Cilnidipine + Nebivolol

Dosage Forms Available

• Cilnidipine + Nebivolol is available in the form of oral tablets.

Age and Dose Restrictions

• Cilnidipine + Nebivolol is intended for use in adults only.

Contraindications

• This combination is contraindicated in patients with severe bradycardia (very slow heart rate).

• It should not be used by those with heart block greater than first-degree, cardiogenic shock, or decompensated cardiac failure.

• Patients with sick sinus syndrome (unless a permanent pacemaker is in place) should avoid this combination.

• Severe hepatic impairment (Child-Pugh class C) also serves as a contraindication.

Other Medications to Avoid

• This combination may interact with CYP2D6 inhibitors (such as quinidine, fluoxetine, and paroxetine), CYP3A4 inhibitors (like itraconazole and ritonavir), digitalis glycosides (like digoxin), and other calcium channel blockers (such as verapamil and diltiazem).

Overdose and Missed Dose

• An overdose may lead to severe low blood pressure, slow heart rate, or even shock. If you suspect an overdose, it is essential to seek immediate medical attention.

• If a dose is missed, take it as soon as you remember. However, if it is nearly time for the next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for the missed one.

Management of Side Effects

Most side effects are temporary and generally harmless and resolve when discontinuing this combination. However, if you experience any severe side effects or worsening of any of the symptoms, please consult your doctor.

• If experiencing dizziness, try lying down until the sensation passes.

• For dry mouth, sipping water regularly can help alleviate discomfort.

Use in Driving and Operating Machinery

• This combination may cause dizziness or fatigue. If you experience these symptoms, avoid driving or operating heavy machinery until you feel that you can perform these activities safely.

Use in Pregnancy and Lactation

• The safety of Cilnidipine + Nebivolol during pregnancy and lactation has not been established. Therefore, it is generally recommended to avoid using this combination during these periods unless deemed necessary by a doctor.

Caution in Other Conditions

• Special caution should be used when administering this combination to patients with bronchospastic diseases, peripheral vascular disease, diabetes, thyroid disorders, and those under anaesthesia.

• Those with existing conditions affecting liver function should also use this combination carefully.

Special Dietary and Lifestyle Recommendations

• Reduce salt intake; high sodium levels can contribute to increased blood pressure.

• Regular physical activity such as walking, cycling, or swimming can help lower blood pressure naturally.

• Monitor your blood pressure regularly.

• Avoid smoking and limit alcohol intake as these can adversely affect blood pressure levels.