MAVILOR PLUS 5 / 25 MG ( NEBIVOLOL / HYDROCHLOROTHIAZIDE ) 30 FILM-COATED TABLETS

This combination pairs a third-generation beta-blocker (Nebivolol) with a thiazide diuretic (Hydrochlorothiazide) to achieve an additive effect in reducing both systolic and diastolic blood pressure.

• Nebivolol Mechanism: It is a highly selective B1-adrenergic receptor antagonist. Beyond slowing the heart rate, it induces nitric oxide-mediated vasodilation by stimulating endothelial nitric oxide synthase, which helps relax blood vessels and reduce peripheral resistance.
• Hydrochlorothiazide Mechanism: A diuretic that inhibits sodium and chloride reabsorption in the kidneys. This increases urine output, initially lowering blood volume and ultimately reducing peripheral vascular resistance. 

Clinical Efficacy

• Response Rates: In clinical studies, approximately 81.4% of patients were considered "responders" to the combination therapy (defined as a significant reduction in blood pressure).
• Bioequivalence: Fixed-dose combination therapy is pharmacokinetically bioequivalent to taking the two individual drugs separately, but simplifies the regimen to improve patient compliance.
• Metabolic Profile: Unlike traditional beta-blockers, Nebivolol is considered metabolically neutral. The combination generally shows no deleterious impact on lipid (cholesterol) or glucose metabolism, though some studies suggest HCTZ may slightly blunt the insulin-sensitivity improvements seen with Nebivolol alone.​

Precautions & Contraindications

• Contraindications:
  • Severe bradycardia (slow heart rate) or heart block.
  • Severe liver impairment or decompensated heart failure.
  • History of bronchospasm or asthma (though Nebivolol is often better tolerated than older beta-blockers).
• Pregnancy & Breastfeeding: Not recommended. Beta-blockers can reduce placental perfusion, potentially leading to growth retardation or other risks to the fetus.
• Diabetes Warning: Beta-blockers may mask signs of hypoglycemia (low blood sugar), such as a rapid heartbeat.

​Common Side Effects
Reported side effects occurring in ≥ 1% or more of patients include:

• Headache and dizziness.
• Fatigue or unusual tiredness.
• Nausea or diarrhea.
• Increased urination (due to the diuretic component).

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