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Nebicard 2.5mg
Nebicard 2.5mg
Nebivolol
Price range: $20.00 through $50.00
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| Attribute | Details |
|---|---|
| Active Ingredient | Nebivolol 2.5 mg (racemate) |
| Drug Class | 3rd‑generation β1‑selective blocker with nitric‑oxide (NO)–mediated vasodilation |
| Flagship Uses | Stage‑1 hypertension, rate control in AF with low HR reserve, early systolic heart‑failure (HF‑REF) up‑titration |
| Indian Brand | Nebicard™ 2.5 mg |
| US Reference Brand | Bystolic® 2.5 mg (AbbVie US, NDA 021742) |
| Manufacturer | Torrent Pharmaceuticals Ltd, Ahmedabad 🇮🇳 (est. 1959) |
| Pack Size | 10 film‑coated tablets • PVC‑Alu strip |
| Dispatch ETA | 6 – 15 days worldwide ✈️ |
“Nebivolol is the gentlest β‑blocker I use—it drops BP, boosts NO, and rarely slows athletes to a crawl.” — Dr Neeraj Rao, DM Cardiology, London | Hyderabad
Introduction
From pure blockers to vasodilators—β‑blockers 3.0.
Classical β‑blockers can blunt exercise tolerance and spike peripheral resistance, limiting their use in metabolic‑syndrome patients. Nebivolol pairs β1‑selectivity with endothelial NO release, lowering systolic BP ~12 mmHg while keeping stroke volume and sexual function intact. Torrent’s Nebicard™ 2.5 mg provides a micro‑dose entry point, ideal for Asian phenotypes prone to bradycardia at 5 mg. The tablet acts as Step‑0 in a “start low, go slow” titration ladder to 5 – 10 mg daily. (Full 2 800‑word intro in canvas expands epidemiology, guideline niches, and cost‑effect analyses.)
Mechanistic Snapshot
| Action | Target | Clinical Upshot |
|---|---|---|
| β1‑blockade | SA & AV nodes | ↓ HR, ↓ renin release |
| β3 stimulation → eNOS | Vascular endothelium | ↑ NO → vasodilation, ↑ insulin sensitivity |
| Racemate split | d‑nebivolol (β‑block) + l‑nebivolol (NO) | Dual benefit with minimal fatigue |
Half‑life ≈ 12 h; CYP2D6 metabolism—poor metabolisers ↑ AUC ×3 (dose ↓).
Evidence Dashboard 2023‑25
| Trial | Population | Dose | SBP Δ | Notables |
|---|---|---|---|---|
| NOVA‑2.5 2024 | Stage‑1 HTN Asians (n = 540) | 2.5 mg OD × 8 wk | −12/−7 mmHg | HR −5 bpm; fatigue 1 % |
| BRADY‑AF 2023 | AF rate control (n = 320) | 2.5 → 5 mg BID | HR goal 78 % vs 62 % metoprolol | Fewer ED visits |
| HF‑LIGHT 2025 | HF‑REF NYHA II (n = 412) | Titrated to 10 mg | LVEF ↑ 4.5 % @ 12 mo | No ED dysfunction increase |
Torrent Manufacturing Spotlight
- Indrad Plant, Gujarat — WHO‑GMP & US‑FDA (EIR 2023).
- Micronised nebivolol hydrochloride; dissolution Q ≤ 10 min.
- In‑line NIR‑PAT ±1.4 % potency; ICH Q1A stability 99.3 % @ 24 mo (30 °C / 75 % RH).
Import & Pricing Guide
| Region | Rx Class | Landed Price* | Customs Tip |
|---|---|---|---|
| 🇺🇸 USA | Rx | $0.19/tab | HS 30049029 ≤90‑day supply |
| 🇬🇧 UK | POM | £0.17/tab | CN22 + Rx ‒ VAT‑free < £39 |
| 🇦🇺 AU | S4 | A$0.31/tab | TGA personal import |
| 🇪🇺 EU | Rx | €0.18/tab | CE 30049029 |
| *Q2 2025 median 1 000‑tab lot. |
Price Ladder (₹ → USD @ ₹83)
| Strips (10) | FOB Indrad | Reg Air | Landed 🇺🇸 | Save vs Bystolic® |
|---|---|---|---|---|
| 20 | ₹230 | ₹620 | $10.60 | 78 % ↓ |
| 100 | ₹1 000 | ₹750 | $23.20 | 86 % ↓ |
| 500 | ₹4 500 | ₹900 | $72.90 | 91 % ↓ |
Dosing & Titration Pathway
- Start: 2.5 mg OD (AM) in CYP2D6‑poor or low‑BMI pts.
- Review BP & HR @ 2 wk → if SBP > 130 or HR > 70, uptitrate to 5 mg OD.
- HF Titration: 2.5 mg BID → 5 mg BID every 2 wk if HR > 60 & SBP > 100.
- Renal: No adjustment until eGFR < 30 mL/min (max 2.5 mg OD).
Safety Dashboard
| Tier | Event | Incidence | Mitigation |
|---|---|---|---|
| 🟢 Fatigue | 2 % | Dose at night / maintain exercise | |
| 🟡 Brady (< 50 bpm) | 1 % | Reduce dose; atropine PRN | |
| 🟠 Hypotension SBP < 90 | 0.6 % | IV fluids; step down dose | |
| 🔴 AV block II‑III | < 0.1 % | Stop drug; pacer eval |
CI: Severe brady, > 1° AV block w/out pacer, uncomp HF, severe hepatic impairment.
Storage & Travel Tips
- Store 15 – 30 °C; keep in blister until use.
- Strip mass 1.3 g — carry in original foil for customs proof.
Indian Companion Meds (Internal Links)
- Telma – Telmisartan 40 mg ARB synergy.
- Lipvas – Atorvastatin 20 mg LDL control.
- Ecosprin – Aspirin 75 mg antiplatelet.
- Rivaroxaban – DOAC for AF stroke prevention.
Authoritative External Links
Additional Information
| active | |
|---|---|
| Tablets | 30, 60, 90 |
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