Nebicard 2.5 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

• β adrenergic receptor blocking agent
• Inhibition of both β1 and β1 adrenergic receptors
• Lack of intrinsic sympathomimetic and membrane stabilizing activity
• Agonism 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
• Mean peak plasma concentrations occur approximately 1.5 to 4 hours post-dosing
• Metabolism primarily via direct glucuronidation
• No significant changes in the pharmacokinetics when co-administered with digoxin or warfarin

Dosage & Administration

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

Interaction

• Use with care when myocardial depressants or inhibitors of AV conduction are used concurrently
• Avoid combination with other β-blockers
• Cautious co-administration with CYP2D6 inhibitors like quinidine, fluoxetine, paroxetine, etc.

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 (Child-Pugh >B)
• Hypersensitivity to any component of this product

Side Effects

• Headache
• Nausea
• Bradycardia

Precautions & Warnings

• Avis against abrupt discontinuation of therapy
• Cautious administration in patients with compensated congestive heart failure
• Not studied in patients with angina pectoris or recent MI
• Contraindicated in patients with bronchospastic diseases
• Close monitoring during anesthesia and major surgery
• Caution in patients with diabetes, hypoglycemia, thyrotoxicosis, and peripheral vascular disease
• Monitoring when concomitantly treated with non-dihydropyridine calcium channel blockers

Use in Special Populations

• Use with caution in patients with severe renal impairment
• Contraindicated in patients with severe hepatic impairment
• Increased reactivity to repeated challenges for patients with history of severe anaphylactic reactions

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

Related Brands

• Bipinor 2.5 mg (Tablet) - aci-limited
• Bipinor 5 mg (Tablet) - aci-limited