pharmacy

Betanorm Tablets SpecificationRequires Prescription (YES/NO)YesGenericsNebivolol HClUsed ForHypertensionHow it worksNebivolol is a ?1 selective adrenoceptor antagonist whose hemodynamic effects differ from those of classical ?-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 ?-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.Betanorm Tablets Usage And SafetyDosageNebivolol HClSide EffectsCommon: 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 InteractionsPhenylalkylamine [verapamil] and benzothiazepine [diltiazem] classes) or antiarrhythmic agents such as disopyramide , digitalis glycosides and ?-blockers , reserpine or guanethidine , clonidine , CYP2D6 inhibitors (quinidine, propafenone, fluoxetine, paroxetine ) , Cimetidine , Sildenafil.IndicationFor 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 UseNebivolol 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.Betanorm Tablets PrecautionsPrecautionIn patients who have compensated congestive heart failure, nebivolol should be administered cautiously. If heart failure worsens, discontinuation of nebivolol should be considered.Betanorm Tablets WarningsWarning 1Care should be taken in diabetic patients however, as nebivolol may mask certain symptoms of hypoglycemia (tachycardia, palpitations). ?-adrenergic blocking agents may mask tachycardic symptoms in hyperthyroidism. Abrupt withdrawal may intensify symptoms.Warning 2The 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?-blockers can precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular diseases. Caution should be exercised in these patients.Betanorm Tablets Additional InformationPregnancy categoryAlways consult your physician before using any medicine.Storage (YES/NO)Store this medicine at room temperature, away from direct light and heat.

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