Niavas Tab

Side Effects of Niavas Tab

Peripheral oedema, bradycardia, chest pain; headache, fatigue, dizziness, insomnia; rash; hypercholesterolaemia, decreased HDL levels, hyperuricaemia, increased triglyceride levels, increased uric acid levels; diarrhoea, nausea, abdominal pain; thrombocytopenia; paraesthesia, weakness; increased BUN; dyspnoea. Potentially Fatal: Anaphylaxis.

Drug Interactions

Attenuation of reflex tachycardia and increased risk of hypotension with volatile halogenated anaesthetics. Increased risk of hypotension with dihydropyridine-type calcium antagonists. Hypotensive effect may be increased with antipsychotics, TCAs, barbiturates and phenothiazines. Effects may be reduced with sympathomimetic agents. Increased levels/effects with CYP2D6 inhibitors e.g. paroxetine, fluoxetine, thioridazine and quinidine. Potentially Fatal: Additive negative influence on contractility and AV conduction with verapamil and diltiazem type drugs; profound hypotension and AV block with IV verapamil. Exacerbation of heart failure with centrally-acting antihypertensive, abrupt withdrawal may increase risk of rebound hypertension. Increased effect on AV conduction with antiarrhythmic drugs. Increased risk of hypertension, severe bradycardia and heart block when used with sympathomimetics with mixed α- and β-adrenergic effects.

Contraindications

Hepatic impairment, sick sinus syndrome, 2nd and 3rd degree heart block (without a pacemaker), history of asthma, metabolic acidosis, severe peripheral arterial disease, severe bradycardia, cardiogenic shock or decompensated heart failure, untreated phaeochromocytoma. Pregnancy and lactation.

Mechanism of Action

Nebivolol exhibits a high selectivity for β1-adrenergic receptors and acts by reducing the peripheral vascular resistance by modulating nitric oxide release. Absorption: Absorbed rapidly from the GI tract (oral). Peak plasma concentrations after 0.5-4 hr. Distribution: Protein-binding: 98%. Enters breast milk. Metabolism: Hepatic: Extensively by alicyclic and aromatic hydroxylation, N-dealkylation and glucuronidation. Excretion: Via urine and faeces (as metabolites). Elimination half-life: 10 hr (nebivolol), 24 hr (hydroxy metabolites).

Special Precautions

Elderly. History of anaphylaxis to various allergens, 1st degree AV block, peripheral arterial disease, DM, compensated heart failure, myasthenia gravis, history of psychiatric illness, renal impairment. May mask signs of hyperthyroidism (e.g. tachycardia).

How to Use

Take orally with food and water, as directed by your physician.

How to Store

Keep in a cool, dry place away from sunlight and moisture.

Safety Concerns

• Alcohol: Avoid during treatment.
• Breastfeeding: Not recommended.
• Pregnancy: Contraindicated.
• Liver/Kidney: Use with caution.

Content Disclaimer

This content is for educational purposes only. Please consult your doctor before use.