Generic
Nebivolol + Hydrochlorothiazide
5 brands available in the market
At a glance
Nebivolol + Hydrochlorothiazide is a combination medicine used for hypertension. Nebivolol reduces heart rate and dilates blood vessels, while hydrochlorothiazide removes excess water and electrolytes to lower blood pressure.
Description
This combination has an additive antihypertensive effect, reducing blood pressure to a greater degree than either component alone. Nebivolol has mild vasodilating properties which reduce heart rate and blood pressure. Hydrochlorothiazide increases sodium and chloride excretion through renal tubular mechanisms, reducing plasma volume.
Indications
- Essential hypertension
Therapeutic class
Combined Antihypertensive Preparations
Pharmacological class
Beta-blocker + Thiazide Diuretic
Pharmacology
Nebivolol blocks β1-adrenergic receptors to reduce heart rate and blood pressure. Hydrochlorothiazide inhibits sodium and chloride reabsorption in renal tubules to produce diuretic effect, reducing plasma volume and blood pressure.
Mechanism of action
Lowers blood pressure by reducing heart rate and removing excess water.
Dosage
Adult Dose (Oral):
- Each tablet contains nebivolol 5 mg + hydrochlorothiazide 12.5 mg: 1 tablet once daily
Administration
- Swallow tablet whole; do not chew, crush or break
- Take at the same time each day (preferably morning)
- 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
Common Side Effects:
- Nausea
- Constipation
- Diarrhea
- Fatigue
- Dizziness
- Headache
- Increased blood uric acid
- Decreased potassium level
- Glucose intolerance
- Breathlessness
- Swelling of hands and feet
- Paresthesia
Precautions & warnings
- Do not abruptly discontinue (risk of heart attack and stroke)
- Monitor blood glucose regularly in diabetic patients
- Drink plenty of fluids (to prevent dehydration)
- Caution while driving (may cause dizziness)
- Avoid alcohol
Contraindications
- Hypersensitivity
- Hepatic impairment
- Anuria
- Sulphonamide allergy
- Pregnancy and lactation
Drug interactions
- Symptomatic hyponatraemia with carbamazepine
- Allopurinol sensitivity reactions and renal impairment
- Potentiates hypotensive effect of beta-blockers and ACE inhibitors
- Increased risk of hypokalaemia with corticosteroids
Food interactions
Caution with alcohol; consult doctor.
Use in pregnancy
Use in Pregnancy: Nebivolol + Hydrochlorothiazide may be unsafe during pregnancy; animal studies show evidence of fetal harm.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably unsafe during breastfeeding; may pass into breast milk and harm the baby.
Pediatric use
Not recommended for children.
Geriatric use
Elderly may require dose adjustment.
Renal / hepatic impairment
Renal Impairment: Not recommended in severe kidney disease (CrCl <30 mL/min); caution.
Hepatic Impairment: Caution in liver disease; dose adjustment may be needed.
Overdose effects
Overdose may cause electrolyte depletion and dehydration; symptomatic treatment.
Storage conditions
Store below 30°C; protect from light & moisture; keep out of reach of children.
Chemical structure
Nebivolol + Hydrochlorothiazide