes, during the initial intake of the drug, a temporary increase in pressure is observed, but after a maximum of five days the patient's condition returns to normal. And after one or two months of regular use, the patient observes a lasting effect.
- Reducing the need of the heart muscle for oxygen and increasing the efficiency of its contractions. People suffering from coronary heart disease, heart failure or arrhythmia know that their "motor" works in constant conditions of lack of oxygen. When taking "Nebilet" and analogues, the heart muscle requires less oxygen, the organ begins to function more efficiently. In this case, patients tolerate stress and physical activity more easily, and their frequency of angina attacks decreases. In addition to the already listed therapeutic effect, the drug actively protects heart cells from toxins and the effects of adverse environmental factors. As a result, the body is maintained in working condition for quite a long time.
- Relief of attacks of arrhythmia.
Despite the abundance of adrenergic blockers in pharmacies, cardiologists in most cases prescribe Nebilet. They believe that taking it carries a minimum number of side effects. Therefore, patients do not face a violation of carbohydrate metabolism, impotence and other consequences.
To whom is the drug indicated?
Keep in mind that "Nebilet" cannot be taken without a doctor's prescription. Only he can decide how your disease can be treated with this remedy. Usually it is discharged in connection with the following problems:
- Increased blood pressure. Often the drug is successfully combined with other similar drugs.
- Coronary artery disease.
- Heart failure of varying severity (the drug has shown itself well in the treatment of people over seventy years of age).
Patients taking Nebilet claim that their quality of life has improved and the risk of hospitalization has significantly decreased. Cardiologists also add that patients who use this particular drug in treatment live longer than those who ignore the doctor's prescriptions.
Tablets "Nebilet": instructions for use
If the doctor does not prescribe a specific dose of the drug, then it is necessary to adhere to the scheme indicated in the instructions. The drug is drunk once a day. It is important that this happens at the same time. Some patients set a reminder on their phone so they don't miss an appointment. Each tablet should be taken with a glass of clean water.
The regimen described by us is general, however, for some diseases, you need to follow a different instruction:
- Hypertension and ischemic heart disease. Start taking the remedy with half and then gradually increase the dose to one tablet. If the desired effect is not achieved, then you can take two Nebilet tablets at a time. However, do not forget that regardless of the dosage, you must drink the medicine once a day. If you suffer only from hypertension in the absence of heart problems, then you can quite effectively combine the drug with a diuretic. In this case, the medicine will act faster and will have a more stable effect.
- Chronic heart failure. "Nebilet" is taken only when for a long time (at least six months) the patient has not experienced exacerbations that led to hospitalization. Cardiologists recommend starting treatment with a quarter and only then slowly reaching the optimal dosage. As soon as you feel an improvement in your condition, then you have found the necessary dosage. Now be prepared that the drug will have to be taken for several years. When taking a quarter tablet for the first time, wait approximately two weeks before increasing the dosage.
It is recommended that after the start of treatment with "Nebilet" to be under round-the-clock supervision of doctors for five days. The specialist will record all changes in the body, if side effects or other alarming symptoms appear, they will immediately take action. Each increase in dosage should also take place under the strict supervision of the attending physician.
Keep in mind that you can not immediately stop taking the drug. The patient should come out from under its influence gradually, reducing the dosage to one fourth of the tablet.
The effect of the drug on the course of pregnancy
Taking "Nebilet" during pregnancy can lead to a number of complications:
- intrauterine growth retardation;
- miscarriage;
- premature contractions.
Doctors try to avoid prescribing this drug to pregnant women. In rare cases, when the life of the expectant mother is in danger and she may die without "Nebilet", the doctor may prescribe this remedy. However, a woman should always be under the supervision of specialists and stop taking pills three days before childbirth and within three days after them. The newborn should also be under the close supervision of doctors, because the drug can cause him many complications.
During breastfeeding, refuse to take the drug, otherwise the baby should be immediately transferred to artificial mixtures.
Combination of the drug with alcohol
"Nebilet" and alcohol are incompatible. This must be clearly understood by all patients. When taking alcoholic beverages in parallel with tablets, intoxication occurs much faster, and its effects often last several days. Therefore, refrain from such drinks for the duration of treatment.
"Nebilet": side effects
Despite its safety, the drug can cause a lot of side effects that patients should be warned about. For example, the central nervous system may react with fainting, depression, insomnia, and increased fatigue.
Also, patients after taking the drug may feel dry mouth, nausea (even vomiting) and bloating. Sometimes patients complain of pain in the heart, arrhythmia and low blood pressure. In the most rare cases, there was a severe skin rash, itching and even swelling. Side effects include such manifestations as:
- dry eyes;
- sweating;
- blurred vision;
- regular swelling;
- hallucinations.
If you notice any side effects when taking Nebilet, then immediately consult a doctor. He will conduct a series of laboratory tests and find out if you should continue treatment with this drug.
Analogues and synonyms
Almost every drug has a number of drugs similar to it. Pharmacists divide them into synonyms and analogues. The former have identical active substances, but the latter have a similar therapeutic effect when using other active ingredients.
Among the synonyms of "Nebilet" are "Binelol", "Nevotens" and "Nebikor". In general, there are about ten such drugs.
Analogues of "Nebilet" are very numerous, thirty-three drugs of a similar effect are known on the drug market. These include well-known titles such as:
- "Egilok";
- "Coronal";
- "Concor";
- "Serdol";
- "Biprol".
If "Nebilet" does not suit you in one way or another, then the cardiologist has the right to prescribe a synonym or analogue of this drug. Perhaps another tool will be more useful to you.
The cost of the drug
Unfortunately, Nebilet tablets do not have the lowest price. Therefore, the drug is not available to every patient. Often its cost reaches almost six hundred rubles per pack. At the same time, reviews often write that with each increase in the price of medicines, Nebilet rises in price by almost a hundred rubles at once.
This fact is recorded by patients as a significant minus of this drug.
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