Byscard Tablets 5Mg

Brand : searle pakistan (pvt) ltd.

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SPECIFICATION

Requires Prescription (YES/NO)

Yes

Generics

Nebivolol HCl

Used For

Hypertension

How it works

Nebivolol is a ß1 selective adrenoceptor antagonist whose hemodynamic effects differ from those of classical ß-adrenoceptor antagonist as a result of a vasodilating action. It has mild vasodilating properties attributed to its interaction with the L-arginine/nitric oxide path way, a property not shared by other ß-blockers. Nebivolol lacks intrinsic sympathomimetic and membrane stabilizing activity at therapeutically relevant concentrations. At clinically relevant doses, nebivolol does not demonstrate a1-adrenergic receptor blockade activity.

USAGE AND SAFETY

Dosage

Nebivolol HCl

Side Effects

Common: Headache, dizziness, paresthesia, dyspnea, constipation, nausea, diarrhea, tiredness, edema.Uncommon: Nightmares, depression, impaired vision, bradycardia, heart failure, slowed AV conduction/AV-block, hypotension, (increase of) intermittent claudication, bronchospasm, dyspepsia, flatulence, vomiting, pruritus, rash, erythematous, impotence.Rare: Syncope, psoriasis aggravated.

Drug Interactions

Phenylalkylamine [verapamil] and benzothiazepine [diltiazem] classes) or antiarrhythmic agents such as disopyramide , digitalis glycosides and ß-blockers , reserpine or guanethidine , clonidine , CYP2D6 inhibitors (quinidine, propafenone, fluoxetine, paroxetine ) , Cimetidine , Sildenafil.

Indication

For the treatment of essential hypertension, stable, mild and moderate chronic heart failure in addition to standard therapies in elderly patients 70 years and may be used alone or in combination with other anti-hypertensive agents.

When not to Use

Nebivolol is contraindicated in patients with:- Hypersensitivity to the active substance or to any of the components.- Severe hepatic insufficiency.- Acute heart failure, cardiogenic shock or episodes of heart failure decompensation requiring I.V. inotropic therapy.- Sick sinus syndrome, including sino-atrial block.- Second and third degree heart block (without a pacemaker).- History of bronchospasm and bronchial asthma.- Untreated phaeochromocytoma.- Metabolic acidosis.- Bradycardia (heart rate < 60bpm prior to start of therapy).- Hypotension (systoli c blood pressure < 90mmHg).- Severe peripheral circulatory disturbances.

PRECAUTIONS

Precaution

In patients who have compensated congestive heart failure, nebivolol should be administered cautiously. If heart failure worsens, discontinuation of nebivolol should be considered.

WARNINGS

Warning 1

Care should be taken in diabetic patients however, as nebivolol may mask certain symptoms of hypoglycemia (tachycardia, palpitations). ß-adrenergic blocking agents may mask tachycardic symptoms in hyperthyroidism. Abrupt withdrawal may intensify symptoms.

Warning 2

The treatment with nebivolol is not recommended to be stopped abruptly since this might lead to a transitory worsening of heart failure. If discontinuation is necessary, the dose should be gradually decreaseddivided into halves weekly. If the angina worsens or acute coronary insufficiency develops, it is recommended that nebivolol be promptly reinstituted, at least temporarily.

Warning 3

ß-blockers can precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular diseases. Caution should be exercised in these patients.