Dosing: Adult
Hypertension (alternative agent):Oral: Initial: 5 mg once daily; titrate as needed at 2-week intervals based on patient response to a maximum dose of 40 mg once daily (ACC/AHA [Whelton 2017]).
Dosing: Renal Impairment: Adult
CrCl 50 to 80 mL/minute: There are no dosage adjustmentsprovided in the manufacturer’s labeling; however, dose adjustment does not appear necessary. Following a single 5 mg dose in patients with CrCl 50 to 80 mL/minute, nebivolol clearance was unchanged.
CrCl 30 to 50 mL/minute: There are no dosage adjustmentsprovided in the manufacturer’s labeling; however, dose adjustment is likely not necessary. Following a single 5 mg dose in patients with moderate impairment, reduction in nebivolol clearance was negligible (~17%) (Shaw 2005).
CrCl <30 mL/minute: Initial: 2.5 mg once daily; if initial response is inadequate, may increase cautiously.
Hemodialysis: There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied).
Dosing: Hepatic Impairment: Adult
Mild impairment (Child-Pugh class A): There are no dosage adjustmentsprovided in the manufacturer’s labeling; use caution.
Moderate impairment (Child-Pugh class B): Initial: 2.5 mg once daily; if initial response is inadequate, may increase cautiously
Severe impairment (Child-Pugh class C): Use is contraindicated.
REF. UpToDate 2020.03.19
