Carvil, Carza, Cardilol
Generic Name
Carva (Carvedilol)
Manufacturer
Square Pharmaceuticals Ltd., Beximco Pharmaceuticals Ltd., Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Carvedilol is a non-selective beta-adrenergic blocker and an alpha1-adrenergic blocker used to treat hypertension, congestive heart failure, and left ventricular dysfunction following myocardial infarction.
Uses & Indications
Dosage
Adults
Hypertension: Initially 6.25 mg twice daily, may be increased to 12.5 mg then 25 mg twice daily. CHF: Initially 3.125 mg twice daily for two weeks, then gradually increased to 25-50 mg twice daily.
Elderly
Similar to adults, but dosage should be titrated cautiously.
Renal_impairment
No dose adjustment is usually needed for mild to moderate renal impairment. Caution with severe impairment.
How to Take
Oral administration. Should be taken with food to slow absorption and reduce orthostatic hypotension.
Mechanism of Action
Carvedilol blocks beta1, beta2, and alpha1 adrenergic receptors. Beta-blockade reduces heart rate and contractility. Alpha1-blockade causes vasodilation, reducing peripheral vascular resistance.
Pharmacokinetics
Onset
Approximately 1 hour
Excretion
Mainly via bile into feces. Minor renal excretion.
Half life
7-10 hours
Absorption
Rapidly absorbed. Bioavailability is 25-35% due to extensive first-pass metabolism.
Metabolism
Extensive hepatic metabolism, primarily by CYP2D6 and CYP2C9 enzymes.
Side Effects
Contraindications
- Bronchial asthma or related bronchospastic conditions
- Severe chronic obstructive pulmonary disease (COPD)
- Decompensated heart failure (requiring IV inotropic therapy)
- Second- or third-degree AV block (without a pacemaker)
- Sick sinus syndrome (without a pacemaker)
- Cardiogenic shock
- Severe bradycardia
- Severe hepatic impairment
- Hypersensitivity to Carvedilol or any component of the formulation
Drug Interactions
Digoxin
Increases digoxin plasma levels.
Rifampin
Decreases carvedilol plasma concentrations.
Cimetidine
Increases carvedilol plasma concentrations.
Insulin/Oral hypoglycemics
May mask hypoglycemia symptoms and enhance hypoglycemic effects.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia and AV block.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, cardiac insufficiency, cardiogenic shock, cardiac arrest, bronchospasm, vomiting. Management includes atropine for bradycardia, vasopressors for hypotension, and glucagon for cardiovascular depression.
Pregnancy & Lactation
Pregnancy Category C. Carvedilol is excreted in breast milk. Use only if potential benefits outweigh the potential risks.
Side Effects
Contraindications
- Bronchial asthma or related bronchospastic conditions
- Severe chronic obstructive pulmonary disease (COPD)
- Decompensated heart failure (requiring IV inotropic therapy)
- Second- or third-degree AV block (without a pacemaker)
- Sick sinus syndrome (without a pacemaker)
- Cardiogenic shock
- Severe bradycardia
- Severe hepatic impairment
- Hypersensitivity to Carvedilol or any component of the formulation
Drug Interactions
Digoxin
Increases digoxin plasma levels.
Rifampin
Decreases carvedilol plasma concentrations.
Cimetidine
Increases carvedilol plasma concentrations.
Insulin/Oral hypoglycemics
May mask hypoglycemia symptoms and enhance hypoglycemic effects.
Calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia and AV block.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, cardiac insufficiency, cardiogenic shock, cardiac arrest, bronchospasm, vomiting. Management includes atropine for bradycardia, vasopressors for hypotension, and glucagon for cardiovascular depression.
Pregnancy & Lactation
Pregnancy Category C. Carvedilol is excreted in breast milk. Use only if potential benefits outweigh the potential risks.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture, depending on the manufacturer and specific formulation.
Availability
Pharmacies, Hospitals
Approval Status
FDA/DGDA approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Carvedilol has been extensively studied in large clinical trials for hypertension and heart failure, such as the COPERNICUS trial and the US Carvedilol Heart Failure Study, demonstrating its efficacy and safety.
Lab Monitoring
- Blood pressure
- Heart rate
- Renal function (BUN, creatinine)
- Liver function tests
- Blood glucose (especially in diabetic patients)
Doctor Notes
- Gradual dose titration is crucial, especially in patients with heart failure, to avoid worsening symptoms.
- Monitor blood pressure and heart rate closely during initiation and dose adjustments.
- Educate patients about the importance of not discontinuing the medication suddenly.
Patient Guidelines
- Do not stop taking Carvedilol abruptly without consulting your doctor.
- Take your medication with food as directed.
- Monitor your blood pressure and heart rate regularly.
- Report any symptoms of worsening heart failure, dizziness, or fainting to your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double doses. Consult your doctor or pharmacist.
Driving Precautions
Carvedilol may cause dizziness or fatigue, especially at the start of treatment or when changing doses. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Maintain a healthy diet, low in sodium.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption.
- Manage stress effectively.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.