Paracétamol Alter

Paracétamol Alter may be available in the countries listed below.

Ingredient matches for Paracétamol Alter

Paracetamol

Paracetamol is reported as an ingredient of Paracétamol Alter in the following countries:

• France

International Drug Name Search

Oxid De Zinc

Oxid De Zinc may be available in the countries listed below.

Ingredient matches for Oxid De Zinc

Zinc Oxide

Zinc Oxide is reported as an ingredient of Oxid De Zinc in the following countries:

• Turkey

International Drug Name Search

Buprenorphine/Naloxone

Pronunciation: BUE-pre-NOR-feen/nal-OX-one
Generic Name: Buprenorphine/Naloxone
Brand Name: Suboxone

Buprenorphine/Naloxone is used for:

Treating opioid dependence. It should be used as part of a complete narcotic dependence treatment plan. It may also be used for other conditions as determined by your doctor.

Buprenorphine/Naloxone is an opioid (narcotic) partial agonist-antagonist. It works by binding to receptors in the brain and nervous system to help prevent withdrawal symptoms in someone who has stopped taking narcotics.

Do NOT use Buprenorphine/Naloxone if:

• you are allergic to any ingredient in Buprenorphine/Naloxone


• you are taking sodium oxybate (GHB)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Buprenorphine/Naloxone:

Some medical conditions may interact with Buprenorphine/Naloxone. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have a history of blood or electrolyte problems, breathing or lung problems (eg, asthma, chronic obstructive pulmonary disease [COPD]), a curvature of the spine (eg, kyphoscoliosis), certain heart problems (eg, cor pulmonale), an underactive thyroid, adrenal gland problems (eg, Addison disease), liver problems (eg, hepatitis B or C), abnormal liver enzyme tests, kidney problems, an enlarged prostate gland, trouble urinating, a blockage of your bladder or urethra, seizures, or gallbladder problems


• if you have a history of stomach or bowel problems (eg, inflammatory bowel disease), blockage, or surgery


• if you have slow or shallow breathing, severe drowsiness, stomach problems, or severe or persistent diarrhea caused by antibiotic use (pseudomembranous colitis)


• if you have a history of a recent head injury, growths in the brain (eg, tumor, lesion), or increased pressure in the brain


• if you have a history of mental or mood problems, suicidal thoughts or behaviors, drug or alcohol abuse, or if you are in alcohol withdrawal

Some MEDICINES MAY INTERACT with Buprenorphine/Naloxone. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Benzodiazepines (eg, diazepam), cimetidine, narcotic pain medicine (eg, codeine), phenothiazines (eg, chlorpromazine), or sodium oxybate (GHB) because the risk of severe drowsiness, severe breathing problems, or seizures may be increased


• Azole antifungals (eg, ketoconazole, voriconazole), delavirdine, HIV protease inhibitors (eg, ritonavir), or macrolide antibiotics (eg, erythromycin) because they may increase the risk of Buprenorphine/Naloxone's side effects


• Carbamazepine, naltrexone, certain nonnucleoside reverse transcriptase inhibitors (NNRTIs) (eg, efavirenz, etravirine, nevirapine), phenobarbital, phenytoin, or rifamycins (eg, rifampin) because they may decrease Buprenorphine/Naloxone's effectiveness or withdrawal symptoms may occur


• Methadone because its effectiveness may be decreased by Buprenorphine/Naloxone

This may not be a complete list of all interactions that may occur. Ask your health care provider if Buprenorphine/Naloxone may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Buprenorphine/Naloxone:

Use Buprenorphine/Naloxone as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Do not swallow, crush, or chew sublingual tablets. Place the tablet under your tongue and allow it to slowly dissolve. Do not eat, drink, or smoke while the tablet is dissolving.


• Take Buprenorphine/Naloxone on a regular schedule to get the most benefit from it.


• Taking Buprenorphine/Naloxone at the same time each day will help you remember to take it.


