Nevalto 5/80mg Tablet 1 Strip

✔️ Side Effects:

• Hypotension
• Hyperkalemia

✔️ Dosage & Administration:

• Initial Dose: 5 mg Nebivolol / 80 mg Valsartan once daily.
• For patients already on 5 mg Nebivolol and 80 mg Valsartan, 5/80 can be substituted.
• Maximum effects are typically reached within 2 to 4 weeks.
• Increasing the dose of 5/80 does not result in significant further blood pressure reduction.
• Pediatric Use: Safety and effectiveness have not been established.
• Geriatric Use: No significant difference in safety or effectiveness compared to younger patients.
• Renal Impairment: Not recommended as initial therapy in severe renal impairment.
• Hepatic Impairment: No studies available for Nebivolol/Valsartan in patients with hepatic insufficiency.

✔️ Drug Interactions:

• CYP2D6 Inhibitors: May increase Nebivolol levels.
• Reserpine / Clonidine: May cause excessive reduction of sympathetic activity.
• Digitalis Glycosides: Increases the risk of bradycardia.
• Verapamil / Diltiazem-type Calcium Channel Blockers: May cause excessive reduction in heart rate and blood pressure.
• Potassium-sparing Diuretics or Supplements: May increase serum potassium levels.
• NSAIDs: Increased risk of renal impairment and reduced antihypertensive effect.
• Dual Inhibition of Renin-Angiotensin System: Increased risk of renal impairment, hypotension, and hyperkalemia.

✔️ Contraindications:

• Severe bradycardia
• Heart block greater than first-degree
• Cardiogenic shock
• Decompensated cardiac failure
• Sick sinus syndrome (unless a pacemaker is in place)
• Severe hepatic impairment (Child-Pugh >B)
• Hypersensitivity to any component of this product
• Do not co-administer with aliskiren in patients with diabetes.

✔️ Nebivolol Overdose:

• Bradycardia: Treat with IV atropine.
• Hypotension: Treat with IV fluids and vasopressors.
• Heart Block: Monitor and treat with isoproterenol infusion, or consider pacemaker.
• Congestive Heart Failure: Use digitalis and diuretics, consider inotropic agents.
• Bronchospasm: Administer bronchodilators.
• Hypoglycemia: Administer IV glucose.
• Supportive measures should be continued until stability.

Valsartan Overdose:

• Likely effects include hypotension and tachycardia.
• Valsartan is not removed by hemodialysis.

✔️ Pregnancy & Lactation:

• Pregnancy: Contraindicated as it can cause fetal harm.
• Lactation: Not recommended for breastfeeding.

✔️ Precautions & Warnings:

• Abrupt Discontinuation: Can exacerbate coronary artery disease; do not suddenly stop therapy.
• Diabetes: Beta-blockers like Nebivolol may mask hypoglycemia symptoms, so glucose monitoring is advised.
• Renal & Potassium Monitoring: Regular monitoring is recommended for susceptible patients.

✔️ Storage:

Store below 30°C, in a dry place, protected from light, and out of reach of children.