Nebicard H Tablet 15'S

INTRODUCTION

NEBICARD H TABLET is a combination of Hydrochlorothiazide and Nebivolol which belongs to the group of medicines called Antihypertensive agents. It is used to treat hypertension (high blood pressure).

Hypertension (also known as high blood pressure) is a medical condition in which the force of the blood exerted against the walls of the artery remains very high and as a result it may lead to severe damage to the blood vessels supplying several vital organs, such as heart, kidney or brain. If left untreated, it may cause serious complications such as heart attack, heart failure, stroke or even blindness.

By lowering blood pressure, NEBICARD H TABLET can also reduce the risk of heart attack (myocardial infarction) or stroke. During treatment with NEBICARD H TABLET your doctor will constantly monitor your kidney functions, blood pressure, electrolyte levels and blood sugar levels to avoid the risk of unwanted side effects.

Before taking NEBICARD H TABLET inform your doctor if you have any liver, kidney or heart problems (such as angina). You must also inform your doctor if you have asthma, diabetes, thyroid problems, poor blood circulation, psoriasis or dehydration as a precaution.

NEBICARD H TABLET is not recommended for use in patients with severe heart problems (such as heart failure or heart block). Consult your doctor before taking this medicine if you are pregnant or breastfeeding.

The most common side effects of taking this medicine are headache, dizziness, tiredness, tingling sensation, diarrhoea, constipation, shortness of breath and swollen hands or feet. Consult your doctor if any of these side effect worsens.

USES OF NEBICARD H TABLET

• Treats Hypertension (high blood pressure)
• Prevents the risk of heart attack or stroke

HOW NEBICARD H TABLET WORKS

NEBICARD H TABLET is an antihypertensive medicine. It contains two medicines namely, nebivolol and hydrochlorothiazide. Nebivolol works by blocking the actions of certain chemical messengers (such as adrenaline) in the body that increases heart rate and blood pressure.

Hydrochlorothiazide works by reducing the thickness of the blood by removing excess fluids from the body in the form of urine. Collectively, these actions improve blood flow, reduce the strain on the heart and helps the heart to pump more blood with less pressure.

DIRECTIONS FOR USE

Take NEBICARD H TABLET as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine.

Try to take NEBICARD H TABLET at the same time each day. NEBICARD H TABLET can be taken with or without food.

Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and health condition.

Continue to take NEBICARD H TABLET for the stipulated duration instructed by your doctor without any interruption to achieve better results.

SIDE EFFECTS OF NEBICARD H TABLET

HOW TO MANAGE SIDE EFFECTS

Nausea and vomiting:

Take NEBICARD H TABLET with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food. Consult your doctor if your nausea worsens.

Dizziness:

Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.

Headache:

Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.

WARNING & PRECAUTIONS

PREGNANCY

NEBICARD H TABLET is not recommended for use in pregnant women unless considered necessary by the physician. Therefore, consult your doctor before taking it.

BREASTFEEDING

NEBICARD H TABLET is not recommended for use in breastfeeding women. Therefore, consult your doctor before taking it.

DRIVING AND USING MACHINES

Do not drive or handle any heavy tools or machines if your ability is affected by NEBICARD H TABLET.

ALCOHOL

Avoid consumption of alcohol while taking NEBICARD H TABLET as it might make you feel dizzier and drowsier.

KIDNEY

NEBICARD H TABLET should be used with caution in patients with kidney problems. Therefore, consult your doctor before taking it.

LIVER

NEBICARD H TABLET is not recommended for use in patients with severe liver impairment. Therefore, consult your doctor before taking it.

ALLERGY

Do not take NEBICARD H TABLET if you are allergic to Nebivolol or Hydrochlorothiazide.

LUNGS

NEBICARD H TABLET is not recommended for use in patients with asthma or other breathing problems. It should be used with caution in patients with chronic bronchitis (inflammation of the airways). Therefore, consult your doctor before taking it.

HEART DISEASE

NEBICARD H TABLET is not recommended for use in patients with slow heartbeat, serious heart rhythm problems or recent heart failure. It should be used with caution in patients having angina (chest pain) or heart block. Therefore, consult your doctor before taking it.