• If you miss a dose of Buprenorphine/Naloxone, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Buprenorphine/Naloxone.

Important safety information:

• Buprenorphine/Naloxone may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Buprenorphine/Naloxone with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Buprenorphine/Naloxone; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.


• Do not inject Buprenorphine/Naloxone. Doing so may cause severe withdrawal symptoms, severe breathing problems, and death.


• Buprenorphine/Naloxone may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.


• Do NOT take more than the recommended dose, use more often than prescribed, or suddenly stop taking Buprenorphine/Naloxone without checking with your doctor.


• Tell your doctor or dentist that you take Buprenorphine/Naloxone before you receive any medical or dental care, emergency care, or surgery.


• Lab tests, including liver function, may be performed while you use Buprenorphine/Naloxone. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Buprenorphine/Naloxone with caution in the ELDERLY; they may be more sensitive to its effects, especially decreased breathing and drowsiness.


• Buprenorphine/Naloxone should not be used in CHILDREN younger than 16 years old; safety and effectiveness in these children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: Buprenorphine/Naloxone may cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Buprenorphine/Naloxone while you are pregnant. Buprenorphine/Naloxone is found in breast milk. Do not breast-feed while taking Buprenorphine/Naloxone.

Some people who use Buprenorphine/Naloxone for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction.

If you suddenly stop taking Buprenorphine/Naloxone, you may experience WITHDRAWAL symptoms including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping.

Possible side effects of Buprenorphine/Naloxone:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Chills; constipation; diarrhea; dizziness; drowsiness; flushing; headache; nausea; sleeplessness; stomach pain; sweating; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); anxiety or nervousness; blurred vision; confusion; dark urine; decreased attention; fainting; irregular heartbeat; loss of appetite; loss of coordination; mental or mood changes (eg, depression); pale stools; persistent trouble sleeping; severe or persistent dizziness or drowsiness; severe or persistent stomach pain or constipation; slow or shallow breathing; slowed reflexes; slurred speech; swelling of the hands, ankles, or feet; yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Buprenorphine/Naloxone side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include excessive drowsiness; severe dizziness or fainting; very slow and shallow breathing; very small pupils.

Proper storage of Buprenorphine/Naloxone:

Store Buprenorphine/Naloxone at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Buprenorphine/Naloxone out of the reach of children and away from pets.

General information:

• If you have any questions about Buprenorphine/Naloxone, please talk with your doctor, pharmacist, or other health care provider.


• Buprenorphine/Naloxone is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Buprenorphine/Naloxone. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Buprenorphine/Naloxone resources

• Buprenorphine/Naloxone Side Effects (in more detail)
• Buprenorphine/Naloxone Use in Pregnancy & Breastfeeding
• Buprenorphine/Naloxone Drug Interactions
• Buprenorphine/Naloxone Support Group
• 303 Reviews for Buprenorphine/Naloxone - Add your own review/rating

Compare Buprenorphine/Naloxone with other medications

• Opiate Dependence

Pemine

Pemine may be available in the countries listed below.

Ingredient matches for Pemine

Penicillamine

Penicillamine hydrochloride (a derivative of Penicillamine) is reported as an ingredient of Pemine in the following countries:

• Italy

International Drug Name Search

Bystolic

Generic Name: Nebivolol Hydrochloride
Class: beta-Adrenergic Blocking Agents
Chemical Name: (1RS,1′RS)-1,1′-[(2RS,2′SR)-bis(6-fluoro-3,4-dihydro-2H-1-benzopyran-2-yl)]- 2,2′-iminodiethanol hydrochloride
Molecular Formula: C₂₂H₂₅F₂NO₄•HCl
CAS Number: 152520-56-4

Introduction

β-adrenergic blocking agent.^{1 2 3 4 5 6 7 8 9 10 11 20 24}

Uses for Bystolic

Hypertension

Management of hypertension (alone or in combination with other classes of antihypertensive agents).^{1 2 3 4 5 6 10 11 24}

One of several preferred initial therapies in hypertensive patients with heart failure, postmyocardial infarction, high CHD risk, and/or diabetes mellitus.¹²

Can be used as monotherapy for initial management of uncomplicated hypertension; however, thiazide diuretics are preferred by JNC 7.¹²

Bystolic Dosage and Administration

General

• 
  

  Individualize dosage according to patient response.¹

  
  


• 
  

  If long-term therapy is discontinued, reduce dosage gradually over a period of about 1–2 weeks.¹ (See Abrupt Withdrawal of Therapy under Cautions.)

