Carvedilol is a drug with antiarrhythmic, vasodilating, and antianginal effects used in hypertension.
Release form and composition
Carvedilol is produced in the form of tablets (slightly biconvex, round, yellowish in color, with a risk on one side). 10 pcs. in blisters, 3 blisters in carton packs; on 7 pieces in blisters, 2-4 blisters in carton packs; on 10, 20, 30, 40, 50 and 100 pieces. in polymer cans.
The composition of 1 tablet contains the active substance - carvedilol in the amount of 6.25 mg, 12.5 mg and 25 mg.
Auxiliary components that make up the drug: crospovidone, povidone, lactose monohydrate, microcrystalline cellulose, colloidal silicon dioxide, quinoline yellow, magnesium stearate.
Indications for use
- Arterial hypertension;
- Chronic heart failure (in combination with other drugs);
- Coronary heart disease (prevention of attacks of stable angina).
- Severe bradycardia;
- AV block II and III degree;
- Heart failure in the decompensation stage;
- Bronchial asthma;
- Liver failure;
- Chronic lung disease with a bronchial obstruction in history;
- Pregnancy and lactation;
- Hypersensitivity to the drug.
Dosing and Administration
Carvedilol is taken orally.
The recommended daily initial dose is 12.5 mg, after which, if necessary, gradually (1 time in 2 weeks) it is increased to 25 mg. The maximum dose is 50 mg per day.
In elderly patients, the effective dose is usually 12.5 mg per day.
During the reception of Carvedilola may develop disorders of the various systems of the body:
- Blood formation system: in some cases - leukopenia, thrombocytopenia;
- Cardiovascular system: at the beginning of therapy (the effect of the first dose) and with an increase in dose, an excessive decrease in blood pressure may be observed (usually it goes on its own, and the patient's condition stabilizes without special correction); further development of bradycardia is possible; less common - AV blockade, angina attacks, episodes of intermittent claudication, impaired peripheral blood flow; in some cases - increased manifestations of heart failure;
- Central and peripheral nervous system: weakness, headache, fatigue; in some cases - mental depression, sleep disturbances, paresthesias;
- Respiratory system: in some cases - nasal congestion;
- Digestive system: increased motility and bowel tone; in some cases, a change in plasma activity of transaminases;
- Dermatological reactions: reactions resembling lichen planus, urticaria, the appearance of psoriatic plaques or exacerbation of the previously existing psoriatic process;
- Allergic reactions: rarely - itching, allergic rash.
Carvedilol should be taken with caution in patients with coronary heart disease and heart failure. In case of heart failure, before starting treatment, adequate treatment should be carried out to eliminate the symptoms of decompensation.
When carvedilol is used by patients with ischemic heart disease, myocardial oxygen demand may be reduced. Therefore, the abolition of the drug should be carried out gradually, which will help to avoid the development of attacks of angina.
In endocrine disorders, the drug may mask the symptoms of hyperthyroidism and the early symptoms of acute hyperglycemia (which is necessary to warn patients with insulin-dependent diabetes mellitus).
Alcohol intake during treatment is not recommended.
Clinical experience with the drug in pediatrics is absent.
At the beginning of therapy, as well as with an increase in the daily dose, it is recommended to refrain from driving and from performing work that requires quick psychomotor reactions and high concentration of attention.
The risk of undesirable drug interactions arises when Carvedilol is used simultaneously with antiarrhythmic and antianginal drugs, anesthetics, antihypertensive drugs, other beta-blockers (including drugs in the form of eye drops).
The development of severe hypotension is possible when combined with verapamil and diltiazem for intravenous administration.
With simultaneous use of carvedilol with digoxin, the concentration of the latter in the blood plasma may increase, and the risk of AV conduction disturbances and severe bradycardia may also increase.
The risk of hypoglycemia increases when combined with insulin and oral hypoglycemic drugs.
With the simultaneous use of carvedilola with clonidine may develop arterial hypotension, severe bradycardia and conduction disorders. With the sudden cancellation of clonidine in patients receiving carvedilol, a sharp increase in blood pressure is possible.
The risk of bradycardia and severe hypotension occurs when used together with MAO inhibitors and reserpine.
With simultaneous use with cyclosporine, the concentration of the latter in the blood plasma may increase, with ergotamine derivatives, peripheral blood circulation may deteriorate.
Terms and conditions of storage
Store in a dark, dry place inaccessible to children at temperature up to 25 ° C.
Shelf life - 3 years.