INTERACTIONS

A. Drug-Drug interactions:

Before taking NEBICARD H TABLET inform to your doctor, if you are taking any of the following medicines such as:

• medicines that can depress the brain such as barbiturates (Ex. phenobarbital)
• narcotic drugs (used for pain relief) such as morphine, fentanyl, pethidine
• medicines used to reduce blood cholesterol levels (such as cholestyramine, colestipol)
• corticosteroids (used to treat inflammation) Ex. prednisolone
• corticotropin (a medicine used to correct hormone problems)
• noradrenaline (a medicine used to increase blood pressure)
• tubocurarine, dantrolene (medicines used to relax muscles)
• medicines used for pain and inflammation (such as ibuprofen or indomethacin)
• calcium channel blockers (used to treat heart problems) such as verapamil, diltiazem, amlodipine, felodipine, lacidipine, nifedipine, nicardipine, nimodipine and nitrendipine
• other medicines used to treat high blood pressure (such as clonidine, guanfacine, moxonidine, methyldopa, rilmenidine, Aliskiren, captopril, enalapril, ramipril, losartan, valsartan)
• medicines used to treat uneven heartbeat (such as digoxin, quinidine, hydroquinidine, amiodarone, cibenzoline, ­ecainide, disopyramide, lidocaine, mexiletine and propafenone)
• medicines used to treat anxiety (such as phenobarbital, chlorpromazine)
• medicines used to treat depression (such as lithium, amitriptyline, trazodone, paroxetine, fl­uoxetine and thioridiazine)
• medicines used to treat asthma (such as salbutamol, salmeterol, budesonide)
• medications used to treat cough and cold (such as pseudoephedrine)
• medicines used to treat glaucoma (such as timolol, pindolol)
• medicines used to treat diabetes (such as insulin, metformin, gliclazide, glibenclamide)
• anaesthetics (used to cause numbness or loss of sensation) such as lidocaine, sevoflurane, halothane
• cimetidine (a medicine used to treat stomach ulcers)
• antacids (medicines used to neutralise stomach acid) such as aluminium hydroxide, magaldrate
• medicines used for pain and inflammation (such as aspirin, ibuprofen, diclofenac)
• baclofen (a medicine used for relaxing muscles)
• amifostine (a kidney protectant used along with chemotherapeutic agents)

Overdosage:

If you or anyone else accidentally took excessive amount of this medicine, consult your doctor immediately or visit the nearby hospital straight away. Symptoms of overdosage might include low blood pressure, fast or slow heart rate, dizziness, kidney problems and shortness of breath.

SYNOPSIS

MORE INFORMATION

• Keep NEBICARD H TABLET out of reach to children
• Store NEBICARD H TABLET at normal room temperature

FAQs ABOUT NEBICARD H TABLET

Q: What are the uses of NEBICARD H TABLET?

A: NEBICARD H TABLET is used to treat hypertension. It can also be used to prevent the risk of heart attack or stroke.

Q: What type of a medicine is NEBICARD H TABLET?

A: NEBICARD H TABLET is an antihypertensive medicine. It slows down your heartbeat and reduces the force of contraction of the heart. It also reduces the thickness of the blood by removing excess fluids from the body in the form of urine. Collectively, these actions reduce the strain on the heart and helps the heart to pump blood more smoothly with less pressure.

Q: What happens when I stop taking NEBICARD H TABLET?

A: Do not stop taking NEBICARD H TABLET without consulting your doctor as your blood pressure may raise once again. Make sure to take NEBICARD H TABLET for the stipulated duration recommended by your doctor to achieve maximum results.

Q: What is the best time to take NEBICARD H TABLET?

A: NEBICARD H TABLET can be taken with or without meals. Your doctor will decide the best time for you to take NEBICARD H TABLET based on your age, body weight and disease condition.

Q: What to do if I forgot to take a dose of NEBICARD H TABLET?

A: If you forgot to take a dose of NEBICARD H TABLET, take it as soon as you remember. However, if it is time for the next dose of NEBICARD H TABLET, skip the missed dose and take the next one regularly. Do not take a double dose of NEBICARD H TABLET to compensate the missed ones.

Q: What precautions should be followed while taking NEBICARD H TABLET?

A: Before taking NEBICARD H TABLET inform your doctor if you have any liver or kidney problems. You must also inform your doctor if you have diabetes, thyroid problems, asthma, poor blood circulation, dehydration or low sodium, potassium or magnesium levels in the blood as a precaution. Consult your doctor before taking this medicine if you are pregnant or breastfeeding. Regularly visit your doctor and take all the necessary blood test recommended by your doctor without fail.

Q: Can I consume alcohol while taking NEBICARD H TABLET?