  
  


• 
  

  β₁-Adrenergic blocking selectivity diminishes as dosage is increased beyond 10 mg.¹

  
  

Administration

Oral Administration

Administer orally once daily without regard to meals.¹

Frequent administration (i.e., daily divided doses) unlikely to be more beneficial than once-daily administration.¹

Dosage

Available as nebivolol hydrochloride; dosage expressed in terms of nebivolol.¹

Adults

Hypertension

Oral

Initially, 5 mg once daily.^{1 11 24} Increase at 2-week intervals (up to 40 mg daily) in patients whose BP is uncontrolled with the initial dosage.^{1 11}

Prescribing Limits

Adults

Hypertension

Oral

Maximum 40 mg daily.¹

Special Populations

Hepatic Impairment

Initially, 2.5 mg once daily in patients with moderate hepatic impairment (Child-Pugh class B).^{1 11} Increase dosage carefully, if necessary.¹

Contraindicated in patients with severe hepatic impairment (Child-Pugh class C).^{1 6} (See Contraindications under Cautions.)

Renal Impairment

Initially, 2.5 mg once daily in patients with severe renal impairment (Cl_cr <30 mL/minute).^{1 11} Increase dosage carefully, if necessary.¹

Geriatric Patients

Dosage adjustment not required.¹

CYP2D6 Metabolizers

No dosage adjustment required in poor metabolizers of CYP2D6 substrates.^{1 7}

Cautions for Bystolic

Contraindications

• 
  

  Severe bradycardia.¹

  
  


• 
  

  Heart block greater than first degree.¹

  
  


• 
  

  Cardiogenic shock.¹

  
  


• 
  

  Decompensated cardiac failure.¹ (See Cardiac Failure under Cautions.)

  
  


• 
  

  Sick sinus syndrome (unless a functioning permanent pacemaker is present).¹

  
  


• 
  

  Severe hepatic impairment (Child-Pugh class C).¹

  
  


• 
  

  Known hypersensitivity to nebivolol or any ingredient in the formulation.¹

  
  

Warnings/Precautions

Warnings

Abrupt Withdrawal of Therapy

Abrupt discontinuance of therapy is not recommended as it may exacerbate angina symptoms or precipitate MI and ventricular arrhythmias in patients with CAD.¹ Gradually decrease dosage over a period of about 1–2 weeks; monitor patients carefully and advise patients to temporarily limit their physical activity during withdrawal of therapy.¹ If exacerbation of angina occurs or acute coronary insufficiency develops, reinstitute therapy (at least temporarily).¹

Cardiac Failure

Possible precipitation of CHF.¹

Avoid use in patients with overt CHF; use cautiously in patients with inadequate cardiac function and, if necessary, in patients with well-compensated heart failure.¹ If heart failure worsens, consider discontinuing therapy.¹

Ischemic Heart Disease

Safety and efficacy in patients with angina pectoris or recent MI have not been established.¹

Major Surgery

Possible increased risks associated with general anesthesia (e.g., severe hypotension, difficulty in restarting or maintaining a heart beat) have occurred in some patients who received β-adrenergic blocking agents.¹ Use with caution in patients undergoing major surgery involving general anesthesia, especially with myocardial-depressant anesthetics (e.g., cyclopropane, ether, trichloroethylene).¹

Effects of β-adrenergic blocking agents can be reversed by administration of β-agonists (e.g., dobutamine, isoproterenol).¹

