Orneb 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
• Lack of 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
• Metabolized by glucuronidation and hydroxylation
• Absorption similar to an oral solution
• Plasma protein binding of approximately 98%
• Metabolism via direct glucuronidation, N-dealkylation, and oxidation
• Excretion via urine and feces
• No significant interactions with digoxin and warfarin

Dosage & Administration

• Individualized dose based on patient needs
• Recommended starting dose of 5 mg once daily
• Dose escalation at 2-week intervals up to 40 mg
• Not beneficial to have a more frequent dosing regimen

Interaction

• Careful use with myocardial depressants or AV conduction inhibitors
• Avoid combination with other beta-blockers
• Close monitoring with catecholamine-depleting drugs
• Caution with CYP2D6 inhibitors

Contraindications

• Severe bradycardia
• Heart block greater than first degree
• Cardiogenic shock
• Decompensated cardiac failure
• Sick sinus syndrome without a permanent pacemaker
• Severe hepatic impairment
• Hypersensitivity to any component

Side Effects

• Headache
• Nausea
• Bradycardia

Precautions & Warnings

• Advised against abrupt discontinuation
• Caution in patients with coronary artery disease
• Use with caution in patients with compensated congestive heart failure
• Not studied in patients with angina pectoris or recent MI
• Patients with bronchospastic diseases should not receive
• Close monitoring perioperatively and during major surgery
• Caution in patients with diabetes, hypoglycemia, thyrotoxicosis, and peripheral vascular disease
• Monitor ECG and blood pressure with non-dihydropyridine calcium channel blockers

Use in Special Populations

• Caution in patients with severe renal impairment
• Caution in patients with moderate hepatic impairment
• Contraindicated in patients with severe hepatic impairment
• Increased risk of anaphylactic reactions in patients with a history of severe anaphylaxis

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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