Nodon (Nebivolol Hydrochloride)
Also sold as: Nodon, Nebicard, Bystolic, Nebicip, Nebivas
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
Tablet 2.5mg, 5mg, 10mg
Indications
- Hypertension (monotherapy or combination)
- Stable heart failure with reduced ejection fraction (HFrEF) in patients ≥70 years or when other beta-blockers not tolerated
Adult Dosing
Hypertension
5 mg PO once daily
Usual maintenance. May increase to 10 mg after 2 weeks if needed. In CKD/elderly: start 2.5 mg.
Heart failure (stable)
Start 1.25 mg once daily; titrate by doubling every 2 weeks to target 10 mg once daily
Ongoing — mortality benefit in HF (SENIORS trial)
Pediatric Dosing
No paediatric indication
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl < 30 mL/min | Start 2.5 mg once daily — titrate cautiously |
Hepatic Adjustment
AVOID in moderate-severe hepatic impairment — hepatic metabolism, risk of accumulation
Pregnancy & Lactation
Pregnancy: Category C
Limited data. Beta-blockers in general can cause intrauterine growth restriction, bradycardia, hypoglycaemia in neonate. Use only if benefit outweighs risk. Labetalol preferred for hypertension in pregnancy.
Lactation: Caution
Limited data for nebivolol specifically — use with caution; monitor infant for bradycardia and hypoglycaemia
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Verapamil / diltiazem (IV or oral) | Severe bradycardia and AV block — AVOID IV CCBs; use caution with oral | Major |
| Clonidine | Withdrawal of clonidine may cause severe rebound hypertension when combined with beta-blocker — taper beta-blocker 3 days before stopping clonidine | Major |
| CYP2D6 inhibitors (fluoxetine, paroxetine, quinidine) | Increase nebivolol levels — excess bradycardia | Moderate |
| Antidiabetics (insulin, sulfonylureas) | Masks hypoglycaemia symptoms (tachycardia); prolongs recovery from hypoglycaemia | Moderate |
DoctorScribe — AI Medical Scribe
Stop looking up Nodon — just speak the prescription
"Nodon as per dose, BD for 5 days." DoctorScribe writes the full prescription with brand, strength, frequency, and route — auto-applies pediatric weight-based dosing and renal adjustments. Try the live demo.
Side Effects
Common
- Headache
- Dizziness
- Fatigue
- Bradycardia
- Cold extremities (less than older beta-blockers due to vasodilation)
- Nausea
Serious / Discontinue If
- Severe bradycardia / AV block
- Heart failure decompensation (if started too fast in acute HF)
- Bronchoconstriction (less than non-selective beta-blockers — but use cautiously in COPD/asthma)
- Hypoglycaemia masking in diabetics
Contraindications
- Acute heart failure / decompensated HF
- Severe bradycardia (< 60/min)
- Second/third degree AV block
- Sick sinus syndrome
- Severe asthma or COPD
- Severe peripheral arterial disease
- Pheochromocytoma (without alpha-blocker first)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Nodon 5mg | Alembic | 30 tab ₹148 |
| Nebicard 5mg | Torrent | 30 tab ₹135 |
| Nebicip 5mg | Cipla | 30 tab ₹142 |
| Nebivas 5mg | Sun Pharma | 30 tab ₹125 |
Monitoring Required
- Heart rate (target 60–75/min)
- Blood pressure
- Signs of heart failure (weight, oedema)
- Blood glucose in diabetics
- Pulmonary function if asthma/COPD concern
Patient Counseling Points
- Take at the same time each day — with or without food
- Never stop suddenly — must be tapered over 1–2 weeks (rebound hypertension/angina risk)
- Your pulse may be slower — this is expected; tell your doctor if < 50/min
- Diabetics: beta-blockers can mask a fast pulse during low blood sugar — check glucose levels more carefully
- Cold hands and feet are less common with nebivolol than older beta-blockers
- Report breathlessness, worsening ankle swelling — possible heart failure sign
Stop Googling drug references mid-consultation
EasyClinic auto-flags Nodon interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Meenakshi Iyer, DM (Cardiology), Consultant Cardiologist
Last reviewed: 2026-04-01
References
- ESC Hypertension Guidelines 2023
- SENIORS Trial (Eur Heart J 2005)
- ESC Heart Failure Guidelines 2021
- BNF — Nebivolol