AboutDomenic Sica Expertise All aspects of hypertension as well as any consideration in drug therapy for the management
of hypertension.
Experience Heavily published in the area of drug therapy in hypertension and renal disease. Primary management physician for a large multi-state referral practice for diagnosis and management of complex hypertension
Organizations Multiple including the American Society of Hypertension, International Society of Hypertension, American Society of Nephrology, American Heart Association, American College of Clinical Pharmacology amongst others.
Publications Over 250 publications (see PubMed)
Education/Credentials Board certified in internal medicine, nephrology, clinical pharmacology, and hypertension
Awards and Honors Multiple awards as clinical and/or teacher of the year.
Question I am 53 years hypertensive male on Atenolol 100 Lisinorpil and Amlodepine 5 mg. Yesterday my dr changed atenolol 100 to nebivolol 5 mg stating that atenolol is no longer recommended and the drug of nebivolol is of 3rd generation. I have occassional ventricular ectopia and sever concentric LVH and dystolic dysfunction. I need your guidance whether nebivolol is superiro in terms of eeficacy I take atenolol 100 since so many years. If a suggested change is must then dose of 5 mg of nebivolol ok because i take atenolol 100 I am ex asthamatic
Answer Has your blood pressure been well-controlled on the regimen prior to the switch to nebivolol ? If so, it is unclear as to why the nebivolol would be stated to be superior unless you were having side-effects with the atenolol. Also, on a dose comparison basis 5-mg of nebivolol is much less than 100-mg of atenolol. As to the issue of side-effects sometimes one does not know if they were feeling poorly on a medication until they come off it and go on a substitute medication; thus, a trial of nebivolol might be useful since it is generally better tolerated than is the case for atenolol.
