Nebinor 2.5 mg Tablet

Highly cardioselective beta-blocker with vasodilating action for:

• High blood pressure
• Stable chronic heart failure in patients aged 70 and over (add-on)

Hypertension: 5 mg once daily (2.5 mg in elderly over 65 or kidney impairment initially); may increase to 10 mg.

Heart failure (70+): start 1.25 mg once daily, doubled every 1–2 weeks to a target of 10 mg once daily.

• Same time each day, with or without food.
• Do not stop suddenly — taper over 1–2 weeks.

• Liver impairment
• Acute or decompensated heart failure needing IV treatment
• Sick sinus syndrome, 2nd/3rd degree heart block (without pacemaker), slow heart rate < 60 before treatment
• Low blood pressure, severe peripheral circulation disorders
• Untreated phaeochromocytoma, metabolic acidosis
• History of bronchospasm/asthma

Common: headache, dizziness, tiredness, tingling, diarrhoea, constipation, nausea, breathlessness, swelling.

Less common: slow heartbeat, low blood pressure, impotence, nightmares, depression, cold extremities, itching.

Rare: heart block, bronchospasm, worsening heart failure, angioedema.

• Diabetes: may mask hypoglycaemia.
• Psoriasis, COPD, thyrotoxicosis: caution.
• Tell the anaesthetist before surgery.

Use in pregnancy only if clearly needed (monitor baby's growth, newborn heart rate and sugar). Not recommended while breastfeeding.

• Verapamil, diltiazem (heart block — avoid)
• Clonidine (rebound if stopped)
• Amiodarone, digoxin (slow pulse)
• Fluoxetine, paroxetine (raise levels)
• Insulin, diabetes tablets (masked hypoglycaemia)
• Other antihypertensives (low BP)

Slow heartbeat, low blood pressure, bronchospasm, heart failure. Emergency care.

Store below 30°C.