Description
Latin name
NEBILONG AM
release form
tablets
packaging 30 pcs
Pharmacological action
Nebilong AM is a third generation cardioselective beta-blocker with vasodilating properties. The active substance is a racemate consisting of two enantiomers: D-nebivolol and L-nebivolol. Nebivolol is a competitive and selective blocker of 1-adrenergic receptors (affinity for 1-adrenergic receptors is 288 times higher than for 2-adrenergic receptors), in addition, it has a mild vasodilating effect due to modulation of the release of relaxing factor (NO) from vascular endothelium. Nebivolol reduces heart rate and blood pressure at rest and during exercise, reduces the final diastolic pressure of the left ventricle, reduces OPSS, improves diastolic function of the heart (reduces filling pressure), increases the ejection fraction and causes an antianginal effect in patients with coronary artery disease. The optimal hypotensive effect is manifested after 1-2 weeks of treatment. In some cases, the maximum effect is achieved after 4 weeks.
Indications
Essential (primary) arterial hypertension, ischemic heart disease.
Contraindications
Bronchial asthma, chronic heart failure in the decompensation stage, untreated pheochromocytoma, severe impaired liver function, depression, angiospastic angina (Prinzmetal angina pectoris), obliterating diseases of the cardiac arrhythmias, intermittent heart disease, less than 50 beats / min), SSSU, AV block II and III degree, myasthenia gravis, muscle weakness, childhood and adolescence up to 18 years, hypersensitivity to nebivolol.
Use during pregnancy and lactation
Use during pregnancy is possible only under strict indications (due to the possible development of newborns bradycardia, hypotension, hypoglycemia and respiratory paralysis). Nebivolol intake should be discontinued 48-72 hours before birth. In cases where this is not possible, strict monitoring of newborns should be provided within 48-72 hours after birth.
Composition
1 tablet contains:
Active substances: amlodipine 5 mg nebivolol 5 mg.
Dosage and administration
Inside, at the same time of the day, without chewing, with plenty of water, during or after a meal – 5 mg once a day. Patients with renal failure or patients over 65 years of age – 2.5 mg / day. The maximum daily dose is 10 mg.
Side effects
From the side of the central nervous system and peripheral nervous system: headache, dizziness, feeling tired, paresthesia, depression, decreased ability to concentrate, drowsiness, insomnia, nightmares, hallucinations.
From the digestive system: nausea, constipation, diarrhea, dry mouth.
From the cardiovascular system: bradycardia, orthostatic hypotension, dyspnea, edema, heart failure, AV block, heart rhythm disturbances, Raynaud’s syndrome, cardialgia.
Allergic reactions: skin rash.
Other: bronchospasm (including in the absence of a history of obstructive pulmonary diseases), photodermatosis, hyperhidrosis, rhinitis.
Drug Interaction
Calcium channel blockers enhance AV conduction blockade, class I antiarrhythmics, and amiodarone prolong atrial excitement. Narcotic drugs (cyclopropane, diethyl ether, trichloroethylene), tricyclic antidepressants, barbiturates, phenothiazine derivatives potentiate hypotension, cimetidine and nicardipine increase plasma concentrations, sympathomimetics level activity.
Overdose
Symptoms: bradycardia, hypotension, bronchospasm, acute heart failure.
Treatment: gastric lavage, activated charcoal intake, prescription of laxatives are possible IVL and the introduction of atropine (with bradycardia and increased vagotonia), plasma or plasma substitutes, if necessary – catecholamines. For the relief of beta-blockade action – isoprenaline hydrochloride (slowly, in / in, at an initial dose of 5 μg / min to achieve the desired effect), dobutamine (in the initial dose – 2.5 mcg / min), in the absence of effect – glucagon (in / in 50-100 mcg / kg, again after 1 h – 70 mcg / kg / h infusion). In AV blockade – transvenous stimulation.
Storage conditions
Store at a temperature not exceeding 25 ° C in a dry place.
Expiration
2 Year
Deystvuyuschee substances
amlodipine, nebivolol
Pharmacy terms
Prescription
Dosage form
dosage form
tablets
Micro Labs Ltd., India