Bronchospastic Disease

Possible bronchospasm.¹ Generally should not be used in patients with bronchospastic disease.^{1 2}

Diabetes Mellitus and Hypoglycemia

Possible decreased signs and symptoms of hypoglycemia (e.g., tachycardia) and increased insulin-induced hypoglycemia.¹

Use with caution in patients with history of spontaneous hypoglycemia and in patients with diabetes receiving hypoglycemic agents.¹

Thyrotoxicosis

Signs of hyperthyroidism (e.g., tachycardia) may be masked.¹ Possible exacerbation of hyperthyroidism or thyroid storm if therapy is abruptly withdrawn.¹

Peripheral Vascular Disease

Possible precipitation or aggravation of arterial insufficiency.¹ Use with caution.¹

Interactions

Concomitant use with nondihydropyridine calcium-channel blocking agents (e.g. verapamil, diltiazem) requires caution.¹ (See Specific Drugs under Interactions.)

General Precautions

Risk of Anaphylactic Reactions

Patients with a history of anaphylactic reactions to a variety of allergens may be more reactive to repeated accidental, diagnostic, or therapeutic challenges with allergens while taking β-adrenergic blocking agents.¹ Such patients may be unresponsive to usual doses of epinephrine.¹

Pheochromocytoma

Use with caution in patients suspected of having pheochromocytoma; initiate therapy with α-adrenergic blocking agent before using any β-adrenergic blocking agent.¹

Specific Populations

Pregnancy

Category C.¹

Lactation

Distributed into milk in rats; not known whether distributed into human milk.¹ Discontinue nursing or drug.¹

Pediatric Use

Safety and efficacy not established in children <18 years of age.¹

Geriatric Use

No substantial differences in safety or efficacy relative to younger adults.¹

Hepatic Impairment

Decreased clearance in patients with moderate hepatic impairment (Child-Pugh class B); use with caution.^{1 7} (See Hepatic Impairment under Dosage and Administration.)

Safety and efficacy not established in patients with severe hepatic impairment (Child-Pugh class C); use is contraindicated in these patients.¹ (See Contraindications.)

Renal Impairment

Decreased clearance in patients with severe renal impairment (Cl_cr <30 mL/minute); use with caution.^{1 7} (See Renal Impairment under Dosage and Administration.)

Not specifically studied in patients undergoing dialysis; use with caution in these patients.¹

Common Adverse Effects

Headache,^{1 2 3 4 5 13} fatigue,^{1 2 3 4 5 11 13} dizziness,^{1 2 3 4 5 11 13} diarrhea,^{1 3 4} nausea.^{1 3}

Interactions for Bystolic

Metabolized by CYP2D6;^{1 7 11} does not inhibit CYP isoenzymes at clinically relevant concentrations.¹

Drugs Affecting Hepatic Microsomal Enzymes

CYP2D6 inhibitors: Potential increased plasma nebivolol concentrations;^{1 11} monitor patients carefully and adjust dosage according to BP response.¹