A: Avoid consumption of alcohol while taking NEBICARD H TABLET as it might make you feel dizzier and drowsier.

Q: What happens if I accidentally take more NEBICARD H TABLET?

A: If you or anyone else accidentally took excessive amount of this medicine, consult your doctor immediately or visit the nearby hospital straight away. Symptoms of overdosage might include low blood pressure, fast or slow heart rate, dizziness, kidney problems and shortness of breath.

Q: Can I take NEBICARD H TABLET daily?

A: Take NEBICARD H TABLET as advised by your physician. Your doctor will evaluate your health condition and suggests whether can you take NEBICARD H TABLET every day or not.

Q: Is NEBICARD H TABLET safe to use in diabetic patients?

A: NEBICARD H TABLET may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking NEBICARD H TABLET as a precaution. Your doctor will closely monitor you blood sugar levels to avoid the risk of side effects.

Q: What are the side effects of NEBICARD H TABLET?

A: The most common side effects of taking this medicine are headache, dizziness, tiredness, tingling sensation, diarrhoea, constipation, shortness of breath and swollen hands or feet. Consult your doctor if any of these side effect worsens.

Q: Can I stop taking NEBICARD H TABLET once my symptoms subside?

A: No. Do not stop taking NEBICARD H TABLET without consulting your doctor. As hypertension is a chronic condition, long term treatment may be necessary to control its symptoms. Therefore, take NEBICARD H TABLET as advised by your doctor for the stipulated duration. Premature discontinuation of therapy may increase your blood pressure once again.

Q: Can NEBICARD H TABLET be taken during pregnancy?

A: NEBICARD H TABLET is not recommended for use in pregnant women unless considered necessary by the physician. Therefore, consult your doctor before taking it.

Q: Is NEBICARD H TABLET safe to use in kidney disease?

A: NEBICARD H TABLET should be used with caution in patients with kidney problems. Your doctor will access your health condition and suggest a suitable dose for you.

Q: Can the use of NEBICARD H TABLET affect the liver?

A: Yes. NEBICARD H TABLET may affect the way your liver work. It can elevate the levels of certain liver enzymes in your body. Therefore, it should be used with caution in patients with liver problems. Consult your doctor before taking it.

Q: Does NEBICARD H TABLET cause frequent urination?

A: Yes. NEBICARD H TABLET may cause frequent urination. It is because NEBICARD H TABLET contains a medicine called hydrochlorothiazide which is a diuretic (water pill). It excretes the excess water from the body in the form of urine. Therefore, it is advised to take NEBICARD H TABLET at least 5 hours before bedtime to avoid the urge at night to urinate.

Q: Can I take potassium supplements along with NEBICARD H TABLET?

A: Yes. Potassium supplements can be taken along with NEBICARD H TABLET. However, consult your doctor before taking it.

REFERENCES

1. KD. Tripathi. Antiadrenergic Drugs (Adrenergic Receptor Antagonists) and Antihypertensive Drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page – 149 & 559.

2. E Malacco. Nebivolol/hydrochlorothiazide (HCTZ) combination in patients with essential hypertension: a pooled analysis from five non-interventional studies with a focus on diabetic and elderly patients. NIH. National Library of Medicine, National center for biotechnology information. Pubmed.gov. May 2010. [Accessed on 30th December 2022]. https://pubmed.ncbi.nlm.nih.gov/20556921/

3. Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in April 2022] [Accessed on 30th December 2022]. https://www.medicines.org.uk/emc/files/pil.5828.pdf

4. Mylan Pharmaceuticals Inc. U.S. Food and Drug Administration. [Revised in May 2011] [Accessed on 30th December 2022]. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/040735s004,040770s003lbl.pdf

5. Torrent Pharmaceuticals Ltd. Nebicard H. [Revised in January 2022] [Accessed on 30th December 2022]. https://www.torrentian.com/pisheet/Upload/PI_Sheet/2011.pdf

6. Central Drugs Standard Control Organization. Nebivolol 5mg + HCTZ 12.5mg tablets. December 2004. [Accessed on 30th December 2022]. https://cdsco.gov.in/opencms/resources/UploadCDSCOWeb/2018/UploadApprovalNewDrugs/dciApprovedfdc.pdf

USEFUL DIAGNOSTIC TESTS

• Kidney Function Test

AUTHOR DETAILS

Written By Srilekha. R, B.Pharm
Last updated on 31 Dec 2022 | 02:05 PM(IST)