X-PRESSOL 5 MG – NEBIVOLOL

Description

WHAT IS X-PRESSOL AND WHAT IS IT USED FOR 
X-Pressol contains a beta blocker nebivolol who is selective and dilates blood vessels (is vasodilator). Is used to treat high blood pressure in the arteries (hypertension). X-Pressol is also used to treat chronic heart failure in patients aged 70 years or older.

Before you use X-PRESSOL
Do not use X-Pressol • if you are allergic (hypersensitive) to nebivolol or any of the other components of X-Pressol • if you have low blood pressure (systolic or maximum pressure is less than 90 mmHg) • if you have poor blood circulation in the arms or legs • if you have a very low heart rate (less than 60 beats per minute, before starting treatment with this medicine) • if you have been diagnosed with heart conduction disorders (such as sick sinus syndrome or atrioventricular block) and you have a pacemaker • if you have acute heart failure or if you receive intravenous (by intravenous drip) to help the heart to work • have difficulty breathing or wheezing high • if you have an adrenal gland tumor called pheochromocytoma • if you have severe liver disease or liver failure • if you have metabolic acidosis (as patients with diabetes when blood sugar concentration rises too much, and the blood becomes too acidic), • if you use products containing or sultopride floctafenină.

Take special care with X-Pressol 
If you or your treatment occurs during one of the following conditions: • heart failure (inability of the heart to pump enough blood to the body needs) • easy atrioventricular block (grade I) to the heart • chest pain caused by coronary artery spasm (Prinzmetal angina or angina condition called variable) • Poor blood circulation in the arms or legs, for example, disease or Raynaud’s syndrome • long-term breathing problems • Diabetes: X-Pressol not affect blood sugar concentration, but may mask manifestations of low sugar concentration (eg, shaking, rapid heart beat). • overactive thyroid gland: X-Pressol may mask the signs of abnormal fast heart rhythm that occurs in this situation • allergy, as allergic reactions may increase and you may need more drugs to treat their • a skin disease called psoriasis since X-Pressol may worsen symptoms • wear contact lenses, because X-Pressol can reduce tearing and may cause dry eyes. In these cases, your doctor will need to adjust your treatment or control more often. If you are going to have surgery will have to be anesthetized, it is important to tell the surgeon or dentist that you are taking this medicine. If you have kidney problems, do not take this medicine for heart failure, and inform your doctor. Not recommended for use by children or adolescents under 18 years.

Taking other medicines Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription, herbal preparations, vitamins and minerals in high concentrations. Always tell your doctor or pharmacist if you use regular or began to be treated with any of the following medicines together with X-Pressol: • diltiazem or verapamil (used for high blood pressure or other heart problems). During treatment with X-Pressol, you should not be administered intravenous verapamil • medicines known as calcium channel blockers for high blood pressure or other heart problems, such as amlodipine, felodipine, lacidipină, nifedipine, nicardipine, nimodipine, nitrendipină • other anti-hypertensive or administered organic nitrates to treat chest pain • clonidine, guanfacin, moxonidine, methyldopa, rilmenidine, used to treat high blood pressure • medicines for heart arrhythmias (irregular heartbeat), such as quinidine, hydroquinidine, amiodarone, cibenzolina, flecainide, disopyramide, lidocaine, mexiletine, propafenone • Tricyclic antidepressants (for depression), phenothiazines (for psychosis), or barbiturates (for epilepsy) • medicines for diabetes (insulin or oral medications) • digoxin or other drugs called digitalis glycosides (for heart failure) • anti-inflammatory painkillers (NSAIDs) for pain and inflammation – please note that you can safely take small daily doses of aspirin used as antithrombotic (eg, 50 or 100 mg) together with X-Pressol • medicines for asthma, blocked nose or certain eye diseases such as glaucoma (increased intraocular pressure) and pupil dilation • anesthetics: always inform your anesthetist you are taking X-Pressol, before anesthesia • cimetidine (used to treat high acidity of the stomach) – X-Pressol should take with meals, between meals and the antacid drug • medicines that affect the metabolism of nebivolol, especially terbinafine (for fungal infections or fungal), bupropion (to help stop smoking), chloroquine (for malaria or rheumatoid arthritis), levomepromazine (for psychosis), paroxetine, fluoxetine, thioridazine (for depression) • amifostine (a substance used in the protective action during radiotherapy and chemotherapy) • baclofen (for muscle relaxation) • mefloquine (an antimalarial).

Using X-Pressol with food and drink
X-Pressol 5 mg tablets may be taken before, during or after meals, but they can be ingest also without food. Tablet or its parts should be swallowed with a drink of water or other liquid.

