Practice Update: Cardiology

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nebivolol hydrochloride
Nebilet® (nebivolol hydrochloride) tablets 1.25 mg, 5 mg, 10 mg. INDICATIONS: Essential hypertension. Stable chronic heart failure (CHF) as an adjunct to standard
therapies in patients 70 years or older. CONTRAINDICATIONS: Hypersensitivity to the active or any of the airment; acute
heart failure; cardiogenic shock or episodes of heart failure decompensation requiring IV inotropic the block; second
and third degree heart block (without a pacemaker); history of bronchospasm (e.g. including COPD) and/or asthma; untreated phaeochromocytoma; metabolic acidosis;
bradycardia (HR < 60 bpm prior to starting therapy); hypotension (systolic BP < 100 mmHg); severe peripheral circulatory disturbances. PRECAUTIONS: Avoid abrupt
cessation unless clearly indicated – reduce dosage gradually over 1-2 wks; refer to full PI. If it must be withdrawn abruptly, close observation is required. Anaesthesia;
untreated congestive heart failure, unless stabilised; bradycardia; peripheral circulatory disorders (e.g. Raynaud’s disease, intermittent claudication); first degree heart
block; Prinzmetal’s or variant angina; lipid and carbohydrate metabolism – does not affect glucose levels in diabetic patients, but may mask symptoms of hypoglycaemia.
Hyperthyroidism; COPD/asthma; phaeochromocytoma; various skin rashes; conjunctival xerosis; oculomucocutaneous syndrome; psoriasis; increased sensitivity to
allergens and severity of anaphylactic reactions; galactose intolerance, Lapp-lactase deficiency or glucose-galactose malabsorption; driving vehicles or operating
machines. Pregnancy (Cat C). Lactation. Children and adolescents. Renal and hepatic insufficiency – see Dosage and Administration. INTERACTIONS: Combination not
recommended: Class I antiarrhythmics; calcium channel antagonists (verapamil/dilitiazem); centrally-acting antihypertensives; other beta-blockers (incl. eye drops).
Combination to be used with caution: Class III antiarrhythmic drugs; anaesthetics (volatile); insulin and other oral diabetic medicines; calcium antagonists (dihydropyridine
type); catecholamine depleting agents; baclofen; amifostine; for other combinations requiring careful consideration, see full PI.ADVERSE EFFECTS: Headache, dizziness,
tiredness, fatigue, paraesthesia, constipation, nausea, diarrhoea, cardiac failure aggravated, bradycardia, hypotension, dyspnoea, oedema, slowed AV conduction/
AV-block, bronchospasm. Post-marketing reports of hypersensitivity, angioneurotic oedema, abnormal hepatic function, acute pulmonary oedema, acute renal failure,
myocardial infarction, others see full PI. DOSAGE AND ADMINISTRATION: Once daily dosing, can be given with or without meals, consistent approach is recommended.
Hypertension: 5 mg daily. Renal insufficiency: recommended starting dose is 2.5 mg daily, can be increased to 5 mg if needed. Patients > 65 years: recommended
starting dose is 2.5 mg daily, can be increased to 5 mg if needed. Patients > 75 years: caution must be exercised and these patients monitored closely.Chronic Heart
Failure: The initial up titration should be done gradually at 1-2 wk intervals based on patient tolerability starting at 1.25 mg once daily, increased to 2.5 mg, then to 5 mg
and then to 10 mg once daily. Initiation of therapy and every dose increase should be done under close supervision for at least 2 h. No dose adjustment is required in
patients with mild to moderate renal insufficiency. Use in patients with severe renal insufficiency (serum creatinine ≥ 250 µmol/L) is not recommended. Date prepared
17 December 2015. References: 1. Nebilet Approved Product Information, 14 December 2015. 2. Flather MD et al. Eur Heart J 2005; 26: 215–25.
PBS Information: Restricted benefit. Moderate to severe heart failure.
Refer to PBS Schedule for full restricted benefit information.
Please review full Product Information before prescribing.