Specific Drugs

Drug	Interaction	Comments
Antiarrhythmic agents (e.g., amiodarone, disopyramide)	Possible conduction disturbances1 2	Use concomitantly with caution1 2 24
Antidiabetic agents (oral)	May mask symptoms of hypoglycemia (e.g., tachycardia)1	Use concomitantly with caution1
β-Adrenergic blocking agents	Possible additive effects1	Concomitant use with other β-adrenergic blocking agents not recommended1
Calcium-channel blocking agents, nondihydropyridine (e.g., diltiazem, verapamil)	Possible conduction disturbances1 2 27 28	Use concomitantly with caution;1 2 24 27 28 monitor BP and ECG with concomitant use1
Catecholamine-depleting agents (e.g., guanethidine, reserpine)	Potential additive effects (e.g., hypotension, bradycardia)1 26	Monitor closely for symptoms (e.g., vertigo, syncope, postural hypotension)1 26
Charcoal (activated)	Pharmacokinetic interaction unlikely1
Cimetidine	Potential increased plasma nebivolol concentrations1 2 7 20 24 No apparent change in pharmacodynamics of nebivolol (e.g., BP, heart rate)2 7 20
Clonidine	Potential for increased rebound hypertension following discontinuance of clonidine25	If used concurrently, discontinue nebivolol therapy several days before clonidine therapy is to be gradually discontinued1 25
Digoxin	Possible additive negative effects on AV conduction and heart rate;1 increased risk of bradycardia1 Concomitant use did not affect pharmacokinetics of digoxin or nebivolol1 7 24	Use concomitantly with caution2
Diuretics (e.g., furosemide, hydrochlorothiazide, spironolactone)	Pharmacokinetic interactions unlikely1 7 24
Fluoxetine	Potential increased plasma nebivolol concentrations 1 11	Use concomitantly with caution1
Insulin	May mask symptoms of hypoglycemia (e.g., tachycardia)1	Use concomitantly with caution1
Losartan	Pharmacokinetic interaction unlikely1 7 24
Myocardial-depressant general anesthetics (e.g., cyclopropane, ether, trichloroethylene)	Increased risk of hypotension and difficulty in restarting or maintaining heartbeat1	Closely monitor with concomitant use1
Paroxetine	Potential increased plasma nebivolol concentrations 1	Use concomitantly with caution1
Propafenone	Potential increased plasma nebivolol concentrations1	Use concomitantly with caution1
Quinidine	Potential increased plasma nebivolol concentrations1	Use concomitantly with caution1
Ramipril	Pharmacokinetic interaction unlikely1 7 24
Ranitidine	Pharmacokinetic interaction unlikely; no apparent change in pharmacodynamics of nebivolol (e.g., BP, heart rate) 1 7 20 24
Sildenafil	Additive effects on BP and pulse1 Potential decreased peak plasma concentrations of sildenafil; modest effect on peak plasma concentration and AUC of d-nebivolol1
Warfarin	No effect on PT or warfarin pharmacokinetics observed1 7 24

Bystolic Pharmacokinetics

Absorption

Bioavailability

Absolute bioavailability not determined.¹

Following oral administration, mean peak plasma concentrations occur within approximately 1.5–4 hours.¹

Food

Food does not alter pharmacokinetics; however, may slightly reduce nebivolol glucuronides.¹

Distribution

Extent

Distributed into milk in rats; not known whether distributed into human milk.¹

Plasma Protein Binding

Approximately 98% (mainly albumin).¹

Elimination

Metabolism

Undergoes first-pass metabolism in the liver mainly via glucuronidation of the parent drug and, to a lesser extent, via N-dealkylation and oxidation by CYP2D6.^{1 2 7 11}

Elimination Route

Excreted in urine (38%) and feces (44%), principally as metabolites;¹ <0.5% eliminated in urine and feces as unchanged drug.^{7 11}

Half-life

12 hours for d-nebivolol.¹

Special Populations

Poor CYP2D6 metabolizers: Eliminated in urine (67%) and feces (13%), principally as metabolites.^{1 7} Half-life is 19 hours.¹

Decreased clearance in patients with moderate hepatic impairment (Child-Pugh class B) or with severe renal impairment (Cl_cr <30 mL/minute).^{1 7}

Stability

Storage

Oral

Tablets

Tight, light-resistant containers at 20–25° C.¹

ActionsActions

• 
  

  Inhibits response to adrenergic stimuli by competitively blocking β₁-adrenergic receptors within the myocardium in extensive CYP2D6 metabolizers and at doses ≤10 mg.¹ Blocks both β₁- and β₂-adrenergic receptors in poor CYP2D6 metabolizers and at doses >10 mg.¹

  
  


• 
  

  Exhibits vasodilatory effects through stimulation of endothelial nitric oxide activity;^{2 7 8 9 10 24} precise mechanism of this effect not fully elucidated.^{7 9}

