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Introduction About NEBULA D TABLET
NEBULA D TABLET is a combination of Indapamide and Nebivolol which belongs to the group of medicines called Anti-hypertensive agents. NEBULA D TABLET is used to manage hypertension (high blood pressure).
Hypertension is a condition in which force of the blood is consistently high against the walls of the arteries which can increase the risk of heart disease, kidney disease or stroke.
Before taking NEBULA D TABLET, inform your doctor if you are pregnant or breast-feeding. Consult your doctor for advice.
Inform your doctor if you have any problems related to kidney, liver, lungs, or heart and if you have other conditions such as diabetes, psoriasis, gout, or metabolic acidosis (excess acid in blood).
NEBULA D TABLET is not recommended for use in children and adolescents less than 18 years of age. If you are taking any other medicines for other conditions or if you have history of drug allergy inform your doctor as it may manage drug-related interactions and serious side effect.
The most common side effect of NEBULA D TABLET are headache, dizziness, tiredness, nausea, and constipation. Consult your doctor for advice if your side effects get worsen over the time.
Uses Of NEBULA D TABLET
- Used to manage hypertension (high blood pressure)
How NEBULA D TABLET Works
NEBULA D TABLET helps to reduce high blood pressure, where Indapamide works by decreasing the extra fluid volume and works by managing reabsorption of sodium in the kidneys, which in turn it relaxes the blood vessels and makes the blood flow more easily in the passage of blood vessels and thus lowers the blood pressure. Nebivolol works by reducing the force of contraction of the heart muscles by the blocking the effects of certain hormones called adrenaline and making the heart to beat more easily thus it lowers the blood pressure.
How to use NEBULA D TABLET
Take NEBULA D TABLET as directed by your physician. Swallow the medicine as a whole and do not crush or chew the medicine. Your doctor will decide the right dose depends on your age, body weight and disease condition.
Side Effects Of NEBULA D TABLET
Common
- headache
- nausea
- tiredness
- dizziness
- unusual itching or tingling sensation
- diarrhea
- constipation
- shortness of breath
- swollen hands or feet
- skin rash
- signs of low potassium levels in the blood (muscle twitches, cramps, and irregular heart rhythm)
Uncommon
- vomiting
- indigestion, flatulence
- purple spots on skin
- impotence (inability to achieve erection)
- low sodium levels in blood leading to dehydration and low blood pressure
- slow heartbeat
- low blood pressure
- visual disturbances
- cramps-like leg pain while walking
- depression, nightmares
Rare
- dry mouth
- signs of low chloride levels in blood (fluid loss, tiredness, breathing difficulty)
- signs of low magnesium levels in blood (loss of appetite, shaking, muscle spasms)
Stop taking NEBULA D TABLET and contact your doctor immediately if you experience any of the following side effects:
- severe allergic reactions like angioedema (such as swelling of the hands, legs, face, lips, tongue, and throat or airways which can lead to difficulty in breathing or swallowing)
- severe skin reactions like stevens-johnson syndrome (such as skin rash and reddening of skin all over the body, itching, blistering of skin, peeling and swelling of the skin, including ulcers of the mouth, throat, eyes, nose, and genitals)
- life-threatening irregular heartbeat
- hepatic encephalopathy (brain disease caused by liver illness)
- inflamed pancreas (may cause severe stomach and back pain accompanied with general illness)
- inflammation of liver (hepatitis)
- muscle weakness, cramps, tenderness, or pain associated with high body temperature and general illness due to abnormal muscle breakdown
How To Manage Side Effects
Diarrhoea:
Drink plenty of fluids such as water, fruit juices to avoid dehydration in your body. Consult your doctor if your symptom does not improve.
Constipation:
Take fiber rich foods in your diet such as fresh fruits, vegetables and whole grain cereals, and drink plenty of fluids. Exercise more regularly and stay active. Consult your doctor if your symptom worsens.
Nausea:
Try to take this medicine with, or just after, a meal or snack and stick to simple meals and do not eat oil rich or spicy food. Consult your doctor if your symptom does not improve.
Dizziness:
Lie down until dizziness passes away and then move slowly and carefully. Take plenty amount of rest and drink plenty of fluids. Consult your doctor if your symptom worsens.
Headache:
Apply hot or cold-water bag on your head. Try taking rest in a quiet and dark room. Drink tea or coffee. Consult your doctor if your symptom worsens.
