Coriol

Coriol - alpha _1- blocker; beta ₁ - and beta ₂ -block; a drug that has a vasodilator, antiarrhythmic and antianginal effect.

Release form and composition

Coriol dosage form - white tablets:

• 3.125 mg: round, slightly biconvex, with beveled edges;
• 6.25 mg: oval, slightly biconvex, notched on one side and “S2” marking on the other;
• 12.5 mg: oval, slightly biconvex, notched on one side and “S3” marking on the other;
• 25 mg: round, slightly biconvex, with beveled edges, notched on one side.

All types of tablets are available in 10 pieces. in blisters, 3 blisters in carton packs.

Ingredients 1 tablet:

• Active ingredient: carvedilol - 3.125; 6.25; 12.5 or 25 mg;
• Auxiliary components: povidone, lactose monohydrate, colloidal silicon dioxide, magnesium stearate, crospovidone, sucrose.

Indications for use

• Arterial hypertension (including in combination with other antihypertensive drugs);
• Stable angina;
• Chronic heart failure (as part of combination therapy).

Contraindications

Absolute:

• Hypotension (systolic blood pressure less than 85 mm Hg);
• AV block II and III degree;
• Sick sinus syndrome;
• Heart failure in the decompensation stage;
• Severe bradycardia;
• Bronchospastic syndrome;
• Bronchial asthma;
• Liver failure;
• Age up to 18 years;
• Pregnancy;
• Lactation period;
• Hypersensitivity to the drug.

Relative (special caution required):

• Chronical bronchitis;
• Emphysema;
• Hypoglycemia;
• Diabetes;
• Thyrotoxicosis;
• Printsmetal angina;
• Pheochromocytoma;
• Occlusive peripheral vascular disease;
• Myasthenia gravis;
• Depression;
• Psoriasis;
• Pronounced metabolic acidosis;
• Renal failure.

Dosing and Administration

Tablets should be taken after meals with a small amount of liquid.

With hypertension, the drug should be taken in the morning after breakfast. The dose is determined individually. The initial recommended dose is 12.5 mg. If necessary, the drug can be taken 2 times a day at 6.25 mg. In the future, Coriol is prescribed 25 mg 1 time per day or 12.5 mg 2 times. If necessary, after 14 days, the dose is increased to 50 mg per day.

The initial dose for stable angina is 12.5 mg 2 times a day. If necessary, after 7-14 days under the careful medical supervision, the dose is increased to 25 mg 2 times a day. In case of insufficient effect, but under the condition of good tolerability of the drug after 14 days, the dose is increased further. The maximum daily dose is 100 mg in 2 doses, for patients over 70 years old - 50 mg in 2 doses.

It is recommended to begin treatment of chronic heart failure with a dose of 3.125 mg 2 times a day. Further, it is gradually increased to achieve a therapeutic effect. Maximum doses: for patients with a body weight of more than 85 kg - 50 mg 2 times a day, with a body weight less than 85 kg - 25 mg 2 times a day. At the beginning of therapy and at each dose increase, special monitoring of the patient’s condition is required. If treatment is interrupted for more than 2 weeks, it should be resumed from the minimum dose (3.125 mg 2 times a day), followed by a gradual increase.

Side effects

• Central and peripheral nervous system: paresthesias, dizziness, headache, depression;
• Blood system: leukopenia and thrombocytopenia;
• Respiratory system: nasal congestion, sneezing, bronchospasm; in predisposed patients - shortness of breath;
• Cardiovascular system: syncopal conditions, intermittent claudication, angina attacks, bradycardia, impaired peripheral circulation, orthostatic hypotension, AV-blockade, progression of heart failure;
• Urogenital system: edema, severe renal impairment; rarely - decrease in potency;
• Digestive system: abdominal pain, nausea, dry mouth, vomiting, diarrhea / constipation, increased liver transaminase activity;
• Others: eye irritation, reduction of tear fluid production, weight gain, muscle weakness (usually at the beginning of treatment), pain in the extremities, hypercholesterolemia, hypo-and hyperglycemia;
• Allergic reactions: rash, exacerbation of psoriatic lesions, itching, skin rash, urticaria.

special instructions

At the beginning of therapy and with each increase in dose, an increase in blood pressure is possible, especially when standing up. In older people, with heart failure, or the simultaneous use of other antihypertensive drugs and diuretics, dizziness and fainting may also occur.

You can not abruptly stop treatment, especially with angina, as possible deterioration. For this reason, the drug should be discontinued gradually, reducing the dose within 1-2 weeks.

In patients with ischemic heart disease, renal failure, low blood pressure and / or heart failure, diffuse diseases of peripheral vessels, it is necessary to monitor renal function, and if it worsens, cancel Coriol.

Like all beta-blockers, Coriol can reduce the sensitivity of allergy tests, aggravate the clinical picture of psoriasis, peripheral angiopathy and anaphylactic reactions, as well as Printsmetal angina pectoris.

Beta-adrenergic blockers slow the heart rhythm, so they can mask the symptoms of thyrotoxicosis in patients with thyroid diseases and the symptoms of hypoglycemia in diabetic patients.

Patients wearing contact lenses should be aware that the drug can reduce tearing.

Before surgery, the patient should inform the doctor that he is taking Coriol.

Special care should be taken when it is necessary to perform general anesthesia with the use of drugs that suppress the activity of the heart muscle, such as cyclopropane, ether, trichlorethylene. Before extensive surgery, Coriol is recommended to gradually cancel.

In pheochromocytoma, β-adrenoreceptor blockers can only be prescribed after the start of α-adrenoreceptor blockers.

For patients receiving carvedilol at the same time as clonidine, if you need to stop treatment, you must first cancel Coriol and only a few days later - clonidine.

With the progression of heart failure during the period of treatment should increase the dose of diuretic. In renal insufficiency, it is necessary to take into account the functional state of the kidneys.

During therapy should not consume alcoholic beverages.

At the beginning of treatment and with each increase in dose, an excessive decrease in blood pressure, accompanied by dizziness, is possible. For this reason, it is recommended to refrain from performing activities that require quick reactions and high concentration of attention (including driving a car).

Drug interaction

The pharmacokinetics of carvedilol may change with the simultaneous use of inducers or inhibitors of the CYP2D6 isoenzyme. For example, rifampicin reduces the concentration of carvedilol in the serum, cimetidine increases.

Patients receiving Coriol should not be administered diltiazem or verapamil intravenously, since Perhaps a significant reduction in blood pressure and a pronounced decrease in heart rate.

The increased effect of carvedilol can be observed with the simultaneous use of some antiarrhythmic drugs, other beta-blockers (for example, in the form of eye drops), sympatholytics (reserpine), cardiac glycosides, drugs for the treatment of angina pectoris, anesthetics, and antihypertensive drugs. If necessary, the appointment of such a combination should be carefully selected dose.

Carvedilol may increase the concentration of digoxin in the blood plasma.

Ergot alkaloids can impair peripheral circulation.

Carvedilol may enhance the effect of hypoglycemic drugs and mask the symptoms of hypoglycemia, therefore, regular monitoring of blood glucose is required.

Diuretics enhance the effect of Coriol.

Terms and conditions of storage

Store at temperatures up to 30 ° C.

Shelf life - 2 years.