سعر مافيلور بلس 5/12.5 مجم 2024

Fixed-dose combination of nebivolol 5 mg and hydrochlorothiazide 12.5 mg film-coated tablets (Multi-Apex, Egypt) for hypertension; pack of 30 tablets.

• Treatment of essential hypertension in patients whose blood pressure is adequately controlled on nebivolol 5 mg and hydrochlorothiazide 12.5 mg given concurrently.Population: Adultsmedicines.ie (Ireland; IPHA medicines information, HPRA-authorised product)

• Common adverse reactions reported with nebivolol alone include headache, dizziness, paraesthesia, dyspnoea, constipation, nausea, diarrhoea and tiredness; uncommon reactions include bradycardia, heart failure, AV block, hypotension, bronchospasm, nightmares, depression and impotence.International label, same formulation · medicines.ie (Ireland; IPHA medicines information, HPRA-authorised product)

• Hypersensitivity to the active substances, excipients or other sulphonamide-derived substances; liver insufficiency; anuria or severe renal insufficiency (CrCl <30 mL/min); acute heart failure, cardiogenic shock or decompensation needing IV inotropes; sick sinus syndrome including sino-atrial block; second- and third-degree AV block without pacemaker; bradycardia below 60 bpm before treatment; hypotension (systolic <90 mmHg); severe peripheral circulatory disturbances; history of bronchospasm or asthma; untreated phaeochromocytoma; metabolic acidosis; refractory hypokalaemia, hypercalcaemia, hyponatraemia and symptomatic hyperuricaemia.International label, same formulation · medicines.ie (Ireland; IPHA medicines information, HPRA-authorised product)

• In ischaemic heart disease, stop the beta-blocker gradually over 1-2 weeks; reduce the dose if resting pulse falls below 50-55 bpm or bradycardia symptoms occur; use with caution in peripheral circulatory disorders, first-degree AV block and Prinzmetal angina.International label, same formulation · medicines.ie (Ireland; IPHA medicines information, HPRA-authorised product)
• Nebivolol may mask symptoms of hypoglycaemia; diabetic patients should monitor blood glucose, and thiazides may impair glucose tolerance and raise cholesterol, triglycerides and uric acid (gout).International label, same formulation · medicines.ie (Ireland; IPHA medicines information, HPRA-authorised product)
• Thiazides can cause fluid and electrolyte imbalance (hypokalaemia, hyponatraemia, hypochloraemic alkalosis, hypomagnesaemia, raised calcium); determine serum electrolytes periodically, with more frequent potassium checks in patients at risk.International label, same formulation · medicines.ie (Ireland; IPHA medicines information, HPRA-authorised product)

• LithiumThiazides reduce renal lithium clearance and increase toxicity risk; combination not recommended, monitor lithium levels if needed.medicines.ie (Ireland; IPHA medicines information, HPRA-authorised product)
• Potassium-depleting drugs (other kaliuretic diuretics, laxatives, corticosteroids, ACTH, amphotericin, carbenoxolone, penicillin G sodium, salicylic acid derivatives)May potentiate hydrochlorothiazide-induced potassium loss; concomitant use not recommended.medicines.ie (Ireland; IPHA medicines information, HPRA-authorised product)
• NSAIDs (including acetylsalicylic acid >3 g/day and COX-2 inhibitors)May reduce the antihypertensive effect of thiazides.medicines.ie (Ireland; IPHA medicines information, HPRA-authorised product)

• No adequate data on the combination in pregnant women. Nebivolol should not be used during pregnancy unless clearly necessary; hydrochlorothiazide should not be used for essential hypertension in pregnancy except in rare situations where no other treatment could be used.International label, same formulation · medicines.ie (Ireland; IPHA medicines information, HPRA-authorised product)
• Nebivolol passes into animal milk and hydrochlorothiazide into human milk in small amounts; high-dose thiazides can inhibit milk production. Use during breast-feeding is not recommended.International label, same formulation · medicines.ie (Ireland; IPHA medicines information, HPRA-authorised product)

• Nebivolol: Beta-adrenergic receptor blocker; the antihypertensive mechanism is not definitively established and may involve decreased heart rate and myocardial contractility, reduced sympathetic outflow, renin suppression and vasodilation with decreased peripheral vascular resistance (US BYSTOLIC label).
• Hydrochlorothiazide: Promotes renal excretion of sodium and chloride, reducing intravascular volume.