The Product Information can be accessed at
A. Menarini Australia Pty Ltd. ABN 62 116 935 758, Level 8, 67 Albert Avenue, Chatswood NSW 2067
Medical Information 1800 644 542. NEB-AU-0501 April 2016 • ALMIN.1.2
NEBILET: Age proven in elderly (≥70 years) CHF patients1,2
Elderly (≥70 years) CHF patients
deserve an age proven blocker1,2
NEBILET reduced the risk of all cause mortality or cardiovascular
hospitalisation in a broad range of elderly CHF patients*1,2
* vs placebo P= 0.039; patients ≥ 70 years regardless of age, gender or left
ventricular ejection fraction
CHF= Chronic Heart Failure
N bilet® ( ebivolol hydrochloride) tablets 1.25 mg, 5 mg, 10 mg. INDICATIONS: Essential hypertension ct to standard
therapies in patients 70 years or old r. CONTRAINDICATIONS: Hypersensitivity to the active or any of the airment; acute
heart failur ; cardiogenic shock or episodes of heart failure decompens tion requiring IV inotropic therapy; sick si us syndrom , including sino-atrial lock; second
and third degree heart lock (with ut pacemaker); history of bronchospasm (e.g. including COPD) and/or asthma; untreated phaeochromocytoma; metabolic acidosis;
bradycardia (HR < 60 bpm prior to starting therapy); hypotension (systolic BP < 100 mmHg); severe peripheral circulatory disturbances. PRECAUTIONS: void abrupt
cessation unless clearly indicated – reduce dosage gradually over 1-2 wks; refer to full PI. If it must be withdrawn abruptly, close observation is required. Anaesthesia;
untreated congestive heart failure, unless stabilised; bradycardi ; peripheral circulatory disorders (e.g. Raynaud’s disease, intermittent claudication); first degree heart
block; Prinzmetal’s or variant angina; lipid and carb hydrate metabolism – does not affect gluc se levels in diabetic patient , but may mask symptoms of hypoglycaemia.
Hyperthyroidism; COPD/asthma; phaeochrom cytoma; various skin rashes; conjunctival xerosis; culomucocutane us syndrome; psoriasis; increased sensitivity to
allergens and severity of anaphyl ctic reactions; galactose intolerance, Lapp-lactase defi i ncy or glucose- al ctose malabsorption; driving vehicles or operating
machines. Pregnancy (Cat C). Lactation. Children and adolescents. Renal and hepatic insufficiency – see Dosage and Administration. INTERACTIONS: Combination not
recommended: Class I antiarrhythmics; calcium channel antagonists (verapamil/dilitiazem); centrally-acting antihypertensives; other bet -blockers (incl. eye drops).
Combin tion to be used with cautio : Class III a ti rrhythmic drugs; anaesthetics (volatile); i sulin and other oral diabetic medicines; calcium antagonists (di ydropyridine
type); catecholamine depleting agent ; b cl fen; amifostine; for other combinations requiring careful consideration, see full PI.ADVERSE EFFECTS: Hea ache, dizziness,
tiredness, fatigue, raesthesia, constipation, nausea, diarrhoea, cardiac failure aggravated, bradycardia, hypotension, dyspnoea, oedema, slowed AV conduction/
AV-block, bronchospasm. Post-marketing reports of hypersensitivity, angioneurotic oedema, bnormal hepatic functi n, acute pulmonary oedema, acut renal failure,
myocardial infarction, others see full PI. DOSAGE AND ADMINISTRATION: Once daily dosing, can be given with or without m als, consistent approach i reco ended.
Hypertension: 5 mg daily. Renal insuffi i ncy: recommended starting dose is 2.5 mg daily, can be increased to 5 mg if needed. Patients > 65 years: recommended
starting dose is 2.5 mg daily, can be increased to 5 mg if needed. Patients > 75 years: caution must be exercised and these patients monitored closely.Chronic Heart
Failure: The initial up titration should be done gradu lly at 1-2 wk intervals based on patie t tolerability starting at 1.25 mg once daily, increased to 2.5 mg, then to 5 mg
and then to 10 mg nce daily. Initiatio of therapy and every dose increas should be done under close supervision for at least 2 h. N dose adjustment is required in
patients with mild to moderate renal insufficiency. Use in patients with severe renal insufficiency (serum creatinine ≥ 250 µmol/L) is not recommended. Date prepared
17 December 2015. References: 1. Nebilet Approved Product Information, 14 December 2015. 2. Flather MD et al. Eur Heart J 2005; 26: 215–25.
PBS Information: Restricted benefit. Moderate to severe heart failure.
Refer to PBS Schedule for full restricted benefit information.
