Nebivolol: Price, Dosage & Where to Buy

Nebivolol is a beta-blocker used to treat hypertension, commonly called high blood pressure, by helping to lower blood pressure. It may be prescribed alone or alongside other blood pressure medicines as part of cardiovascular risk management. Nebivolol requires a prescription in the United Kingdom, and generic versions have been available since 2015-04-16.

Nebivolol is indicated for hypertension, meaning high blood pressure. It can be used alone or in combination with other medicines for lowering blood pressure. Reducing blood pressure helps reduce the risk of cardiovascular events, particularly strokes and heart attacks.

However, the label states that controlled trials have not demonstrated this risk reduction specifically with nebivolol. Blood pressure control forms part of wider cardiovascular risk management, which may also include cholesterol control, diabetes management, smoking cessation, exercise and limiting sodium intake.

Nebivolol belongs to the beta-blocker class of medicines. Beta-blockers reduce the effects of adrenaline and related chemical signals on beta receptors, particularly those in the heart. This can slow the heartbeat and reduce the force with which the heart contracts, helping to lower blood pressure.

Beta-blockers can also reduce signals from the kidneys that contribute to blood pressure regulation. These effects explain why this class can affect heart rate as well as blood pressure.

The label lists oral tablets containing 2.5 mg, 5 mg, 10 mg and 20 mg of nebivolol. The usual starting dose is 5 mg once daily for most patients with hypertension, with or without food, either alone or alongside other blood pressure medicines. The label lists increases at 2-week intervals up to 40 mg when further blood pressure reduction is required.

Treatment is individualised, with monitoring during increases; a more frequent dosing schedule is described as unlikely to be beneficial. The label lists an initial dose of 2.5 mg once daily for severe renal impairment, with slow increases if needed. The label lists an initial dose of 2.5 mg once daily for moderate hepatic impairment, also with slow increases if needed.

Nebivolol has not been studied in patients receiving dialysis or those with severe hepatic impairment, and it is not recommended in severe hepatic impairment. The label states that older patients and CYP2D6 poor metabolisers do not require dose adjustment.

For a missed dose, usual pharmacy advice is to resume treatment when remembered unless the next scheduled dose is nearly due. In that situation, the missed dose is omitted rather than doubled.

A pharmacist can clarify the timing. Repeated missed doses or interruption of nebivolol should be discussed with the prescriber because abrupt stopping can cause heart complications.

Data in pregnant women are insufficient to determine whether nebivolol causes adverse developmental outcomes. Poorly controlled hypertension carries risks for both mother and baby. Beta-blocker use during the third trimester may increase the newborn's risk of low blood pressure, slow heartbeat, low blood sugar and respiratory depression.

There is no information about nebivolol in human milk or its effects on breastfed infants or milk production. Breastfeeding is not recommended because of potential serious adverse effects, particularly a slow heartbeat, in nursing infants.

Store at 20 to 25 °C; excursions between 15 and 30 °C are permitted. Keep in a tight, light-resistant container with a child-resistant closure, and keep out of the reach of children.