"Nebivolol": analogues, instructions for use, testimonials. "Nebivolol Sandoz"

Drugs from the group of adrenoblockers have become widespread in the treatment of many cardiological diseases. Among the drugs in this group, "Nebivolol" stands out. Analogues of this medicine also gained great popularity due to their effectiveness. What is this medicine, how does it work and in what cases can it be used?

What is this drug?

"Nebivolol" refers to a group of beta-blockers. The main effect of this drug is antihypertensive (drug reduces blood pressure). The effect is observed due to selective blocking of beta-receptors located in the vessels (affects beta-1-adrenergic receptors).

Currently, "Nebivolol Sandoz" is being used.

This drug is a combined, consisting of several isomers (D- and L-rotatable). Such a combination of substances favorably affects the development of the clinical effect. One of the isomers is responsible for the development of antihypertensive action, while the second has a greater impact on the heart rhythm.

The drug appeared relatively recently, in the middle of the last century. Since then, it has become widespread in the cardiac environment. "Nebivolol Sandoz" is a drug of choice in the treatment of hypertension, as well as some disorders of the heart rhythm.

How does the drug work and what organs are responsible for its digestibility?

Pharmacokinetics

The best is "Nebivolol Sandoz". The drug is well absorbed in the gastrointestinal tract. Can be taken with food (suction does not deteriorate). Bioavailability is relatively low - about 12 percent. If possible, joint medication with alcohol should be avoided, as side effects may develop.

Getting into the blood plasma, the drug binds to albumins and forms insoluble complexes. In such a related form, the availability of the drug is about 98 percent, that is, practically the entire "Nebivolol Sandoz" is absorbed. Analogues of it go the same way before they get into the blood plasma and do not communicate with the protein.

The non-digested drug is excreted through the gastrointestinal tract and the kidneys. It is processed in the liver, where it binds to glucuronic acid.

The half-life of the drug in persons with an accelerated metabolite is about one day. In the case of delayed metabolism, Nebivolol can accumulate and remain in the blood plasma for about 48 hours.

In the tissues the preparation does not accumulate, which allows to avoid its overdose (it is possible only if used in patients with kidney or liver pathology).

Indications for use

In what cases is Nebivolol appointed, analogues of this drug or drugs with a similar pharmacological effect?

The first indication for the purpose of the drug is arterial hypertension. The use of beta-blockers is resorted to ineffective use of ACE inhibitors (Enalapril, Captopril). In addition, Nebivolol is used for endocrine hypertension.

Another, no less important indication for the use of Nebivolol, is ischemic heart disease. With frequent exacerbations of angina pectoris, as well as for the prevention of such attacks, Nebivolol is shown. Analogues of it in this case may be even more effective than the pure drug itself.

"Nebivolol" is included in the combination therapy in the treatment of chronic heart failure. In this case, the drug contributes to improving the work of the heart, reducing pre- and post-loading on the body chambers, as well as reducing the pressure.

You can use this medicine to prevent the development of hypertensive crises, as well as people prone to atherosclerotic lesions of the brain vessels.

Contraindications

When is it not worth using Nebivolol? Instructions for use usually includes all those cases that were detected clinically, when the use of the drug observed the development of certain complications. Due to the strong antihypertensive effect, it is not possible to prescribe a remedy for severe arterial hypotension.

First of all, it is forbidden to use the drug in acute heart failure. This is due to the fact that it has an inotropic effect, which can adversely affect the body due to lack of function of the heart.

When developing pheochromocytoma, it is also forbidden to use Nebivolol. Instructions for use indicate that with this endocrine tumor, the drug can only be used in conjunction with alpha receptor blockers.

Do not prescribe the drug to children, as well as people with existing mental health disorders.

Nebivolol is contraindicated in individuals with intolerance to the drug. When the first signs (lachrymation, difficulty breathing), you should immediately abandon further use of the drug and move to a safer option.

Side effects

Like any drug, Nebivolol has its side effects. The main among them are:

From the nervous system - headache, depression, drowsiness, insomnia, hallucinations, fainting, dizziness.

Side effect of the digestive system is nausea, constipation, dry mouth, vomiting. Perhaps the emergence of dyspeptic disorders, and when combined with antibiotics - dysbiosis.

Cardiovascular system responds to the introduction of "Nebivolol" bradycardia, dyspnea, edema, the development of acute heart failure, atrioventricular blockade, Reynaud's syndrome. Overdose can lead to uncontrolled arterial hypotension, which can be complicated by collapse and fainting. In severe cases, shock develops.

Side effect "Nebivolol" can manifest itself in the form of erythematous rash, psoriasis.

In severe cases, angioedema develops (Quincke's edema). In more mild cases, indigestible sneezing or coughing develops.

Features of the drug use

The drug is used with caution in patients with renal insufficiency, diabetes mellitus or hyperproduction of thyroid hormones. The drug is withdrawn gradually, within 10-14 days. At the beginning of the course of treatment, you should definitely monitor the Ad and heart rate. If possible, you should stop smoking while you use the drug. Before the forthcoming operation, the anesthesiologist must be warned that the patient is using beta-blockers.

