Acecard
Generic Name
Carvedilol
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| acecard 25 mg tablet | ৳ 5.00 | ৳ 50.00 |
Description
Overview of the medicine
Acecard 25 mg tablet contains Carvedilol, a non-selective beta-adrenergic blocker with alpha1-adrenergic blocking activity. It is used to treat essential hypertension, chronic stable angina pectoris, and symptomatic chronic heart failure.
Uses & Indications
Dosage
Adults
Hypertension: Initially 12.5 mg once daily for 2 days, then 25 mg once daily. Maximum 50 mg once daily. Angina: Initially 12.5 mg twice daily for 2 days, then 25 mg twice daily. Maximum 50 mg twice daily. Heart Failure: Initially 3.125 mg twice daily for 2 weeks, then if tolerated, increase to 6.25 mg twice daily. The dose can be doubled every 2 weeks up to 25 mg twice daily for patients <85 kg, or 50 mg twice daily for patients >85 kg or severe heart failure.
Elderly
For hypertension/angina, dose adjustment is not typically required. For heart failure, careful dose titration and monitoring are recommended.
Renal_impairment
No dose adjustment is necessary for patients with mild to moderate renal impairment. For severe renal impairment, caution is advised.
How to Take
Administer orally, preferably with food to slow the rate of absorption and reduce the risk of orthostatic hypotension.
Mechanism of Action
Carvedilol exerts its effects by non-selectively blocking beta-adrenergic receptors (beta-1 and beta-2) and selectively blocking alpha-1 adrenergic receptors. Beta-blockade leads to a reduction in heart rate and myocardial contractility, while alpha-1 blockade causes peripheral vasodilation, reducing total peripheral resistance and blood pressure.
Pharmacokinetics
Onset
Antihypertensive effect usually within 1 hour, full effect may take several weeks.
Excretion
Primarily excreted via bile into the feces (approximately 60-65%), with a small amount (approximately 16%) excreted renally.
Half life
Approximately 7-10 hours.
Absorption
Rapidly and extensively absorbed from the gastrointestinal tract; however, due to significant first-pass metabolism, absolute bioavailability is approximately 25-35%. Peak plasma concentrations occur within 1-2 hours.
Metabolism
Extensively metabolized in the liver, primarily via aromatic hydroxylation and glucuronidation, mainly by CYP2D6 and CYP2C9.
Side Effects
Contraindications
- •Bronchial asthma or any bronchospastic conditions
- •Second or third-degree atrioventricular (AV) block (unless a permanent pacemaker is in place)
- •Sick sinus syndrome (unless a permanent pacemaker is in place)
- •Severe bradycardia (<50 beats/minute)
- •Cardiogenic shock
- •Decompensated heart failure requiring intravenous inotropic therapy
- •Severe hepatic impairment
- •Known hypersensitivity to carvedilol or any component of the formulation
Drug Interactions
Digoxin
May increase digoxin plasma concentrations and effects. Monitor digoxin levels.
Clonidine
Co-administration with clonidine can potentiate blood pressure and heart rate lowering effects. If discontinuing, clonidine should be withdrawn several days after carvedilol.
Rifampicin
Strong CYP inducers like rifampicin can significantly decrease carvedilol plasma concentrations, reducing its efficacy.
Calcium Channel Blockers (e.g., Verapamil, Diltiazem)
Concomitant use may increase the risk of AV conduction disturbances and heart failure. Careful monitoring is required.
CYP2D6 Inhibitors (e.g., Fluoxetine, Paroxetine, Quinidine)
Can increase carvedilol plasma concentrations. Dose adjustment of carvedilol may be needed.
Storage
Store in a cool, dry place below 30°C, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include severe hypotension, bradycardia, heart failure, cardiogenic shock, cardiac arrest, bronchospasm, vomiting, and impaired consciousness. Treatment is supportive and symptomatic, including atropine for severe bradycardia, glucagon, and vasopressors for hypotension, and diuretics for heart failure.
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 known to be excreted in breast milk; therefore, breastfeeding is not recommended during carvedilol treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, specific expiry date is printed on the packaging.
Availability
Pharmacies, Hospitals
Approval Status
Approved by FDA (for generic Carvedilol)
Patent Status
Generic available
WHO Essential Medicine
YesAlternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine
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