Bipinor 2.5 mg (Tablet)

Unit Price: ৳ 7.00 (3 x 10: ৳ 210.00)
Strip Price: ৳ 70.00

Medicine Details

Category Details
Generic Nebivolol hydrochloride
Company Aci limited
Also available as
Bipinor 5 mg tablet

Indications

  • Hypertension
  • Treatment of essential hypertension
  • Chronic heart failure (CHF)
  • Treatment of stable mild and moderate chronic heart failure in elderly patients.

Pharmacology

  • Beta-adrenergic receptor blocking agent
  • Inhibition of beta1 and beta2 adrenergic receptors
  • Lacks intrinsic sympathomimetic and membrane stabilizing activity
  • Decreased heart rate
  • Decreased myocardial contractility
  • Diminution of tonic sympathetic outflow to the periphery from cerebral vasomotor centers
  • Suppression of renin activity
  • Vasodilation and decreased peripheral vascular resistance
  • Metabolized by glucuronidation and hydroxylation by CYP2D6
  • Mean peak plasma concentrations occur approximately 1.5 to 4 hours post-dosing
  • 98% human plasma protein binding, mostly to albumin
  • Metabolized via direct glucuronidation, N-dealkylation, and oxidation via cytochrome P450 2D6
  • 38% of the dose recovered in urine and 44% in feces for extensive metabolizers
  • No significant changes in pharmacokinetics with digoxin or warfarin co-administration

Dosage & Administration

  • Recommended starting dose of 5 mg once daily
  • Can be increased at 2-week intervals up to 40 mg
  • More frequent dosing regimen unlikely to be beneficial

Interaction

  • Use with care when myocardial depressants or inhibitors of AV conduction are used concurrently
  • Not to be combined with other beta-blockers
  • CYP2D6 Inhibitors may require caution when co-administered

Contraindications

  • Severe bradycardia
  • Heart block greater than first degree
  • Cardiogenic shock
  • Decompensated cardiac failure
  • Sick sinus syndrome (unless a permanent pacemaker is in place)
  • Severe hepatic impairment
  • Hypersensitivity to any component

Side Effects

  • Headache
  • Nausea
  • Bradycardia

Precautions & Warnings

  • Abrupt cessation can lead to severe exacerbation of angina and occurrence of myocardial infarction
  • Sympathetic stimulation is vital in congestive heart failure, Beta-blockade may result in further depression of myocardial contractility
  • Not studied in patients with angina pectoris or recent myocardial infarction
  • Patients with bronchospastic diseases should not receive beta-blockers
  • Close monitoring advised when anesthetic agents which depress myocardial function are used
  • May mask some manifestations of hypoglycemia
  • May mask clinical signs of hyperthyroidism
  • Can precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease

Use in Special Populations

  • Use with caution in patients with severe renal impairment
  • Use with caution in patients with moderate hepatic impairment
  • Bipinor is contraindicated in patients with severe hepatic impairment

Therapeutic Class

  • Beta-adrenoceptor blocking drugs
  • Beta-blockers

Storage Conditions

  • Keep below 30°C temperature
  • Away from light & moisture
  • Keep out of the reach of children

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