Carceva-Plus
Generic Name
Carvedilol
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| carceva plus 75 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Carceva-Plus 75 mg Tablet contains Carvedilol, which is a non-selective beta-blocker and alpha-1 blocker. It is used to treat essential hypertension (high blood pressure), chronic stable angina pectoris (chest pain due to heart disease), and symptomatic chronic heart failure (weak heart condition).
Uses & Indications
Dosage
Adults
The usual initial dose for hypertension is 6.25 mg twice daily, increased gradually as needed. For angina, initial 12.5 mg twice daily. For heart failure, initial 3.125 mg twice daily, gradually increasing. Carceva-Plus 75 mg is a high dose and should only be taken as directed by a physician, based on individual patient needs and response.
Elderly
Similar to adults, but dosage titration should be slower, and patients should be monitored carefully.
Renal_impairment
No dosage adjustment is usually required for mild to moderate renal impairment. For severe impairment, monitor patients carefully.
How to Take
Take Carceva-Plus 75 mg tablet orally, with food, to reduce the risk of orthostatic hypotension (dizziness upon standing). Swallow the tablet whole with water.
Mechanism of Action
Carvedilol works by blocking beta-1, beta-2, and alpha-1 adrenergic receptors. Beta-blockade reduces heart rate and contractility, thereby decreasing cardiac output. Alpha-1 blockade causes vasodilation, which reduces peripheral vascular resistance and thus lowers blood pressure.
Pharmacokinetics
Onset
Blood pressure lowering effect starts within 30 minutes, with maximum effect typically seen within 1-2 hours.
Excretion
Primarily excreted via bile into feces (approximately 85%), with minor renal excretion.
Half life
Approximately 7-10 hours.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations occurring within 1-2 hours. Absolute bioavailability is approximately 25-35% due to extensive first-pass metabolism.
Metabolism
Extensively metabolized in the liver, primarily by CYP2D6 and CYP2C9 enzymes, to active and inactive metabolites.
Side Effects
Contraindications
- Bronchial asthma or related bronchospastic conditions
- Severe chronic obstructive pulmonary disease (COPD)
- Decompensated heart failure requiring intravenous inotropic therapy
- Second- or third-degree AV block (unless a permanent pacemaker is in place)
- Sick sinus syndrome (unless a permanent pacemaker is in place)
- Cardiogenic shock
- Severe bradycardia (heart rate <50 beats/minute)
- Severe hepatic impairment
- Hypersensitivity to carvedilol or any component of the formulation
Drug Interactions
Digoxin
May increase digoxin levels.
Clonidine
Potentiates blood pressure and heart rate lowering effects.
Rifampicin
May decrease carvedilol plasma concentrations.
Insulin and oral hypoglycemics
May mask the symptoms of hypoglycemia (e.g., tachycardia).
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of AV conduction disturbances and heart failure.
CYP2D6 inhibitors (e.g., Quinidine, Fluoxetine, Paroxetine)
May increase carvedilol plasma concentrations.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, heart failure, cardiogenic shock, cardiac arrest, bronchospasm, vomiting. Management is symptomatic and supportive; atropine for bradycardia, glucagon, vasopressors, and bronchodilators may be used as appropriate.
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 breast milk; therefore, breastfeeding is not recommended during Carvedilol therapy.
Side Effects
Contraindications
- Bronchial asthma or related bronchospastic conditions
- Severe chronic obstructive pulmonary disease (COPD)
- Decompensated heart failure requiring intravenous inotropic therapy
- Second- or third-degree AV block (unless a permanent pacemaker is in place)
- Sick sinus syndrome (unless a permanent pacemaker is in place)
- Cardiogenic shock
- Severe bradycardia (heart rate <50 beats/minute)
- Severe hepatic impairment
- Hypersensitivity to carvedilol or any component of the formulation
Drug Interactions
Digoxin
May increase digoxin levels.
Clonidine
Potentiates blood pressure and heart rate lowering effects.
Rifampicin
May decrease carvedilol plasma concentrations.
Insulin and oral hypoglycemics
May mask the symptoms of hypoglycemia (e.g., tachycardia).
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of AV conduction disturbances and heart failure.
CYP2D6 inhibitors (e.g., Quinidine, Fluoxetine, Paroxetine)
May increase carvedilol plasma concentrations.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, heart failure, cardiogenic shock, cardiac arrest, bronchospasm, vomiting. Management is symptomatic and supportive; atropine for bradycardia, glucagon, vasopressors, and bronchodilators may be used as appropriate.
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 breast milk; therefore, breastfeeding is not recommended during Carvedilol therapy.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from the manufacturing date, consult packaging for exact date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by relevant regulatory authorities (e.g., DGDA in Bangladesh, FDA in USA)
Patent Status
Generic available (original patent expired)
WHO Essential Medicine
YesClinical Trials
Carvedilol has undergone extensive clinical trials demonstrating its efficacy and safety in the treatment of hypertension, angina, and chronic heart failure, including landmark studies like COPERNICUS and US Carvedilol Heart Failure Trials.
Lab Monitoring
- Blood pressure monitoring
- Heart rate monitoring
- Blood glucose levels (especially in diabetic patients)
- Renal function tests
- Liver function tests (periodically)
Doctor Notes
- Monitor patient's heart rate, blood pressure, and signs of heart failure exacerbation closely, especially during initiation and dose titration.
- Emphasize the importance of gradual withdrawal of the drug to avoid rebound effects in patients with coronary artery disease.
- Advise patients to take with food to minimize orthostatic hypotension.
Patient Guidelines
- Take your medicine regularly as prescribed by your doctor.
- Always take Carceva-Plus with food to minimize dizziness.
- Do not stop taking this medicine abruptly without consulting your doctor, as it can worsen your condition.
- Report any new or worsening symptoms, especially dizziness, fainting, swelling, or breathing difficulties, to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Carceva-Plus may cause dizziness or fatigue, especially at the start of treatment or after dose adjustments. Avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet, regular exercise, and stress management.
- Limit sodium intake and avoid smoking and excessive alcohol consumption, as these can worsen cardiovascular conditions.
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Global Brand Names
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