Cardobis Plus
Generic Name
Carvedilol + Hydrochlorothiazide
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cardobis plus 25 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Cardobis Plus 25 mg Tablet is a combination medication containing Carvedilol, a beta-blocker, and Hydrochlorothiazide, a thiazide diuretic, used to treat high blood pressure and heart failure.
Uses & Indications
Dosage
Adults
Usually 1 tablet once daily, adjusted based on patient response and tolerability.
Elderly
Initial dose may be lower, titrated carefully.
Renal_impairment
Use with caution; dose adjustment may be required based on creatinine clearance. Contraindicated in anuric patients.
How to Take
Oral, taken once daily, preferably with food to increase absorption and reduce orthostatic effects.
Mechanism of Action
Carvedilol non-selectively blocks beta-adrenergic receptors and selectively blocks alpha-1 adrenergic receptors, leading to vasodilation and reduced heart rate. Hydrochlorothiazide inhibits sodium reabsorption in the distal convoluted tubules, increasing water and sodium excretion.
Pharmacokinetics
Onset
Carvedilol: 1-2 hours. Hydrochlorothiazide: 2 hours.
Excretion
Carvedilol: Primarily fecal (biliary excretion). Hydrochlorothiazide: Renally (unchanged).
Half life
Carvedilol: 7-10 hours. Hydrochlorothiazide: 5.6-14.8 hours.
Absorption
Carvedilol: Rapid and extensively absorbed (approx. 25-35% bioavailability due to first-pass metabolism). Hydrochlorothiazide: Readily absorbed.
Metabolism
Carvedilol: Extensively metabolized in the liver by oxidation and glucuronidation. Hydrochlorothiazide: Not metabolized.
Side Effects
Contraindications
- Severe bradycardia or heart block
- Cardiogenic shock
- Decompensated heart failure
- Severe hepatic impairment
- Anuria
- Hypersensitivity to carvedilol, hydrochlorothiazide, or sulfonamide-derived drugs
Drug Interactions
NSAIDs
Reduced antihypertensive effect.
Digoxin
Increased digoxin levels and bradycardia.
Lithium
Increased lithium toxicity due to reduced renal clearance by HCTZ.
Corticosteroids
Enhanced electrolyte depletion by HCTZ.
Other antihypertensives
Additive hypotensive effect.
Insulin/Oral hypoglycemics
Carvedilol may mask hypoglycemia symptoms; HCTZ may cause hyperglycemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms: Severe hypotension, bradycardia, cardiac insufficiency, cardiogenic shock, cardiac arrest, respiratory depression, seizures, and hypokalemia (HCTZ). Management: Symptomatic and supportive treatment. Atropine for bradycardia, vasopressors for hypotension, glucagon for persistent bradycardia/hypotension.
Pregnancy & Lactation
Generally not recommended during pregnancy (especially in the 2nd and 3rd trimesters due to HCTZ risks). Carvedilol is excreted in breast milk. Consult a doctor.
Side Effects
Contraindications
- Severe bradycardia or heart block
- Cardiogenic shock
- Decompensated heart failure
- Severe hepatic impairment
- Anuria
- Hypersensitivity to carvedilol, hydrochlorothiazide, or sulfonamide-derived drugs
Drug Interactions
NSAIDs
Reduced antihypertensive effect.
Digoxin
Increased digoxin levels and bradycardia.
Lithium
Increased lithium toxicity due to reduced renal clearance by HCTZ.
Corticosteroids
Enhanced electrolyte depletion by HCTZ.
Other antihypertensives
Additive hypotensive effect.
Insulin/Oral hypoglycemics
Carvedilol may mask hypoglycemia symptoms; HCTZ may cause hyperglycemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms: Severe hypotension, bradycardia, cardiac insufficiency, cardiogenic shock, cardiac arrest, respiratory depression, seizures, and hypokalemia (HCTZ). Management: Symptomatic and supportive treatment. Atropine for bradycardia, vasopressors for hypotension, glucagon for persistent bradycardia/hypotension.
Pregnancy & Lactation
Generally not recommended during pregnancy (especially in the 2nd and 3rd trimesters due to HCTZ risks). Carvedilol is excreted in breast milk. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date.
Availability
Pharmacies and Hospitals
Approval Status
Approved by regulatory authorities
Patent Status
Generics available
Clinical Trials
Extensive clinical trials support the efficacy and safety of carvedilol and hydrochlorothiazide in hypertension and heart failure, individually and in combination.
Lab Monitoring
- Blood pressure
- Heart rate
- Electrolyte levels (Potassium, Sodium)
- Renal function (BUN, Creatinine)
- Liver function tests
- Blood glucose (especially in diabetics)
Doctor Notes
- Monitor patient for signs of heart failure exacerbation, especially during dose titration.
- Regularly check electrolyte levels and renal function.
- Educate patients on symptoms of orthostatic hypotension.
Patient Guidelines
- Take as directed by your doctor, usually once daily.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Monitor your blood pressure regularly.
- Report any unusual side effects to your doctor.
Missed Dose Advice
Take the missed dose as soon as you remember. If it's almost time for your next dose, skip the missed dose and continue your regular schedule. Do not double the dose.
Driving Precautions
May cause dizziness or fatigue, especially at the start of treatment or dose increases. Avoid driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Adopt a healthy diet low in sodium.
- Engage in regular physical activity.
- Limit alcohol consumption.
- Quit smoking.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.