"Nebilong" is an effective drug intended for the treatment of diseases associated with impaired heart function. Improvements can be achieved after using it for one month. After applying the Nebilong, the pulse and blood pressure normalize, vascular relaxation is achieved, a sufficient amount of oxygen enters the myocardium. In almost all cases, a positive result of therapy persists for a long time.
Composition, release form
The drug is available in tablets. One tablet may contain 2.5, 5 or 10 mg of the active ingredient. The medicine is made on the basis of nebivolol hydrochloride. Of the excipients, povidone, lactose, magnesium stearate are present. The composition is supplemented with talc, microcrystalline cellulose, sodium dioctyl sulfate, colloidal silicon dioxide, croscarmellose sodium, beta-cyclodextrin.
pharmachologic effect
"Nebilong" instructions for use displays as a tool that contains two enantiomers (L- and D-nebivolol). D-nebivolol is a highly selective, competitive blocker of β1-adrenergic receptors, L-nebivolol gently affects the vessels, expands them, which occurs as a result of the process in the vascular endothelium (modulation of the release of the vasodilating factor).
Nebivolol helps to lower blood pressure and heart rate, the result is saved not only at rest, but also under exertion. After taking the medicine, OPSS and the final diastolic pressure of the left ventricle are reduced, there is a positive effect on one of the functions that the heart performs - diastolic. Due to the use of Nebilong, the ejection fraction increases, and people with coronary artery disease have an antianginal effect.
The hypotensive effect that the Nebilong tablets perform is explained by the instruction as a decrease in activity in the renin-angiotensin system. Antiarrhythmic effect is achieved by reducing AV conductivity and suppressing pathological automatism of the heart. A stable hypotensive effect occurs after 7-14 days of treatment, often in a month. A stable result from taking the tablets is noted after one to two months of treatment.
Pharmacokinetics
The drug taken orally is well absorbed, this process is equally effective, regardless of food intake. Metabolism is carried out in the liver and ends with the formation of active hydroxymetabolites. On average, the bioavailability after internal use of the drug by a person with a fast metabolism is 12%, with a slow metabolism this figure is much higher. Since the metabolism in patients can proceed at different speeds, the “Nebilong” instruction recommends prescribing taking into account the individual characteristics of the patient’s body. With slow metabolism, low doses of the drug are used. In people with fast metabolism, elimination half-life occurs in about 10 hours, in patients whose metabolism is slower, the elimination half-life is increased by 3-5 times. After seven days of therapy, about 38% of the drug taken is excreted by the kidneys, approximately 48% of the Nebilonga is present in the feces. The urine contains a small amount of the drug unchanged - up to 0.5%.
Indications
Instructions for use "Nebilong" can be used for hypertension, for the implementation of preventive measures in patients with coronary artery disease (bouts of angina pectoris) and for the implementation of complex therapy for heart failure of a chronic form.
Treatment using the drug "Nebilong"
Hypertension
Adult patients are prescribed 5 mg of Nebilong, which corresponds to one tablet of the drug and is a daily dose. The medicine is recommended to be consumed daily, at the same time. A small effect is noticeable after one to two weeks of therapy, it is most pronounced after a month, during which treatment was performed. The tablets are suitable both for the implementation of monotherapy, and for the implementation of treatment based on the integrated use of drugs, which also have a hypotensive effect. For people who take Nebilong AM, the instruction recommends using Hydrochlorothiazide 12.5-25 mg in order to obtain an additional effect. Such combined treatment allows you to enhance the effect of "Nebilong", but this can only be done after consulting a doctor.
Chronic heart failure
First, a small dose of the drug is used, which the doctor gradually increases, taking into account the characteristics of the patient's body. “Nebilong” is not suitable for the treatment of an acute form of the disease; in such cases, other drugs are used. Usually, 1.25 mg of the drug is prescribed first for a single daily intake, after 1-2 weeks the dose can be increased to 5 mg, later to 10 mg. The daily dose cannot exceed 10 mg of the Nebilong medication. Instructions for use show that at the initial stage of the implementation of therapy, the patient is left under observation for two hours after taking the pill, they do the same with each dose increase. The increased dose can be reduced again, if there is such a need.
If the symptoms of heart failure manifested themselves more severely or the patient was found to be intolerant of the components of the drug, reduce the dose or cancel it. Typically, heart failure of a chronic form with Nebilong is treated quickly. With therapy aimed at eliminating such conditions, the drug is withdrawn slowly, this action cannot be performed sharply, since the problem can worsen. When a medication is canceled every week, its dose is reduced by half. For taking Nebilong AM tablets, the instructions for use provide some limitations.
Limitations:
- Renal failure. First, 2.5 mg of the drug per day is used for therapy, later the dose can be increased, but it should not exceed 5 mg.
- Elderly age. The initial dose can not exceed 2.5 mg, if necessary, it is increased to 5 mg. After 65 years, a regular check of kidney activity is required (once every four to five months).
- Pregnancy. A newborn may develop some pathologies, these include respiratory paralysis, hypoglycemia, hypotension, bradycardia, therefore, pregnant women are very rarely prescribed the drug. If Nebilong is used by a pregnant woman, cancellation is required 48-72 hours before delivery. If this is not possible, the newborn should be monitored for 48-72 hours.
Contraindications
"Nebilong N" instruction for use prohibits the use in the following cases:
- age less than 18 years;
- hypersensitivity to the components of the drug;
- bronchospasm, asthma (history);
- pheochromocytoma, the treatment of which has not been carried out before;
- metabolic acidosis;
- severe liver disease, liver failure;
- hypotension in individuals whose systolic pressure is 90 or less mmHg. st .;
- AV block (grade I, III), bradycardia, which is accompanied by a heart rate corresponding to 60 beats. in a minute;
- the period of gestation, breastfeeding;
- acute heart failure ;
- problems with peripheral circulation, having a pronounced severity;
- cardiogenic shock, conditions in which the use of isotropic drugs is necessary;
- syndrome accompanied by weakness of the sinus node.
Caution is required when prescribing medication to patients with such conditions:
- diabetes;
- psoriasis (history);
- Prinzmetal's angina pectoris.
Side effects
When using Nebilong, instructions for use, reviews note the likelihood of some side effects that manifest themselves in the work of the cardiovascular, digestive and nervous systems. Among other disorders - bronchospasm, reactions that affect the skin condition.
special instructions
"Nebilong" can cause an increase in sensitivity to allergens, which threatens the development of a pronounced anaphylactic reaction.
Treatment with the drug does not affect the level of glucose in the body in the presence of diabetes mellitus, however, patients in this group should use the medication with caution. Both with diabetes and hyperthyroidism, the drug can mask the symptoms of tachycardia, which are more pronounced due to the abrupt cancellation of the tablets.
If Nebilong is used by patients with problems in the respiratory system, the instructions for use report the likelihood of increased constriction of the respiratory tract in COPD. The possibility of combining the drug with other drugs should be checked with your doctor.
"Nebilong" affects the ability to drive a vehicle, can lead to fatigue and dizziness.
Analogs
There is the possibility of replacing the drug when it does not allow the use of the drug "Nebilong" instructions for use. Analogues of the drug include Nebilet, Binelol. Substitutes also include Nebikor and Nebivator.
Reviews
According to reviews, the drug is effective when used correctly. It is very important to use the medicine correctly and follow all the doctor’s recommendations. A medication prescribed taking into account contraindications and the characteristics of the patient's body leads to a positive effect. So that treatment does not lead to the development of side effects, it is necessary to constantly monitor the patient's condition.