{"id":1704,"date":"2023-06-25T17:32:51","date_gmt":"2023-06-25T17:32:51","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/carvedilol\/"},"modified":"2023-06-25T19:41:39","modified_gmt":"2023-06-25T19:41:39","slug":"carvedilol","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/carvedilol\/","title":{"rendered":"Carvedilol"},"content":{"rendered":"

<\/p>\n

Carvedilol<\/h1>\n

CLINICAL USE<\/h3>\n

Beta-adrenoceptor blocker with alpha1-blocking action:<\/p>\n

  • Hypertension, angina and heart failure
    \n

    DOSE IN NORMAL RENAL FUNCTION<\/h3>\n<\/li>\n
  • Hypertension: 12.5\u201350 mg daily in single or divided doses<\/li>\n
  • Angina: 12.5\u201325 mg twice daily<\/li>\n
  • Heart failure: 3.125\u201325 mg twice daily (50 mg twice daily if wt>85 kg)
    \n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :406.5<\/li>\n
  • %Protein binding                           :>98<\/li>\n
  • %Excreted unchanged in urine     : <2<\/li>\n
  • Volume of distribution (L\/kg)       :2<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :6\u201310\/Unchanged
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function<\/li>\n
  • 10 to 20     : Dose as in normal renal function<\/li>\n
  • <10           : Dose as in normal renal function
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :Unlikely dialysability. Dose as in normal renal function. Start with low doses and titrate according to response<\/li>\n
  • HD                     :Not dialysed. Dose as in normal renal function. Start with low doses and titrate according to response<\/li>\n
  • HDF\/high flux   :Unknown dialysability. Dose as in normal renal function. Start with low doses and titrate according to response<\/li>\n
  • CAV\/VVHD      :Unlikely dialysability. Dose as in normal renal function. Start with low doses and titrate according to response
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Anaesthetics: enhanced hypotensive effect Analgesics: NSAIDs antagonise hypotensive effectAnti-arrhythmics: increased risk of myocardial depression and bradycardia; increased risk of bradycardia, myocardial depression and AV block with amiodarone<\/li>\n
  • Antibacterials: concentration reduced by rifampicin<\/li>\n
  • Antidepressants: enhanced hypotensive effect with MAOIs<\/li>\n
  • Antihypertensives: enhanced hypotensive effect; increased risk of withdrawal hypertension with clonidine; increased risk of first dose hypotensive effect with post-synaptic alpha-blockers such as prazosin<\/li>\n
  • Antimalarials: increased risk of bradycardia with mefloquine<\/li>\n
  • Antipsychotics enhanced hypotensive effect with phenothiazines<\/li>\n
  • Calcium-channel blockers: increased risk of bradycardia and AV block with diltiazem; hypotension and heart failure possible with nifedipine and nisoldipine; asystole, severe hypotension and heart failure with verapamil<\/li>\n
  • Ciclosporin: increased trough concentration, reduce dose by 20% in affected patients<\/li>\n
  • Diuretics: enhanced hypotensive effect Moxisylyte: possible severe postural hypotension<\/li>\n
  • Sympathomimetics: severe hypertension with adrenaline and noradrenaline and possibly with dobutamine<\/li>\n
  • Tropisetron: increased risk of ventricular arrhythmias \u2013 use with caution
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    Oral<\/p>\n

    Rate of Administration<\/h4>\n

    \u2013<\/p>\n

    Comments<\/h4>\n

    \u2013<\/p>\n

    OTHER INFORMATION<\/h4>\n

    First pass elimination of 60\u201375% following oral administration<\/li>\n","protected":false},"excerpt":{"rendered":"

    Carvedilol CLINICAL USE Beta-adrenoceptor blocker with alpha1-blocking action: Hypertension, angina<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1704","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1704","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1704"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1704\/revisions"}],"predecessor-version":[{"id":2839,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1704\/revisions\/2839"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1704"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1704"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1704"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}