Carvedilol

Carvedilol
(Beta-Blockers)

Dosage form	Brand	Strength
Tablet	Caraten®   Dilatrend®	6.25 mg, 12.5 mg, 25 mg

Indication : hypertension, heart failure, left ventricular dysfunction, angina pectoris

Mechanism of action : α₁, β₁ and β₂ adrenergic receptor blocker and  potent antioxidant and a scavenger of reactive oxygen radicals. Carvedilol has antiproliferative effects on human vascular smooth muscle cells.

Pregnancy Category C; D in 2nd & 3rd trimesters

Contraindication : Hypersensitivity; severe chronic heart failure, bronchial asthma or related bronchospastic conditions; severe hepatic impairment. Patients with cardiogenic shock or severe bradycardia. Lactation. Precaution  : Avoid abrupt withdrawal as it may precipitate thyroid storm or exacerbate hyperthyroidism. Liver injury; vascular disease, renal failures,  variable angina; worsening cardiac failure

Drug Interaction : Insulin, catecholamine-depleting agents , β-receptor blockers. Serum levels may be increased by fluoxetine. May increase serum levels of ciclosporin and digoxin.Food reduces rate of absorption .

Side Effect : Bradycardia, AV block, angina pectoris, hypervolaemia, leucopenia, hypotension, peripheral oedema, allergy, malaise, fluid overload, melena, periodontitis, hyperuricaemia, hyponatraemia

Monitoring parameters : HR, BP, renal function, BUN, liver function.

Usual Dose : - Hypertension Initially, 12.5 mg once daily increased to 25 mg once daily after 2 days.

                      - Angina pectoris Initially, 12.5 mg bid increased to 25 mg bid after 2 days.
                      - Heart failure Initially, 3.125 mg bid, doubled to 6.25 mg bid after 2 wk if tolerated, then gradually increased to the max dose the patient can tolerate at intervals of not <2 wk. Max dose: >85 kg: 50 mg bid; <85 kg: 25 mg bid.
                      - Left ventricular dysfunction after myocardial infarction Initially: 6.25 mg bid, if tolerated, after 3-10 days, increase to 12.5 mg bid and then to a target dose of 25 mg bid.

Missed Dose : Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only the next regularly scheduled dose. It is not necessary to take a double dose

Auxiliary labels  : Do not take other medicines without your doctor's advice.This medication can cause disorientation or even drowsiness. So should not be driving or working on machinery and change position slowly.Avoid alcoholic beverages while taking this medication.

 

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