  
  


• 
  

  Precise mechanism of hypotensive action not fully elucidated;¹ may reduce BP by decreasing heart rate, myocardial contractility, and sympathetic outflow from the CNS; suppressing renin activity; and/or decreasing peripheral vascular resistance as a result of its vasodilating effects.^{1 11}

  
  


• 
  

  Does not exhibit intrinsic sympathomimetic (β₁-agonist) activity, membrane-stabilizing (local anesthetic) activity, or α₁-adrenergic blocking activity at clinically relevant concentrations.^{1 7}

  
  


• 
  

  Racemic mixture: d-isomer has substantial β-adrenergic blocking activity; l-isomer appears to be pharmacologically active, but precise contribution to pharmacologic effects not fully established.^{2 7}

  
  

Advice to Patients

• 
  

  Importance of taking nebivolol exactly as prescribed.¹

  
  


• 
  

  Importance of not interrupting or discontinuing therapy without consulting a clinician;¹ patients should temporarily limit physical activity when discontinuing therapy.¹

  
  


• 
  

  If a dose is missed, importance of patient taking only the next scheduled dose (i.e., the next dose should not be doubled).¹

  
  


• 
  

  Importance of avoiding some activities (e.g., driving, operating machinery) until effects on the patient are known.¹

  
  


• 
  

  Importance of warning patients receiving insulin or oral hypoglycemic agents and those subject to spontaneous hypoglycemia that β-adrenergic blocking agents can mask some symptoms of hypoglycemia (e.g., tachycardia).¹

  
  


• 
  

  Importance of immediately informing clinician at the first sign or symptom (e.g., weight gain, shortness of breath) of CHF.¹

  
  


• 
  

  Importance of patients informing their anesthesiologist or dentist about nebivolol therapy before undergoing major surgery.¹

  
  


• 
  

  Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses.¹

  
  


• 
  

  Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.¹

  
  


• 
  

  Importance of informing patients of other important precautionary information.¹ (See Cautions.)

  
  

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Nebivolol Hydrochloride

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets	2.5 mg (of nebivolol)	Bystolic	Forest
		5 mg (of nebivolol)	Bystolic	Forest
		10 mg (of nebivolol)	Bystolic	Forest
		20 mg (of nebivolol)	Bystolic	Forest

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Bystolic 10MG Tablets (FOREST): 30/$69.99 or 90/$193.95

Bystolic 2.5MG Tablets (FOREST): 30/$67.77 or 90/$186.96

Bystolic 20MG Tablets (FOREST): 30/$68.98 or 90/$184.7

Bystolic 5MG Tablets (FOREST): 30/$67.77 or 90/$182.29

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions July 2009. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

1. Forest Laboratories, Inc. Bystolic (nebivolol) tablets prescribing information. St. Louis, MO; 2008 Aug.

2. Veverka A, Nuzum DS, Jolly JL. Nebivolol: A third-generation β-adrenergic blocker. Ann Pharmacother. 2006; 40:1353-60. [PubMed 16822893]

3. Weiss RJ, Weber MA, Carr AA et al. A randomized, double-blind, placebo-controlled parallel-group study to assess the efficacy and safety of nebivolol, a novel β-blocker, in patients with mild to moderate hypertension. J Clin Hypertens. 2007; 9:667-76.

4. Saunders E, Smith WB, DeSalvo KB et al. The efficacy and tolerability of nebivolol in hypertensive African American patients. J Clin Hypertens. 2007; 9:866-75.

5. Gradman AH. Addition of the β-blocker nebivolol to ongoing therapy in the management of mild-moderate hypertension. Poster presentation from American Society of Hypertension 22nd Annual Meeting; Chicago, IL; May 19-22, 2007.