Pregnancy and lactation
Ask your doctor or pharmacist for advice before taking any medicine. X-Pressol should not be used during pregnancy unless recommended by physician.

Breastfeeding
Breast-feeding is not recommended during treatment with X-Pressol.

Driving and using machines
There have been studies on the effects on ability to drive and use machines. This medicine may cause dizziness or fainting due to blood pressure reduction. If you develop these simptoms, do not drive or operate machinery. These effects are likely to occur after initiation of treatment or after dose increases.

Important information about some of the X-Pressol
This product contains lactose. If your doctor told you that you have intolerance to some sugars, please ask your doctor before taking this medicine.

HOW TO USE X-PRESSOL Always use X-Pressol exactly as recommended by your doctor. If you are unsure on how to use, ask your doctor or pharmacist. Blood pressure (hypertension) • The usual dose is 5 mg (1 tablet) per day. It should be administered, preferably at the same time of day. • Usually, the elderly and patients with kidney problems begin treatment with a dose of 2.5 mg (half tablet) daily. • The therapeutic effect on blood pressure becomes evident after 1-2 weeks. Sometimes, the optimal effect is reached only after 4 weeks. Treatment of chronic heart failure • Treatment should be initiated and supervised by an experienced physician. • Your doctor will start treatment with a dose of 1.25 mg (quarter tablet) per day. The dose may be increased after 1-2 weeks at 2.5 mg (half tablet) a day, then to 5 mg (1 tablet) per day and subsequently to 10 mg (2 tablets) per day until reaching optimal dose to treat your condition. • The maximum recommended dose is 10 mg (2 tablets per day). • You must be supervised by an experienced physician within 2 hours of starting treatment and also every time you dose is increased. • If necessary, your doctor may reduce the dose. You should not stop treatment abruptly as this can worsen heart failure. • This drug is contraindicated in patients with severe renal impairment. Take medicine once a day, preferably at the same time of day. Your doctor may decide the combination of these tablets with other medicines necessary to treat your condition. X-Pressol is not recommended for children and adolescents below 18 years.

If you use too much of X-Pressol
If you accidentally take more tablets (higher dose than recommended), you may experience slow heartbeat, low blood pressure, other heart problems, difficulty breathing or wheezing, seek emergency department or nearest hospital immediately inform your doctor or pharmacist. Take your box of tablets remaining.

If you forget to take X-Pressol 
If you miss a dose but remember to take it soon, take your next tablet, normally at the appointed time. However, it has been a long time (eg all day) since you forgot to take your medicine, skip that dose and take the next dose the next day at the appointed time, skipping missed dose. Do not take a double dose or higher for a forgotten dose. Avoid repeated doses oblivion.

If you stop using X-Pressol
Do not stop taking X-Pressol without the consent of your doctor. If you suddenly stop taking the medicine, the risk of dangerous worsening of symptoms. This can happen, especially in patients with angina pectoris. If you have questions about using this medicine, ask your doctor or pharmacist.

POSSIBLE SIDE EFFECTS
Like all medicines, X-Pressol can cause side effects although not everybody gets them. Common side effects (estimated frequency is less than 1 in 10 but more than 1-100) to use this medicine for high blood pressure: • Headaches • Dizziness • Fatigue • Feeling unusually itching or tingling • Diarrhea • Constipation • Nausea • Feeling short of breath • Swelling of hands or feet Uncommon side effects (estimated frequency is less than 1 in 100 but less than 1-1000) to use this medicine for high blood pressure: • low frequency heartbeat or other heart problems • Low blood pressure • Visual disturbances • Impotence (erectile difficulties) • depression • Indigestion, gas in stomach or intestine • Vomiting • Rash • Chest pain, difficulty breathing or wheezing • Nightmares • After conducting a clinical trial on chronic heart failure, adverse reactions observed were low frequency heart rate, dizziness, worsening heart failure, low blood pressure (such as feeling faint when suddenly lifting up), lack of tolerance to the drug , irregular heartbeat, swelling (such as swollen ankles). Very rare (estimated frequency is less than 1 in 10,000): • Fainting • Angioedema: swelling of the skin of the face or extremities, lips, tongue, and throat membranes of the airways, which causes shortness of breath or difficulty in swallowing – contact your doctor immediately! • Worsening of psoriasis. If any side effects or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

HOW TO STORE X-PRESSOL
Keep out of reach and sight of children. Do not use X-Pressol after the expiry date stated on the carton after <EXP>. The expiry date refers to the last day of that month. Do not store above 30 ° C.