about Carvedilol class, uses, side effects contraindications
Carvedilol
Short Description
Carvedilol is a beta-blocker that dilates blood vessels and treats high?blood pressure?.
Carvedilol may also be used to treat heart failure.
Sometimes carvedilol is given with other medicines, such as diuretics.
Category
Chemical class: Nonselective beta-adrenergic blocker with alpha1-adrenergic blocking activity
Therapeutic class: Antihypertensive, heart failure treatment adjunct
Pregnancy category: C
Indications
To control hypertension
Adults. 6.25 mg b.i.d. for 7 to 14 days, if tolerated. Then dosage increased to 12.5 mg b.i.d. for 7 to 14 days, and up to 25 mg, if tolerated and needed. Maximum: 50 mg daily.
Adults.Initial: 20 mg once daily with food. After 7 to 14 days, increased to 40 mg once daily. After another 7 to 14 days, increased to 80 mg once daily. Maximum: 80 mg once daily. As adjunct to treat mild to severe heart failure of ischemic or cardiomyopathic origin
Adults.3.125 mg b.i.d. for 2 wk; then increased to 6.25, 12.5, and 25 mg b.i.d. at successive 2-wk intervals, as tolerated. Maximum (for patients with mild to moderate heart failure): 50 mg b.i.d. if patient weighs more than 85 kg (187 lb).
Adults.Initial: 10 mg once daily with food for 2 wk. Then increased to 20 mg once daily, as needed. Subsequent dosage increased by 20 mg every 2 wk, as needed. Maximum: 80 mg once daily. To reduce CV mortality after acute phase of MI in patients with left ventricular ejection fraction of 40% or less
Adults. 6.25 mg b.i.d. for 3 to 10 days, if tolerated. Then dosage increased to 12.5 mg b.i.d. for 3 to 10 days and up to 25 mg b.i.d., if needed and tolerated.
Adults.Initial: 10 to 20 mg once daily. After 3 to 10 days, increased to 20 to 40 mg once daily. Increased again as needed every 3 to 10 days until reaching tolerance or target dose of 80 mg once daily. Maximum: 80 mg once daily.
DOSAGE ADJUSTMENT For patient with fluid retention or low blood pressure or heart rate, starting dosage may be decreased to 3.125 mg b.i.d., increase may be slowed, or both for tablet form. For patient with heart rate below 55 beats/min, extended-release dosage decreased as clinical condition indicates. Route Onset Peak Duration P.O. In 30 min 1.5–7 hr Unknown
Mechanism of Action
Reduces cardiac output and tachycardia, causes vasodilation, and decreases peripheral vascular resistance, which reduces blood pressure and cardiac workload. When given for at least 4 weeks, carvedilol reduces plasma renin activity.
Contraindications
Asthma or related bronchospastic conditions; cardiogenic shock; decompensated heart failure that requires I.V. inotropics; history of serious hypersensitivity reactions, such as anaphylaxis, angioedema, or Stevens-Johnson syndrome; hypersensitivity to carvedilol or its components; secondor third-degree AV block, severe bradycardia or hepatic impairment, or sick sinus syndrome unless pacemaker is in place
Interactions
amiodarone; other CYP2C9 , such as fluconazole: Increased risk of bradycardia or heart block beta blockers, digoxin: Increased risk of bradycardia calcium channel blockers (especially diltiazem and verapamil): Abnormal cardiac conduction and, possibly, increased adverse effects of calcium channel blockers carvedilol 179 C catecholamine-depleting (such as reserpine, MAO inhibitors): Additive effects, increased risk of hypotension and bradycardia
cimetidine: Increased blood carvedilol level
clonidine: Risk of tachycardia and hypertension when clonidine is discontinued cyclosporine, digoxin: Increased blood levels of these digoxin: Possibly increased digoxin level oral antidiabetics: Increased risk of hypoglycemia
rifampin: Decreased blood carvedilol level
Side Efect
CNS: Asthenia, depression, dizziness, fatigue, fever, headache, hypesthesia, hypotonia, insomnia, light-headedness, malaise, paresthesia, somnolence, stroke, syncope, vertigo
CV: Angina, AV block, bradycardia, edema, heart failure, hypertension, hypertriglyceridemia, orthostatic hypotension, palpitations, peripheral vascular disorder
EENT: Blurred vision, dry eyes, periodontitis, pharyngitis, rhinitis
ENDO: Hyperglycemia, hypoglycemia
GI: Abdominal pain, diarrhea, elevated liver function test results, melena, nausea, vomiting
GU: Albuminuria, hematuria, elevated BUN and creatinine levels, impotence, renal insufficiency, UTI
HEME: Aplastic anemia, decreased PT, thrombocytopenia, unusual bleeding or bruising
MS: Arthralgia, arthritis, back pain, muscle cramps
RESP: Dyspnea, increased cough
SKIN: Jaundice, pruritus, purpura, urticaria
Other: Anaphylaxis, angioedema, fluid overload, gout, hyperkalemia, hyperuricemia, hyponatremia, hypovolemia, viral infection, weight gain or loss
Cautions
Use carvedilol cautiously in patients with peripheral vascular disease because it may aggravate symptoms of arterial insufficiency. In patients with diabetes mellitus it may mask signs of hypoglycemia, such as tachycardia, and may delay recovery. Monitor patient’s blood glucose level, as ordered, during carvedilol therapy because drug may alter blood glucose level.
