Concise Prescribing Info
Mild or moderate heart failure of ischemic or cardiomyopathic origin in conjunction w/ digitalis, diuretic & ACE inhibitor to reduce the progression of disease. Patients unable to tolerate ACE inhibitor & who are or not receiving digitalis, hydralazine or nitrate therapy. Management of essential HTN, monotherapy or in combination w/ other antihypertensives eg, thiazide diuretics.
Dosage/Direction for Use
CHF Individualized dosage. Initially 3.125 mg twice daily for 2 wk. If tolerated, may be increased to 6.25 mg twice daily. Dose should be doubled every 2 wk to the highest level tolerated by the patient. Patient >85 kg Max: 50 mg twice daily, <85 kg Max: 25 mg twice daily. Essential HTN Adult Initially 12.5 mg once daily or 6.25 mg twice daily for the 1st 2 days, continued at 25 mg once daily thereafter. May gradually increased at least 2 wk interval, max: 50 mg daily or in divided doses twice daily. Elderly Initially 12.5 mg once daily. If response is inadequate, may be titrated at least 2 wk interval, max: 50 mg once daily or in divided doses.
Should be taken with food.
Hypersensitivity, allergic disorder including asthma & allergic rhinitis. NYHA class-IV decompensated heart failure requiring IV inotropic support; bronchial asthma; COPD w/ bronchospastic component; clinically manifest liver dysfunction; 2nd & 3rd degree AV-block; severe bradycardia (<50 bpm); shock including cardiogenic & hypovolaemic shock; sick sinus syndrome including SA block; severe hypotension (systolic BP <85 mmHg). Not to be used during pregnancy or lactation. Not to be used in childn <18 yr.
Special Precautions
Patients w/ history of serious hypersensitivity reactions & in those undergoing desensitization therapy. Not to be used in markedly reduced performance of the heart, labile or secondary (organically induced) high BP, unstable angina pectoris, impulse conductions disturbance in the heart (complete bundle branch block), final stages of peripheral artery disease, impaired renal function (serum creatinine conc >1.8 mg/dL or CrCl <30 mL/min), recent heart attack (<6 mth old), tendency to drop in BP lowering drugs (α1 receptor antagonists). Close medical surveillance in DM patients w/ pronounced fluctuations in blood sugar levels & in the event of strict fasting. Discontinue use of diuretics prior to initiating the treatment. Patients w/ personal or familiar history of psoriasis. Treatment should not be discontinued abruptly but must be gradually tapered for few days in patients w/ concomitant CAD (angina pectoris). Regular medical surveillance in the treatment of HTN. Perform eye exam regularly at 6 mth intervals during treatment. Carefully monitor patients w/ mild to moderate occlusive vascular disease during initiation of therapy. Avoid use in patients w/ severe occlusive vascular disease particularly w/ rest pain. Should only be used in patients w/ COPD w/ bronchospastic component not receiving oral or inhaled medication. Closely monitor patients during initiation & up-titration of dose. Reduce dose if any evidence of bronchospasm is observed; pulse rate decreases to <55 beats/min. May obscure the symptoms of thyrotoxicosis. Patients suspected of having pheochromocytoma; Prinzmetal's variant angina. May exacerbate symptoms in patients suffering from peripheral circulatory disorders (Raynaud's phenomenon). Patients undergoing general surgery. May induce bradycardia. Carefully monitor ECG & blood in patients receiving concomitant therapy w/ Ca channel blocker (eg, verapamil or diltiazem), or other antiarrhythmic drugs. Monitor decreasing heart rate, negative inotropism & delayed stimulus conductions w/ anesth drugs. May masked or attenuated the signs of hypoglycaemia. Regularly monitor blood sugar in diabetic patients. May impair the ability to drive or operate machinery. Sharp drop of BP may occur in elderly & patients already taking diuretics after administration of 1st dose.
Adverse Reactions
Edema, dizziness, bradycardia, hypotension, nausea, diarrhea & blurred vision.
Drug Interactions
Intensified effects of other BP-lowering drugs; insulin or oral blood-sugar-lowering drugs. Intensified BP & heart rate lowering effect w/ simultaneous therapy w/ reserpine, guanethidine, methyldopa, clonidine or guanfacine. Reduced systemic availability & possible BP lowering action w/ rifampicin. More abrupt drop in BP w/ concomitant use w/ nifedipine. Elevation of plasma digoxin conc. May intensify BP lowering effect w/ sedative (eg, barbiturates, phenothiazines), acyclic anti-depressants, vasodilating drugs & alcohol.
MIMS Class
ATC Classification
C07AG02 - carvedilol ; Belongs to the class of alpha and beta blocking agents. Used in the treatment of cardiovascular diseases.
Carvilol tab 6.25 mg
3 × 10's (Rp60,000/boks)
Carvilol tab 25 mg
3 × 10's (Rp214,500/boks)
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