manufacturer: Berlin-Chemie AG / Menarini
active substance: Nebivolol
dosage form: tablet
The following overview summarizes the side effects associated with the treatment with the drug in both hypertension and cardiac insufficiency. This can lead to duplication when specifying the frequency.
Very common side effects:
heartbeat slowing, dizziness.
Common side effects:
Limb discomfort, headache, dizziness, fluid retention, fatigue, dyspnoea, constipation, nausea, diarrhea, deterioration of myocardial insufficiency, decreased blood pressure in body posture, intolerance reactions, cardiac arrhythmia (AV block) , Water accumulation in the legs.
Uncommon side effects:
blurred vision, nightmares, worsening heart failure, heartbeat retardation, cardiac arrhythmia (AV block), low blood pressure, increased circulatory disorders, vomiting, bloating, indigestion, itching, redness, impotence, depression. !!!
Very rare side effects:
Short unconsciousness, facial swelling (angioneurotic edema), psoriasis exacerbation.
Nebivolol may increase the effects of other antihypertensive agents, resulting in excessive blood pressure drop. This applies, for example, to the use together with other beta-blockers, as well as with clonidine, guanfacine, moxonidine, methyldopa and rilmenidine. Adding the active ingredient to one of them also increases the risk of a sharp increase in blood pressure after the treatment has ended. Neuroleptics (against psychosis) and the tricyclic antidepressants and barbiturates used against depression, together with nebivolol, also cause a sharp drop in blood pressure.
Likewise, combination with calcium channel blockers such as verapamil and diltiazem and anesthetics are not recommended.
Nebivolol may increase the effect of anti-arrhythmic drugs (antiarrhythmics), which may lead to cardiac dysfunction. Such agents include the active ingredients quinidine, hydroquinidine, cibenzoline, flecainide, disopyramide, lidocaine, mexiletine and propafenone.
When used concomitantly with insulin or other agents used to treat diabetes, their effects may be exacerbated or prolonged. Warning signs of hypoglycaemia such as palpitations and muscle tremors (tremor) can be so mitigated that they are no longer recognizable as signs of disease (obfuscation). Therefore, regular blood sugar level checks are required.
Ingesting agents that activate the subconscious autonomic nervous system (sympathomimetics) may negate the effect of nebivolol with increases in blood pressure, arrest of heart rate, and blockage of cardiac excitation.
Substances that inhibit the breakdown of nebivolol increase its effects and side effects. These include the psychotropic drugs paroxetine, fluoxetine and thioridazine as well as quinidine, which is used to combat cardiac arrhythmias.
With acid blockers, effects may be reduced. They should be taken after the meal, when nebivolol was taken for the meal.