During the entire period of the drug use, it is necessary to monitor the blood sugar level, especially in diabetics. In addition, the filtration capacity of the kidneys (especially levels of creatinine and urea) should be assessed if Nebivolol is prescribed for a long time. Instructions for use (analogues have a similar effect) warns that it is possible to develop renal failure with irrational administration of this medication.

It is forbidden to use the drug for children under 18 years old, as well as for elderly patients with decompensated heart failure. This prohibition is due primarily to the possibility of developing metabolic disorders and the appearance of pressure problems.

Since the use of the drug may develop dizziness, it should not be prescribed to drivers and doctors.

Use of the drug by pregnant women

The prescription of this medicine to a pregnant woman is possible only after consulting with a gynecologist and therapist. The drug is used quite rarely due to the negative impact on the body of the mother and child.

The drug is prescribed only in case of emergency, since it is possible to develop bradycardia, arterial hypotension, hypoglycemia, paralysis of the respiratory center, seizures.

Three days before the expected delivery, you must stop using this medication. If this is not possible, in the early postpartum period careful monitoring of the health of the mother and child is necessary. It is mandatory when using spinal anesthesia, to warn an anesthesiologist about the treatment with adrenoblockers.

It should be remembered that against the background of using the drug, the development of fetal hypoxia is possible. Teratogenic effect of the drug is not proven, but there are cases of such effects on the fetus.

If nebivolol is nevertheless assigned to a pregnant woman, the instructions for use warn that it may distort the therapeutic effect of the drug when administered with intravenous magnesium.

Interaction with preparations of other medicinal groups

The joint use of Nebivolol and class 1 antiarrhythmics can lead to an increase in the negative inotropic effect. Possible development of AV blockade. A similar effect is observed if calcium channel blockers and Nebivolol Sandoz are simultaneously used.

Instructions for prescribing the drug warns that when you administer it intravenously, cardiac arrest (provided that the drug is administered with Verapamil). In this case, an emergency cardioversion using electropulse therapy is required.

There is a significant risk of development of severe arterial hypotension with the appointment of the drug with "Nitroglycerin".

Simultaneous appointment of sympathomimetics and Nebivolol promotes oppression of the latter.

Joint use with drugs for anesthesia can lead to a sharp drop in blood pressure, which will serve as an indication for ventilation and the use of hypertensive medications.

When prescribing the drug with insulin, it is possible to develop an overdose of the hormone and conceal the clinical signs of hypoglycemia.

Dosage of the drug

So in what doses should you use the drug to develop the necessary clinical effect? If Nebivolol Sandoz is used, the instructions for use suggest the following type of dosing.

The most optimal dose for an adult is 20 milligrams per day. The drug is administered orally in the morning on an empty stomach. The maximum effect from the used dose develops in one to two weeks from the start of treatment. If necessary, the daily amount of the drug can be increased to 10 milligrams. For elderly patients, the maximum daily dose is 5 milligrams, and the optimal dose for treatment is 2.5 milligrams per day. For pregnant women, the amount of the drug is selected according to clinical signs and body weight. It is best to use Nebivolol Sandoz (5 mg) in tablets.

If the liver or kidney function is impaired , it is better to stop using Nebivolol or to prescribe it in minimal dosages.

With the simultaneous appointment of sympathomimetics and Nebivolol, potentiation of the effect is possible, so that the prescribed dose of the drug can be somewhat reduced.

The administration of the drug in smaller doses does not have an effect on the body. It is possible to develop tolerance of the receptors to the drug with long-term administration of small doses of the drug.

Drug analogues

Not always in pharmacies can find the right drug, so you have to resort to the use of analogues. Due to the expansion of the market of medicines, it is not difficult to find similar products. What drugs can replace Nebivolol?

Analogues (synonyms) of this drug are as follows:

• Binelol;
• "Nebivator";
• Nebivolol canon;
• "Nebivolol stada";
• "Nebivolol teva;
• "Nebikar";
• "Nebilet";
• "Nebilong";
• "Od-heaven."

Each of these drugs has its positive and negative features. Some of them are stronger than the classic "Nebivolol". The instruction on the use of each of them, however, also warns of a greater number of negative effects. Therefore, decide on the question of which drug is better, can only help a qualified and competent doctor.

It is not necessary to apply these funds on your own without first consulting a doctor, as this can only significantly worsen your condition and harm both your health and the health of friends and relatives.

Reviews about the drugs

Many patients actively praise on the forum such a drug as Nebivolol Sandoz. Reviews about it are mostly positive, as this drug has helped to cure or cure the symptoms of the disease to the majority of patients.

Despite the number of side effects that the drug possesses, it is considered one of the most important in the treatment of hypertension and heart failure.

Nebivolol has a lot of positive feedback. Analogues of a drug to someone approach or suit more, to someone - it is less, owing to what opinions of patients vary. It is necessary to take into account also the concomitant pathology, which can significantly worsen the effect of the drug.

It is necessary to take into account the age of patients who used this drug.

Of all beta-adrenoblokatorov used in cardiac patients, the first place is "Nebivolol" (analogs). Reviews about this drug can be called its most effective drug of this drug group.