Unique dose of Nebivolol – 10 mg
Hypertension is the most important modifiable risk factor for cardiovascular diseases, and according to WHO is also the major cause of premature death in the world. Based on the NATPOL and WOBASZ II studies, it is estimated that currently in Poland hypertension affects 11 million patients, and by 2035 their number may increase by up to half.
In 2019, the Polish Hypertension Society issued guidelines specifying new rules for the management of hypertension. They recommend antihypertensive therapy using preparations from five basic groups of drugs called first-line drugs, including thiazide diuretics, β-calcium antagonists, ACE inhibitors and sartans.
Place of nebivolol in the 2019 guidelines of the Polish Hypertension Society
Nebivolol is a 3rd generation cardioselective beta blocker. It is a racemic mixture of dextrorotatory and levorotatory enantiomers with different pharmacodynamic properties. D-nebivolol is a highly selective β1-blocker, while L-nebivolol is an β3 receptor agonist. Stimulation of β3 receptors stimulates the production of endogenous nitric oxide. The 2019 guidelines indicate that vasodilatation and very cardioselective ones are preferred among β-blockers. Therefore, Nebivolol is recommended for young patients up to 40 years of age with hypertension, patients with hypertension accompanied by coronary heart disease or heart failure in the elderly, patients with hypertension and potency disorders or with associated metabolic disorders. The guidelines’ authors also pay attention to the special position of nebivolol in patients requiring correction of central pressure - due to different hemodynamic properties, i.e. lower chronotropic negative effect and additional vasodilatation effect resulting from stimulation of β3 receptors.
It is noteworthy that since April 2019 nebivolol has been also available in an increased dose of 10 mg, and Biofarm is the first and so far the only pharmaceutical company in Poland that offers 10 mg of nebivolol. In accordance with SmPC of Nebicard 10 mg, an increased dose of nebivolol is indicated in patients with chronic heart failure and stable coronary artery disease. The introduction of nebivolol at a dose of 10 mg is a response to European and American cardiological guidelines.
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