Warning & Precautions
Pregnancy
NEBULA D TABLET is not recommended for use during pregnancy. Consult your doctor for advice before taking NEBULA D TABLET.
Breastfeeding
NEBULA D TABLET is not recommended for use in breast-feeding women. Consult your doctor for advice before taking NEBULA D TABLET.
Driving and Using Machines
Do not drive or operate any machines if you experience dizziness, or tiredness due to low blood pressure. Consult your doctor for advice before taking NEBULA D TABLET.
Alcohol
Consumption of alcohol is not recommended during management with NEBULA D TABLET.
Kidney
NEBULA D TABLET is not recommended for use in patients with severe kidney disease. It should be used with caution in patients with severe kidney impairment or kidney problems. Consult your doctor before taking NEBULA D TABLET.
Liver
NEBULA D TABLET is not recommended for use in patients with severe liver disease or impairment, hepatic encephalopathy and in patients with any problems in the liver. Consult your doctor for advice before taking NEBULA D TABLET.
Allergy
Do not take NEBULA D TABLET if you are allergic to Indapamide, Nebivolol or any other ingredients of this medicine.
Lungs
NEBULA D TABLET is not recommended for use in patients with history of asthma or wheezing and should be used with caution in patients with prolonged breathing problems or chronic obstructive pulmonary disease. Consult your doctor for advice before taking NEBULA D TABLET.
Heart Disease
NEBULA D TABLET is not recommended for use in patients with heart failure, heart rhythm and conduction disorders, slow heart rate or low blood pressure. It should be used with caution in patients with chest pain and first-degree heart block. Consult your doctor for advice before taking NEBULA D TABLET.
Others
NEBULA D TABLET is not recommended if you have:
- low levels of potassium in the blood
- metabolic acidosis
- unmanageed phaeochromocytoma
- very low or no urine production (anuria)
- poor circulatory problems in arms or legs
Before taking NEBULA D TABLET, inform your doctor if you have:
- diabetes
- gout
- symptoms of fluid accumulation in the vascular layer of the eye (choroidal effusion) or increase in eye pressure (such as eye pain or low eye vision, if left unmanageed it may lead to permanent vision loss)
- muscle disorders such as muscle pain, tenderness, weakness, or cramps
- photosensitivity reactions
- test to check your parathyroid gland functions
- psoriasis
- thyroid problems
- upcoming surgery or procedures
Use in pediatrics:
NEBULA D TABLET is not recommended for use in children and adolescents below 18 years of age. Consult your doctor before taking NEBULA D TABLET.
Use in geriatrics:
NEBULA D TABLET should be used with caution in elderly patients, usually initiating the management with the lowest effective dose. Consult your doctor for advice before taking NEBULA D TABLET.
Interactions
A. Drug - Drug interactions:
Before taking NEBULA D TABLET inform your doctor, if you are taking any of these following medicines:
- quinidine, hydroquinidine, disopyramide, amiodarone, sotalol, digoxin, ibutilide, clonidine, nifedipine, nimodipine (used to manage heart rhythm problems or high blood pressure)
- amitriptyline, nortriptyline, aripiprazole, clozapine and neuroleptic drugs such as sulpiride, amisulpiride, haloperidol (used to manage depression, anxiety and schizophrenia)
- phenobarbital, phenytoin, carbamazepine (used to manage seizures)
- bepridil (used to manage angina)
- cisapride (used to manage reduced movement of the gullet and stomach)
- diphemanil (used to manage gastro-intestinal problems)
- sparfloxacin, moxifloxacin, erythromycin, trimethoprim (used to manage bacterial infections)
- vincamine (used to manage cognitive disorders in elderly including memory loss)
- halofantrine (used to manage certain types of malaria)
- pentamidine (used to manage pneumonia)
- mizolastine, astemizole (used to manage allergic reactions such as hay fever)
- amphotericin B (used to manage fungal infections)
- aspirin or ibuprofen (used to manage pain and swelling)
- prednisolone, hydrocortisone (used to manage swelling)
- enalapril, ramipril (used to manage high blood pressure)
- bisacodyl (used to manage constipation)
- allopurinol (used to manage gout)
- metformin (used to manage diabetes)
- baclofen (used to manage muscle spasm)
- amifostine (used as protective agent during cancer management)
- spironolactone, amiloride (used to retain or increase potassium levels)
- iodinated contrast media (used for tests involving X-rays)
- calcium supplements
- tetracosactide (used to manage crohn’s disease)
- methadone (used to manage addiction)
- ciclosporin, tacrolimus (used to manage organ rejection after transplant and manages autoimmune disease)
- chlorpromazine, prochlorperazine (used to manage nausea and vomiting)
- salbutamol, theophylline (used to manage asthma)
- oxymetazoline, naphazoline (used to manage blocked nose)
- travoprost, bimatoprost (used to manage glaucoma)
- cimetidine (used to manage excess stomach acid or ulcers)
Overdosage:
If you or anyone else accidentally takes too much of NEBULA D TABLET, consult your doctor immediately. Symptoms of overdose are nausea, vomiting, slow heartbeat, low blood pressure with possible of fainting, breathlessness, cramps, drowsiness, dizziness, confusion, changes in amount of urine produced by the kidneys.
