Maximum antihypertensive effects are attained within 2 to 4 weeks.
Increasing the dose does not result in any meaningful further blood pressure reduction.
Renal Dose Adjustments
Mild or moderate renal impairment: No adjustment recommended.
Moderate and severe renal impairment (CrCl 60 mL/min or less): Data not available
This drug combination is not recommended as initial treatment in patients with severe renal impairment, because the recommended starting dose of nebivolol in this population, 2.5 mg once daily, is lower than the dose of nebivolol contained in the combination formulation.
Liver Dose Adjustments
Mild hepatic impairment: No initial dosage adjustment is required.
Moderate hepatic impairment: This drug is not recommended as initial treatment.
Severe hepatic impairment (Child-Pugh greater than B): Contraindicated
Precautions
US BOXED WARNINGS:
When pregnancy is detected, discontinue this drug as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Nebivolol: Data not available
Valsartan: Not removed by hemodialysis.
Other Comments
Administration advice:
This drug may be taken with or without food.
Storage requirements:
The manufacturer product information should be consulted.
Reconstitution/preparation techniques:
The manufacturer product information should be consulted.
IV compatibility:
The manufacturer product information should be consulted.