6. Forest Laboratories, Inc., St. Louis, MO: Personal communication.

7. Prisant LM. Nebivolol: pharmacologic profile of an ultraselective, vasodilatory β₁-blocker. J Clin Pharmacol. 2008; 48:225-39. [PubMed 18083889]

8. Mason RP, Kalinowski L, Jacob RF et al. Nebivolol reduces nitroxidative stress and restores nitric oxide bioavailability in endothelium of black Americans. Circulation. 2005; 112:3795-801. [PubMed 16330685]

9. Dessy C, Saliez J, Ghisdal P et al. Endothelial B3-adrenoreceptors mediate nitric oxide-dependent vasorelaxation of coronary microvessels in response to the third-generation β-blocker nebivolol. Circulation. 2005; 112:1198-205. [PubMed 16116070]

10. Rosei EA, Rizzoni D. Metabolic profile of nebivolol, a β-adrenoceptor antagonist with unique characteristics. Drugs. 2007; 67:1097-107. [PubMed 17521213]

11. Anon. Nebivolol (Bystolic) for hypertension. Med Lett Drugs Ther. 2008; 50:17-9. [PubMed 18323772]

12. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) Express. Bethesda, MD: May 14 2003. From NIH website. (). (Also published in JAMA. 2003; 289.)

13. Van Nueten L, Taylor FR, Robertson JL.. Nebivolol vs. atenolol and placebo in essential hypertension: a double-blind randomised trial. J Hum Hypertens. 1998; 12:135-40. [PubMed 9504355]

14. Uhlir O, Feifusa M, Havanek K et al. Nebivolol versus metoprolol in the treatment of hypertension. Drug Invest. 1991; 3(Suppl):107.

15. Rosei EA, Rizzoni D, Comini S et al. Evaluation of the efficacy and tolerability of nebivolol versus lisinopril in the treatment of essential arterial hypertension: a randomized, multicentre, double-blind study. Blood Pressure 2003; (Suppl 1): 30-35. [PubMed 21067346]

16. Van Bortel LM, Bulpitt CJ, Fici F. Quality of life and antihypertensive effect with nebivolol and losartan. Am J Hypertens. 2005; 18:1060-6. [PubMed 16296572]

17. Van Nueten LM. , Schelling A, Verommen C et al. Nebivolol vs enalapril in the treatment of essential hypertension: a double-blind randomised trial. J Hum Hypertens. 1997; 11:813-9. [PubMed 9468009]

18. Van Nueten LM. , Lacouriere Y, Vyssoulis G et al. Nebivolol versus nifedipine in the treatment of essential hypertension: A double-blind, randomized, comparative trial. Am J Ther. 1998; 5:237-43. [PubMed 10099065]

19. Mazza A. , Gil-Extremera B, Maldonato A et al. Nebivolol vs amlodipine as first-line treatment of essential arterial hypertension in the elderly. Blood Press. 2002; 11:182-8. [PubMed 12126265]

20. Kamali F, Howes A, Thomas SH et al. A pharmacokinetic and pharmacodynamic interaction study between nebivolol and the H2-receptor antagonists cimetidine and ranitidine. Br J Clin Pharmacol. 1997; 43:201-4. [PubMed 9131955]

21. Douglas JG, Bakris GL, Epstein M et al. Management of high blood pressure in African Americans: Consensus statement of the Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks. Arch Intern Med. 2003; 163:525-41. [IDIS 494836] [PubMed 12622600]

22. Wright JT, Dunn JK, Cutler JA et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA. 2005; 293:595-607.

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25. Boehringer Ingelheim. Catapres (clonidine hydrochloride) tablets prescribing information. Ridgefield, CT; 2007 Jan 5.

26. King Pharmaceuticals, Inc. Corgard (nadolol) tablets prescribing information. Bristol, TN; 2007 Jul.

27. Biovail Pharmaceuticals, Inc. Cardizem (diltiazem hydrochloride) capsules prescribing information. Bridgewater, NJ; 2001 Aug.

28. Pfizer. Calan (verapamil hydrochloride) tablets prescribing information. New York, NY; 2006 May.

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