Maxineb 2.5

Presentation: Each tablet contains 2.5 mg of Nebivolol (as Nebivolol Hydrochloride). 

Indications: Maxineb (Nebivolol) is indicated for the treatment of:

• Hypertension (high blood pressure).
• Stable mild and moderate chronic heart failure in addition to standard therapies in elderly patients ≥ 70 years.  

Dosage and Administration:

• Hypertension: The usual starting dose is 5 mg once daily. However, some patients may be started on 2.5 mg once daily, particularly elderly patients or those who may be more sensitive to the effects of beta-blockers. The dose may be increased to 10 mg once daily if needed for adequate blood pressure control. The maximum recommended daily dose is 20 mg. 
• Chronic Heart Failure: Treatment must be initiated and supervised by a physician experienced in the management of chronic heart failure. The stabilization phase involves a gradual up-titration schedule:
  • Start with 1.25 mg once daily, increase to 2.5 mg once daily after 1-2 weeks.
  • Then increase to 5 mg once daily after another 1-2 weeks.
  • Then increase to 10 mg once daily after a further 1-2 weeks.
  • The maximum recommended dose is 10 mg once daily.
• Renal Impairment: In patients with severe renal impairment, the recommended initial dose is 2.5 mg once daily, and the dose should be titrated up slowly if needed.
• Hepatic Impairment: In patients with moderate hepatic impairment, the recommended initial dose is 2.5 mg once daily, and the dose should be titrated up slowly if needed.
• Geriatric Patients: It is not always necessary to adjust the dose in the elderly, but a lower starting dose of 2.5 mg may be considered.

Maxineb 2.5 tablets should be taken orally once daily, preferably at the same time each day. It can be taken with or without food. 

Side Effects: Common side effects may include:

• Headache
• Dizziness
• Fatigue
• Paresthesia (tingling or numbness)
• Diarrhea
• Constipation
• Nausea
• Shortness of breath  

Less common side effects may include:

• Slow heart rate (bradycardia)
• Low blood pressure (hypotension)
• Worsening of heart failure symptoms
• AV block
• Claudication (leg pain when walking)
• Visual disturbances
• Depression

Precautions:

• Inform your doctor if you have a history of heart failure, slow heart rate, low blood pressure, asthma, chronic obstructive pulmonary disease, peripheral arterial disease, diabetes, thyroid disorders, or kidney or liver problems.
• Use with caution in elderly patients.
• Maxineb may cause dizziness and fatigue, especially at the start of treatment or when the dose is increased. Caution should be exercised while driving or operating machinery. 
• Avoid abrupt discontinuation of the medication, as it may worsen heart conditions. The dosage should be tapered gradually under medical supervision. 
• The safety of Maxineb during pregnancy has not been fully established. It should only be used if the potential benefit outweighs the risk to the fetus. Consult your doctor before use.
• It is not known if Nebivolol passes into breast milk. Breastfeeding is generally not recommended while taking Maxineb.

Storage: Store below 30°C, protected from light and moisture. Keep out of the reach of children.

Important Note: This information is for general knowledge and informational purposes only, and does not substitute professional medical advice. Always consult your doctor or pharmacist for specific instructions and guidance regarding your medication, including the appropriate dosage for your condition. They can assess your individual medical condition and provide the most appropriate advice.