Generic
Nebivolol + Valsartan
1 brands available in the market
At a glance
Nebivolol + Valsartan is a combination medicine for hypertension. Nebivolol is a beta-blocker that reduces heart rate and dilates blood vessels, while valsartan blocks AT1 receptors to dilate blood vessels and lower blood pressure.
Description
Nebivolol is a selective beta-blocker that prevents increased heart rate and controls heart pumping strength, widening blood vessels to lower blood pressure. Valsartan blocks angiotensin II receptor action on AT1 subtype, dilates blood vessels and reduces blood pressure without affecting pulse rate.
Indications
- Hypertension (high blood pressure)
Therapeutic class
Combined Antihypertensive Preparations
Pharmacological class
Beta-blocker + ARB
Pharmacology
Nebivolol blocks β1-adrenergic receptors to reduce heart rate and blood pressure. Valsartan blocks AT1 receptors to prevent vasoconstrictor effects of angiotensin II, resulting in vasodilation and blood pressure reduction.
Mechanism of action
Lowers blood pressure by reducing heart rate and dilating blood vessels.
Dosage
Adult Dose (Oral):
- As initial therapy and for patients not adequately controlled on valsartan 80 mg or nebivolol up to 10 mg: 1 tablet daily (nebivolol 5 mg/valsartan 80 mg)
- Maximum antihypertensive effects attained within 2-4 weeks
Administration
- Swallow tablet whole; do not chew, crush or break
- Take at the same time each day
- May be taken with or without food
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Side Effects:
- Hypotension
- Hyperkalemia
Precautions & warnings
- Do not abruptly discontinue (acute exacerbation of coronary artery disease)
- Monitor glucose in diabetics (beta-blockers may mask hypoglycemia symptoms)
- Monitor renal function and potassium levels
Contraindications
- Severe bradycardia
- Heart block greater than first degree
- Cardiogenic shock
- Decompensated cardiac failure
- Sick sinus syndrome (unless permanent pacemaker in place)
- Severe hepatic impairment (Child-Pugh >B)
- Hypersensitivity
- Do not co-administer aliskiren with diabetes patients
- Pregnancy
Drug interactions
- CYP2D6 enzyme inhibitors increase nebivolol levels
- Reserpine or clonidine may cause excessive reduction of sympathetic activity
- Digitalis glycosides increase risk of bradycardia
- Verapamil or diltiazem-type Ca channel blockers may cause excessive reductions in heart rate, BP and contractility
- Potassium-sparing diuretics, supplements or salt substitutes may increase serum potassium
- NSAIDs may increase risk of renal impairment and loss of antihypertensive effect
Food interactions
Caution with alcohol; consult doctor.
Use in pregnancy
Use in Pregnancy: Can cause fetal harm when administered to pregnant women; not recommended during pregnancy.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Advise not to breastfeed; consult doctor.
Pediatric use
Safety and effectiveness not established in pediatric patients.
Geriatric use
No overall differences in safety or effectiveness between elderly and younger patients.
Renal / hepatic impairment
Renal Impairment: Not recommended as initial treatment in severe renal impairment (because nebivolol starting dose is 2.5 mg).
Hepatic Impairment: No studies of Nebivolol/Valsartan in patients with hepatic insufficiency.
Overdose effects
Overdose - Nebivolol: Bradycardia, hypotension, heart block, heart failure, bronchospasm, hypoglycemia; treat with atropine, IV fluids, vasopressors, glucagon, isoproterenol, digitalis, bronchodilators. Valsartan: Hypotension and tachycardia; not removed by hemodialysis.
Storage conditions
Do not store above 30°C; keep in a dry place; protect from light; keep out of reach of children.
Chemical structure
Nebivolol + Valsartan