Synopsis
| Drug | : | Indapamide, Nebivolol |
| Pharmacological Category | : | Thiazide like diuretics and Beta-blockers |
| Therapeutic Indication | : | Hypertension |
| Dosage Forms | : | Tablet |
More Information
- Keep NEBULA D TABLET out of reach to children
- Store at room temperature
FAQs About NEBULA D TABLET
Q: For how long should I take NEBULA D TABLET?
A: You should continue taking NEBULA D TABLET unless your doctor tells you to stop taking the medicine. Your doctor may change management with other medicine if you do not attain effective therapeutic outcome with NEBULA D TABLET.
Q: Can NEBULA D TABLET cause sunburn skin reactions?
A: Yes, NEBULA D TABLET may cause patients to become more sensitive to sunlight or ultraviolet radiation. Avoid going out or minimize the exposure of natural sunlight or artificial UV rays. Inform your doctor if you have previous history of skin problems before taking NEBULA D TABLET.
Q: What to do If I miss to take NEBULA D TABLET?
A: You should take NEBULA D TABLET immediately when you remember. If it is time for your next dose skip the dose and follow your regular dose schedule. Do not double the dose to match up your missed dose.
Q: Does NEBULA D TABLET impair ability to drive?
A: Yes, NEBULA D TABLET may cause dizziness, or tiredness due to low blood pressure, do not drive or operate any machines which requires concentration because it can impair your ability to drive or work.
Q: Can NEBULA D TABLET cause electrolyte disturbances?
A: Yes, NEBULA D TABLET may cause electrolyte disturbances, mainly low blood potassium or low sodium levels. Inform your doctor if you have any symptoms (such as tiredness, drowsiness, restlessness, muscle cramps or weakness, nausea or vomiting, fast heart rate or pulse, and low blood pressure) while taking NEBULA D TABLET as it may be due to altered electrolyte levels.
References
1. KD. Tripathi. Diuretics & Antihypertensive Drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page – 583; 149 & 563.
2. J H Morledge. Clinical efficacy and safety of indapamide in essential hypertension. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. July 1983. [Accessed 12th April 2022] https://pubmed.ncbi.nlm.nih.gov/6346846/
3. Jun-Ying Liu, Li-Na Guo, Wan-Zhong Peng, Yang Jiang, Ai-Li Wang, Xue-Min Guo, Ze-Sheng Xu. Efficacy and safety of nebivolol in hypertensive patients: a meta-analysis of randomized controlled trials. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. October 2020. [Accessed 12th April 2022] https://pubmed.ncbi.nlm.nih.gov/33081551/
4. Servier (Ireland) Industries Ltd. Electronic Medicines Compendium (EMC). [Revised in October 2021] [Accessed 12th April 2022] https://www.medicines.org.uk/emc/files/pil.1152.pdf
5. Balkanpharma Dupnitsa AD. Health Products Regulatory Authority (HPRA). [Revised on May 2021] [Accessed 12th April 2022] http://www.hpra.ie/img/uploaded/swedocuments/80c0a2ec-3e9a-4b23-915c-984871eb9d11.pdf
6. Mylan Laboratories, Inc. U.S. Food & Drug Administration. [Revised in June 2011] [Accessed 12th April 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021742s013lbl.pdf
7. Aventis Pharmaceuticals Inc. U.S. Food & Drug Administration. [Revised in July 2005] [Accessed 12th April 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/018538s028lbl.pdf
Useful Diagnostic Tests
- Kidney function test
Author Details
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