Before taking NEBIVOLOL+VALSARTAN, inform your doctor if you have decreased potassium levels in the blood, kidney disease or on dialysis, liver disease, heart disease, hyperthyroidism (overactive thyroid), are on a low-salt diet, and dehydration (due to vomiting or diarrhea).  If you notice dizziness, confusion, weakness and fainting while using NEBIVOLOL+VALSARTAN, inform your doctor immediately. Do not exercise heavily or avoid hot weather as excess sweating may lead to dehydration, thereby resulting in low blood pressure and electrolyte imbalances. Severe nausea, vomiting and diarrhea may also lead to dehydration resulting in low blood pressure. Inform your doctor immediately if you experience chest pain, extreme tiredness, irregular heartbeat or difficulty breathing, as NEBIVOLOL+VALSARTAN may worsen symptoms of heart failure in some patients. If you notice stomach pain, difficulty breathing, numbness in the hands, feet or lips, weakness in the legs and irregular heartbeat, inform your doctor immediately. These symptoms can be a sign of hyperkalemia (high potassium levels in the blood).

Drug-Drug Interactions: NEBIVOLOL+VALSARTAN may interact with blood pressure-lowering medication (aliskiren), water pills, other blood pressure-lowering medications, medicine that suppresses the immune system (cyclosporine),  antidepressants (fluoxetine and lithium), antitubercular agent (rifampin), a medicine used to treat HIV (ritonavir), potassium supplements, pain killers (aspirin, ibuprofen, naproxen, celecoxib, diclofenac, etc.).

Drug-Food Interactions: Do not take alcohol as it can further lower blood pressure and may increase the risk of side effects.

Drug-Disease Interactions: NEBIVOLOL+VALSARTAN should not be used in patients with severe heart problems such as ‘sick sinus syndrome’ (unless you have a pacemaker) or heart block, severe heart failure, severe liver disease and history of bradycardia (slow heartbeat) that have resulted in fainting.

• Keep your weight under control with a BMI of 19.5-24.9.
• Do regular physical activity or exercise for at least 150 minutes per week or about 30 minutes most days of the week. Doing this can help you to lower your raised blood pressure by about 5 mm of Hg.
• Option for a diet rich in whole grains, fruits, veggies and low-fat dairy products.
• Limit intake of sodium chloride (table salt) in your daily diet to 2300 mg per day or less than 1500 mg is ideal for most adults.
• If you are taking alcohol then only one serving for women and two servings for men is advisable.
• Quitting smoking is the best strategy to lower the risk of heart disease.
• Avoid chronic stress as it can raise your blood pressure. Try to enjoy and spent time with your loved ones to cope with stress and practice mindfulness techniques.
• Monitor your blood pressure daily and if there is too much fluctuation then immediately contact your doctor.
• Try to include heart-healthy omega 3 fatty acid containing food drinks in your daily diet. You can also use low-fat cooking oil like olive oil, soybean oil, canola oil and coconut oil can help in lowering your elevated blood pressure.

• Do not take potassium supplements, a potassium-rich diet, or salt substitutes while using this medicine as it may increase potassium levels in the blood.
• Your doctor may also monitor blood pressure, kidney function and potassium levels while taking this medicine.
• NEBIVOLOL+VALSARTAN may cause orthostatic hypotension, so do not stand up too fast when rising from a sitting or lying position.
• Do not stop taking this medication suddenly, as the abrupt stopping of this medicine may lead to chest pain or heart attack.