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CARDIOVASCULAR SYSTEM › BETA BLOCKING AGENTS › BETA BLOCKING AGENTS › Beta blocking agents, selective
nebivolol
C07AB12
Forms & Strengths
- Tablet: 2.5 mg
- Tablet: 5 mg
- Tablet: 10 mg
- Tablet: 20 mg
Adult Dosing
- Hypertension: Initial 5 mg once daily, titrate up to 40 mg daily at 2-week intervals as needed.
- Heart Failure (HFrEF): Initial 1.25 mg once daily, double every 2 weeks as tolerated to target 10 mg once daily.
Pediatric Dosing
- Safety and efficacy not established in pediatric patients.
Indications
- Hypertension
- Heart failure with reduced ejection fraction (HFrEF)
Mechanism of Action
- Highly selective beta-1 adrenergic receptor blocker.
- Induces vasodilation via L-arginine/nitric oxide pathway.
Contraindications
- Severe bradycardia
- Heart block greater than first degree
- Cardiogenic shock
- Decompensated heart failure
- Sick sinus syndrome (unless permanent pacemaker in place)
- Severe hepatic impairment (Child-Pugh Class C)
Adverse Reactions
- Headache
- Fatigue
- Dizziness
- Nausea
- Insomnia
- Bradycardia
- Hypotension
Drug Interactions
- CYP2D6 inhibitors (e.g., fluoxetine, paroxetine) may increase nebivolol plasma concentrations.
- CCBs (verapamil, diltiazem) increase risk of bradycardia and AV conduction delay.
- Digitalis glycosides increase risk of bradycardia.
- Insulin and oral antidiabetic agents may mask symptoms of hypoglycemia.
Curated Content: Needs Vetting Before Put to Clinical Use