WARNING Avoid stopping drug abruptly in patients with hyperthyroidism because thyroid storm may occur and in patients with angina because it may worsen or MI may occur. If patient has heart failure, expect to also give digoxin, a diuretic, and an ACE inhibitor. PATIENT TACHING Instruct patient prescribed extendedrelease capsules to swallow them whole. If swallowing capsules is difficult, tell patient he may open capsule and sprinkle beads on a spoonful of cold applesauce and then eat the applesauce immediately without chewing. Warn patient that drug may cause orthostatic hypotension, light-headedness, and dizziness; advise him to take precautions. Tell patient with heart failure to notify prescriber if he gains 5 lb or more in 2 days or if shortness of breath increases, which may signal worsening heart failure. Alert patient with diabetes to monitor his glycemic control closely because drug may increase blood glucose level or mask symptoms of hypoglycemia. Stress the need to seek emergency care if patient develops hives or swelling of the face, lips, tongue, or throat that causes trouble swallowing or breathing.
trad drugs based on Carvedilol
| Gen name | Trade name | Catagory name |
| carvedilol | Coreg | Non-cardioselective beta blockers |
| carvedilol | Coreg CR | Non-cardioselective beta blockers |
| Carvedilol | CARVIDOL 12.5 MG TAB | |
| Carvedilol | CARVIDOL 25 MG TAB | |
| Carvedilol | CARVIDOL 6.25MG TABLET | |
| Carvedilol | DILATREND 25MG TABLET | |
| Carvedilol | DILATREND 6.25 MG TABLET | |
| Carvedilol | RIACAVILOL 12.5 MG TAB | |
| Carvedilol | RIACAVILOL 25MG TABLET | |
| Carvedilol | RIACAVILOL 6.25 MG TABLET | |
other drugs from same cataogory
| Gen name | trade name | catogry |
| propranolol | Inderal | Non-cardioselective beta blockers |
| carvedilol | Coreg | Non-cardioselective beta blockers |
| propranolol | Inderal LA | Non-cardioselective beta blockers |
| nadolol | Corgard | Non-cardioselective beta blockers |
| carvedilol | Coreg CR | Non-cardioselective beta blockers |
| propranolol | InnoPran XL | Non-cardioselective beta blockers |
| sotalol | Betapace AF | Non-cardioselective beta blockers |
| sotalol | Betapace | Non-cardioselective beta blockers |
| pindolol | Visken | Non-cardioselective beta blockers |
| labetalol | Trandate | Non-cardioselective beta blockers |
| labetalol 1 review | Normodyne | Non-cardioselective beta blockers |
| sotalol | Sotylize | Non-cardioselective beta blockers |
| sotalol | Sorine | Non-cardioselective beta blockers |
| penbutolol | Levatol | Non-cardioselective beta blockers |
| propranolol | Hemangeol | Non-cardioselective beta blockers |
| timolol | Blocadren | Non-cardioselective beta blockers |