Byvalson

See Contraindications. Avoid concomitant CYP2D6 inhibitors (eg, quinidine, propafenone, fluoxetine, paroxetine), other beta-blockers. If concomitant with clonidine, discontinue nebivolol for several days before tapering clonidine. Increased risk of bradycardia with concomitant digitalis glycosides; monitor. Concomitant anesthetics (eg, ether, cyclopropane, trichloroethylene), reserpine, guanethidine; monitor closely. β-blockers may mask hypoglycemia; caution with concomitant insulin or antihyperglycemics. Concomitant verapamil or diltiazem (monitor HR, BP), disopyramide (monitor HR, cardiac conduction). Concomitant K⁺ supplements, K⁺ sparing diuretics, K⁺-containing salt substitutes may cause hyperkalemia; monitor. May be antagonized by, and renal toxicity potentiated by, NSAIDs, including selective COX-2 inhibitors (monitor renal function periodically in elderly and/or volume depleted). Dual inhibition of the renin-angiotensin system with ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely, in general, avoid combined use of RAS inhibitors. Concomitant aliskiren in renal impairment (GFR <60mL/min): not recommended. May increase lithium levels; monitor. May be potentiated by inhibitors of OATP1B1 (eg, rifampin, cyclosporine) or MRP2 (eg, ritonavir).