Please review full Product Information
The Product Information can be accessed at
A. Menarini Australia Pty Ltd. ABN 62 116 935 758, Level 8, 7 lbert Avenue, Chatswood NSW 2067
Medical Information 1800 644 542. NEB-AU-0501 April 2016 • ALMIN.1.2
NEBILET: Age proven in elderly (≥70 years) CHF patients1,2
Elderly (≥70 years) CHF patients
deserve an age proven blocker1,2
NEBILET reduced the risk of all cause mortality or cardiovascular
hospitalisation in a broad range of elderly CHF patients*1,2
* vs placebo P= 0.039; patients ≥ 70 years regardless of age, gender or left
ventricular ejection fraction
CHF= Chronic Heart Failure
bilet® (nebivolol hydrochloride) tablets 1.25 mg, 5 mg, 10 mg. INDICATIONS: Essential hypertension. St ble ch on c heart failure (CHF) s an j nct to stand
rapies in patients 70 y ars or older. CONTRAINDICATIONS: Hypersensitivity to the active or any of the excipients; liver insufficiency or liver function impairment; ac
art failure; cardiogenic shock or episodes of heart failure decompensation requiring IV inotropic therapy; sick sinus syndrome, including sino-atrial block; sec
d third degree heart block (without a pacemaker); history of bronchospasm (e.g. including COPD) and/or asthma; untreated phaeochromocytoma; metabolic acido
dycardia ( R < 60 bpm prior to starting therapy); hypotensi n ( ystolic BP < 100 mmHg); severe peripheral circulatory disturbances.PRECAUTIONS: Avoid abr
ssation unless clearly indicated – redu e dosage gradu lly ver 1-2 wks; refer to full PI. If it must be withdrawn abruptly, close observation is required. Anaesthe
treated congestive heart f ilure, unless stabilised; bradycardia; peripheral circulatory disorders (e.g. Ray aud’s di ea e, intermittent claudication); first degree he
ck; Prinzmetal’s or variant angina; lipid and carbohydrate metabolism – does not affect glucose levels in diabetic patients, but may mask symptoms of hypoglycae
perthyroidism; COPD/asthma; phaeochromocytoma; various skin rashes; conjunctival xerosis; oculomucocutaneous syndrome; psoriasis; increased sensitivity
ergens and sev rity of anaphylactic reactions; galactose intolerance, Lapp-lactase deficienc or glucos -galactose malabsorption; driving vehicles or operat
chines. Pregnan y (Cat C). Lactati n. Children and adolescents. enal and hepatic insufficiency – see Dosage and Admin t ation. INTERACTIONS: Combination
ommended: Class I antiarrhythmics; calcium channel antagonists (verapamil/dilitiazem); centrally-acting antihyp rtensives; other beta-blockers (incl. eye dro
mbination to be used with caution: Class III antiarrhythmic drugs; anaesthetics (volatile); insulin and other oral diabetic medicines; calcium antagonists (dihydropyrid
e); catecholamine depleting agents; baclofen; amifostine; for other combinations requiring careful consideration, see full PI.ADVERSE EFFECTS: Headache, dizzine
dness, fatigue, paraesthesia, constipation, nausea, diarrhoea, cardiac failure aggravate , bradycardia, hypotension, dyspn ea, oedema, slowed AV conducti
-block, bronchospasm. Post- arke ing reports of h persensi vity, angion urotic oedema, abnor al hepatic function, acute pulmonary oedema, acute renal fail
ocardial infarction, others see ull PI. DOSAGE AND ADMINISTRATION: Once daily dosing, can be given with or without meals, consistent approach is recommend
pertension: 5 mg daily. Renal insufficiency: recommended starting dose is 2.5 mg daily, can b increased to 5 mg if needed. Patients > 65 years: recommen
rting dose is 2.5 mg daily, can be increased to 5 g if needed. Patients > 75 years: caution must be exercised and these patients monitored closely. Chronic He
ilure: The initial up titration should be done gradually at 1-2 wk intervals based on patient tolerability starting at 1.25 mg once daily, increased to 2.5 mg, then to 5
d then to 10 mg once daily. Initiation of therapy and every dose increase should be done under close supervision for at least 2 h. No dose adjustment is require
tients with mild to moderate renal insufficiency. Use in patients with severe renal insufficiency (serum creatinine ≥ 250 µmol/L) is not recommended. Date prepar
PBS Information: Restricted benefit. Moderate to severe heart failure.
Refer to PBS Schedule for full restricted ben fit information.
Please review full Product Informatio
The Pr duct Information can be accessed at
NEBILET: Age proven in elderly (≥70 y rs) CHF patients1,2
Elderly (≥70 years) CHF patients
deserve an age proven blocker1,2
NEBILET reduced the risk of all cause mortality or cardiovascular
hospitalisation in a broad range of lderly CHF patients*1,2
* vs placebo P= 0.039; patients ≥ 70 years regardless of age, gender or left
ventricular ejection fraction
F= Chronic Heart Failure