Each film coated tablet of Nebivel® contains:

• Nebivolol        2.5 mg
• Nebivolol         5 mg
• Nebivolol        10 mg
• Nebivolol         20 mg (as Nebivolol Hcl).

• Nebivel® prevents increased heart rate, controls heart pumping strength.
• It also exerts a dilating action on blood vessels, which contributes as well to lower blood pressure.
• Nebivel® is also used to treat mild and moderate chronic heart failure in patients aged 70 or over, in addition to other therapies.

do not take this medcine if you:

• Are allergic to nebivolol or any of the other ingredients in Nebivel® . 
• Have heart failure and you notice that your symptoms are getting worse. For example you feel more tired, are out of breath more often, or have   
  swelling of the ankles.
• Have severe heart damage and your heart is not able to pump enough blood to meet your body’s needs.
• Have a slow or irregular heart beat.
• Have an abnormal heart rate or rhythm.
• Have a problem with your heart’s electrical conduction (that causes you to have chest pain, difficulty breathing, nausea, fatigue and fainting).
• Have severe liver disease.
• Have serious problems with blood flow in your feet and legs (peripheral artery disease).

Have one of the following rare hereditary diseases:

• Galactose intolerance.
• Lapp lactase deficiency.
• Glucose Galactose malabsorption.
• You are 18 years and younger.

the following drugs may ineract with Nebivel® :   

• Drugs used for lowering blood pressure (such as ACE inhibitors (such as lisinopril), Calcium channel blockers (such as verapamil and diltiazem) and Clonidine.
• Drugs used to treat depression and mood disorders (such as fluoxetine, paroxetine, and venlafaxine)
• Anesthetic drugs used during surgery (such as ether and cyclopropane)
• Drugs used to treat diabetes such as insulin and oral medicines.
• Drugs used to treat heartburn and ulcers (such as cimetidine)
• Antidiuretic drugs used to reduce the fluid build-up in your body (such ashydrochlorothiazide, furosemide and spironolactone)
• Sildenafil, a drug used to treat erectile dysfunction
• Drugs used to treat HIV/AIDS
• Drugs used to treat heart rhythm disorders (such as amiodarone، disopyramide، flecainide and digoxin)
• Dexamethasone, a steroid drug used to treat inflammation
• Rifampin used to treat tuberculosis
• Fingolimod, a medicine used to treat multiple sclerosis

• Nebivel® should not be used during pregnancy, unless clearly necessary.
• It is not recommended for use while breast-feeding.
• If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby,ask your doctor or pharmacist for advice before taking this medicine.

¤ These are not all the possible side effects you may feel when you are taking Nebivel®.If you experience any side effects not listed here, contact your healthcare professional.

Side effects may include:

• Cough
• Diarrhea
• Dizziness
• Dry mouth
• Headache
• Joint and back pain
• Nausea
• Stuffy nose and colds
• Tiredness
• Trouble sleeping
• Serious side effects:

Common:

• Bradycardia: decreased heart rate that causes you to be dizzy or faint. 
• Chest pain. 

Uncommon:

• Allergic reactions: rash, swelling of the lips, face or neck, difficulty breathing or speaking.
• Heart attack: chest pain, squeezing or pressure, fast or irregular heartbeat,nausea, trouble breathing, sweating.
• Heart conduction disorders: feeling lightheaded, dizzy, or passing out.
• Hypotension (low blood pressure):dizziness or lightheadedness leading to fainting can occur when changing positions, for example from lying down to standing up.
• Irregular heart beats or heart palpitations (skipped beats).
• Leg swelling from fluid retention .
• Memory problem
• Shortness of breath 
• Skin reactions: rash 
• Vision problems

• Always take this medicine exactly as your doctor has told you.
• Check with your doctor or pharmacist if you are not sure.
• Nebivel® may be taken before, during or after the meal, but, alternatively, you can take it independently of meals,the tablet is best taken with some water.

Usual Adult dose:

• Starting daily dose: 5 mg once a day
• Maximum daily dose: 20 mg once a day

Your doctor may:

• start you on a different dose or change your dose over time depending on how Nebivel® works for you.
• add another medicine like a diuretic (water pill) or an ACE inhibitor for you to take along with Nebivel® to treat your high blood pressure.
• Do not stop taking Nebivel® or change your dose without consulting your doctor because this can be dangerous.

• Have asthma or other lung problems (like bronchitis or emphysema).
• Have a history of heart problems.
• Have a history of fainting.
• Have diabetes and take medicine to control your blood sugar or have low blood sugar (hypoglycemia).
• Have a condition called pheochromocytoma (a tumour of the adrenal gland).
• Have thyroid problems.
• Have liver or kidney problems.
• Have had allergic reactions or have allergies.
• Are scheduled for surgery and will be given an anesthetic.
• Develop a skin rash while taking Nebivel®.

 Other warnings you should know about:

• Do not stop taking Nebivel® suddenly. This could cause chest pain or a heart attack. If your doctor decides that you should stop taking Nebivel®, your dose may be reduced so that you need to use less and less before you stop the medication completely.

Children and adolescents:

• Because of the lack of data on the use of the product in children and adolescents, Nebivel® is not recommended for use in them.

• Nebivel® film coated tablets  (Blister of 10 tablets, pack of 2 blisters).

• Store at a temperature below 25 °C.
• Protect from light