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CARDIOVASCULAR SYSTEM › LIPID MODIFYING AGENTS › LIPID MODIFYING AGENTS, COMBINATIONS › Lipid modifying agents in combination with other drugs
rosuvastatin and nebivolol
C10BX22
Forms & Strengths
- Rosuvastatin/Nebivolol 5 mg/5 mg oral tablet
- Rosuvastatin/Nebivolol 5 mg/10 mg oral tablet
- Rosuvastatin/Nebivolol 10 mg/5 mg oral tablet
- Rosuvastatin/Nebivolol 10 mg/10 mg oral tablet
Adult Dosing
- Hypertension and hyperlipidemia: 1 tablet daily, individualized based on component titration and renal function
- Maximum daily dose: Rosuvastatin 40 mg / Nebivolol 40 mg (typically achieved via separate components if needed)
Pediatric Dosing
- Safety and efficacy not established in pediatric patients; combination not recommended
Indications
- Management of hypertension and dyslipidemia simultaneously in patients already controlled on the individual agents
- Reduction of cardiovascular morbidity and mortality risk in patients with primary hyperlipidemia or mixed dyslipidemia and concomitant essential hypertension
Mechanism of Action
- Rosuvastatin: Selective and competitive inhibitor of HMG-CoA reductase, halting hepatic cholesterol synthesis and upregulating LDL receptors
- Nebivolol: Competitive and selective beta-1 adrenergic receptor blocker with L-arginine-mediated nitric oxide-dependent vasodilatory properties
Contraindications
- Hypersensitivity to rosuvastatin, nebivolol, or any component
- Active liver disease or unexplained persistent elevations of serum transaminases
- Severe hepatic impairment (Child-Pugh Class B or C)
- Severe bradycardia, cardiogenic shock, decompensated heart failure, sick sinus syndrome, or second/third-degree AV block without a pacemaker
- Pregnancy and lactation
Adverse Reactions
- Headache, dizziness, fatigue, and asthenia
- Myalgia, arthralgia, and elevated creatine kinase
- Nasopharyngitis, upper respiratory tract infection
- Nausea, constipation, and abdominal pain
- Bradycardia, hypotension, and peripheral edema
Drug Interactions
- Cyclosporine: Significantly increases rosuvastatin exposure
- Gemfibrozil: Increases rosuvastatin exposure and risk of myopathy
- Strong CYP2D6 inhibitors (e.g., paroxetine, fluoxetine): May increase nebivolol plasma concentrations
- CYP3A4 inducers/inhibitors: May alter metabolism of specific beta-blockers, monitor closely
- Antihypertensive agents and negative chronotropes: Potential for additive hypotensive and bradycardic effects
- Coumarin anticoagulants: Rosuvastatin may potentiate INR; monitor prothrombin time
Curated Content: Needs Vetting Before Put to Clinical Use