Carvedilol


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult: PO Hypertension Initially, 12.5 mg once daily for 2 days, increased to 25 mg once daily. May gradually increase further at intervals of at least 2 weeks, if necessary. Max: 50 mg daily. Chronic stable angina Initially, 12.5 mg bid for 2 days, increased to 25 mg bid. May gradually increase further at intervals of at least 2 weeks, if necessary. Max: 100 mg/day in 2 divided doses. Heart failure Mild to severe: Initially, 3.125 mg bid for 2 weeks. If tolerated, increase gradually to 6.25 mg bid at intervals of at least 2 weeks, followed by 12.5 mg bid, then 25 mg bid. Max: <85 kg: 25 mg bid. >85 kg: 50 mg bid, if condition is not severe. Left ventricular dysfunction post myocardial infarction Initially, 6.25 mg bid, increased after 3-10 days (based on tolerability) to 12.5 mg bid, and up to target dose of 25 mg bid. Lower initial dose of 3.125 mg bid may be used in symptomatic patients and rate of up-titration may be slowed if clinically indicated.
Administration
Should be taken with food.
Contraindications
Patient with decompensated heart failure requiring IV inotropic treatment, bronchial asthma or related bronchospastic conditions, 2nd- or 3rd-degree AV block without permanent pacemaker, severe bradycardia (<50 bpm), sick sinus syndrome, cardiogenic shock, untreated phaeochromocytoma, Severe hepatic impairment.
Special Precautions
Patient with salt and volume depletion, hypotension; ischaemic heart disease, Prinzmetal's variant angina, diabetes mellitus, thyrotoxicosis, peripheral vascular disease, psoriasis. Avoid abrupt withdrawal. Renal and mild to moderate hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause syncope during initial therapy, if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure, heart rate, BUN, blood glucose (diabetics), renal and liver function.
Adverse Reactions
Significant: Hypotension with or without syncope, bradycardia. Blood and lymphatic system disorders: Anaemia. Cardiac disorders: Dyspnoea, pulmonary oedema. Eye disorders: Visual impairment, eye irritation, dry eye. Gastrointestinal disorders: Nausea, diarrhoea, vomiting, dyspepsia, abdominal pain. General disorders and administration site conditions: Asthenia, fatigue. Infections and infestations: Bronchitis. Metabolism and nutrition disorders: Oedema, hypervolaemia, weight gain, hypercholesterolaemia, hyperglycaemia, hypoglycaemia. Musculoskeletal and connective tissue disorders: Pain in extremities, arthralgia. Nervous system disorders: Dizziness, headache. Psychiatric disorders: Depression. Renal and urinary disorders: Micturition disorders, abnormal renal function, renal failure. Vascular disorders: Orthostatic hypotension, peripheral vascular disease.
C D in 2nd & 3rd trimesters.
Drug Interactions
Additive effect with Ca channel blockers (e.g. diltiazem, verapamil), amiodarone, MAO inhibitors, reserpine, guanfacine, methyldopa. May increase atrioventricular conduction time and decrease heart rate with digitalis glycosides. Increased serum concentrations of ciclosporin. Increased hypoglycaemic effect of insulin and oral antidiabetics. May cause synergistic, negative inotropic and hypotensive effect with anaesthetics. Serum concentration may be reduced by CYP450 inducers (e.g. rifampicin, barbiturates) or increased by CYP450 inhibitors (e.g. ketoconazole, cimetidine, fluoxetine, haloperidol, erythromycin). Increased vasoconstriction effect with ergotamine.
ATC Classification
C07AG02 - carvedilol ; Belongs to the class of alpha and beta blocking agents. Used in the treatment of cardiovascular diseases.
Disclaimer: This information is independently developed by CIMS based on carvedilol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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