Acecard
Generic Name
Carvedilol
Manufacturer
ACI Pharmaceuticals
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| acecard 125 mg tablet | ৳ 3.00 | ৳ 30.00 |
Description
Overview of the medicine
Carvedilol is a non-selective beta-adrenergic blocker and an alpha-1 adrenergic blocker used to treat essential hypertension, angina pectoris, and mild to severe chronic heart failure.
Uses & Indications
Dosage
Adults
For hypertension: Initially 6.25 mg twice daily; may be increased to 12.5-25 mg twice daily. For heart failure: Initially 3.125 mg twice daily for two weeks, then gradually increased as tolerated.
Elderly
Similar to adults, but cautious titration may be required due to increased sensitivity and potential for adverse effects.
Renal_impairment
No dose adjustment is generally needed in patients with renal impairment, but careful monitoring is advisable.
How to Take
Take orally with food to slow absorption and reduce the incidence of orthostatic hypotension.
Mechanism of Action
Carvedilol blocks beta-1, beta-2, and alpha-1 adrenergic receptors. This action leads to a reduction in heart rate, myocardial contractility, and vasodilation, resulting in lower blood pressure and improved cardiac function.
Pharmacokinetics
Onset
Approximately 1 hour for blood pressure lowering effect.
Excretion
Mainly excreted via bile into feces. Less than 2% is excreted renally.
Half life
About 7-10 hours.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations occurring within 1-2 hours. Extensive first-pass metabolism, resulting in approximately 25-35% absolute bioavailability.
Metabolism
Extensively metabolized in the liver, primarily by CYP2D6 and CYP2C9, producing several active and inactive metabolites.
Side Effects
Contraindications
- •Bronchial asthma or related bronchospastic conditions
- •Second or third-degree AV block (without a permanent pacemaker)
- •Sick sinus syndrome (without a permanent pacemaker)
- •Severe bradycardia (<50 bpm)
- •Cardiogenic shock or decompensated heart failure requiring intravenous inotropic therapy
- •Severe hepatic impairment
- •Hypersensitivity to carvedilol or any component of the formulation
Drug Interactions
Digoxin
Increased digoxin levels and enhanced bradycardia, requiring monitoring of digoxin levels and heart rate.
Clonidine
Potentiates blood pressure and heart rate lowering effects. If co-administration is necessary, withdraw carvedilol first, then gradually discontinue clonidine.
Insulin/Oral hypoglycemics
Beta-blockers can mask symptoms of hypoglycemia and potentiate the hypoglycemic effects of these drugs.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia, AV block, and hypotension. Administer with caution.
CYP2D6 inhibitors (e.g., Fluoxetine, Paroxetine, Quinidine)
May increase carvedilol plasma concentrations, requiring dose adjustment.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, heart failure, cardiogenic shock, and cardiac arrest. Management involves symptomatic and supportive treatment, including gastric lavage, activated charcoal, and intravenous fluids/vasopressors as needed.
Pregnancy & Lactation
Pregnancy Category C. Carvedilol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human milk, therefore, breastfeeding is not recommended.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, depending on manufacturer specifications.
Availability
Pharmacies, Hospitals
Approval Status
DGDA approved
Patent Status
Off-patent
WHO Essential Medicine
YesAlternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine
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