Carvista
Generic Name
Carvedilol
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| carvista 25 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Carvista 25 mg tablet contains Carvedilol, which is used to treat high blood pressure, angina, and heart failure. It works by relaxing blood vessels and slowing heart rate, improving blood flow.
Uses & Indications
Dosage
Adults
Hypertension: Initially 6.25 mg twice daily, increased to 12.5 mg twice daily after 1-2 weeks. Max 50 mg/day. Heart Failure: Initially 3.125 mg twice daily for two weeks, then gradually increased to a maximum of 25 mg twice daily (for patients <85 kg) or 50 mg twice daily (for patients >85 kg). Angina: Initially 12.5 mg twice daily, increased to 25 mg twice daily after 1-2 weeks. Max 50 mg/day.
Elderly
No specific dose adjustment generally required, but close monitoring is advised, especially for heart failure.
Renal_impairment
No specific dose adjustment is usually required for mild to moderate renal impairment. For severe impairment, caution is advised.
How to Take
Carvista tablets should be taken orally with food to reduce the risk of orthostatic hypotension and to increase absorption.
Mechanism of Action
Carvedilol is a non-selective beta-adrenergic blocker with alpha-1 blocking activity. It reduces cardiac output, inhibits renin release, and causes vasodilation, leading to a reduction in blood pressure and heart rate.
Pharmacokinetics
Onset
Within 1 hour for blood pressure lowering, full effect within 7-14 days.
Excretion
Mainly excreted in feces via bile, a small amount excreted via urine.
Half life
Approximately 7-10 hours.
Absorption
Rapidly and extensively absorbed from the gastrointestinal tract, but undergoes extensive first-pass metabolism, resulting in approximately 25-35% absolute bioavailability.
Metabolism
Extensively metabolized in the liver, primarily by oxidation and glucuronidation, involving various CYP450 enzymes (CYP2D6, CYP2C9).
Side Effects
Contraindications
- Hypersensitivity to Carvedilol or any component of the formulation
- 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)
- Severe bradycardia (<50 bpm)
- Cardiogenic shock
- Severe hepatic impairment
Drug Interactions
Digoxin
Increased digoxin levels and additive bradycardia. Monitor digoxin levels and heart rate.
Clonidine
If discontinuing concomitant clonidine and carvedilol, carvedilol should be withdrawn first, several days before gradual withdrawal of clonidine.
Cimetidine
Increased plasma concentrations of carvedilol. Monitor for increased carvedilol effects.
Rifampicin
Decreased plasma concentrations of carvedilol. Monitor therapeutic effect.
Insulin or oral hypoglycemics
May mask symptoms of hypoglycemia and potentiate blood sugar lowering effect. Monitor blood glucose closely.
Non-dihydropyridine calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of AV conduction disturbances and heart failure. Monitor ECG and blood pressure.
Storage
Store in a cool, dry place, below 30°C. Protect 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 supportive therapy, including atropine for bradycardia, vasopressors for hypotension, and glucagon for severe cardiovascular depression.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Carvedilol is excreted in human milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to Carvedilol or any component of the formulation
- 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)
- Severe bradycardia (<50 bpm)
- Cardiogenic shock
- Severe hepatic impairment
Drug Interactions
Digoxin
Increased digoxin levels and additive bradycardia. Monitor digoxin levels and heart rate.
Clonidine
If discontinuing concomitant clonidine and carvedilol, carvedilol should be withdrawn first, several days before gradual withdrawal of clonidine.
Cimetidine
Increased plasma concentrations of carvedilol. Monitor for increased carvedilol effects.
Rifampicin
Decreased plasma concentrations of carvedilol. Monitor therapeutic effect.
Insulin or oral hypoglycemics
May mask symptoms of hypoglycemia and potentiate blood sugar lowering effect. Monitor blood glucose closely.
Non-dihydropyridine calcium channel blockers (e.g., Verapamil, Diltiazem)
Increased risk of AV conduction disturbances and heart failure. Monitor ECG and blood pressure.
Storage
Store in a cool, dry place, below 30°C. Protect 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 supportive therapy, including atropine for bradycardia, vasopressors for hypotension, and glucagon for severe cardiovascular depression.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Carvedilol is excreted in human milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Carvedilol has been extensively studied in numerous clinical trials for hypertension, angina, and heart failure, demonstrating its efficacy and safety profile in these conditions.
Lab Monitoring
- Blood pressure
- Heart rate
- Liver function tests (periodically)
- Renal function tests (periodically)
- Blood glucose levels (in diabetic patients)
Doctor Notes
- Carvedilol should be initiated with low doses and gradually titrated upwards, especially in heart failure patients, to minimize the risk of hypotension and bradycardia.
- Monitor vital signs, fluid balance, and renal function regularly.
- Educate patients on symptoms of worsening heart failure and orthostatic hypotension.
Patient Guidelines
- Take Carvista with food to minimize dizziness and improve absorption.
- Do not stop taking this medication abruptly without consulting your doctor.
- Avoid driving or operating heavy machinery until you know how this medicine affects you, as it may cause dizziness.
- Report any new or worsening symptoms, especially shortness of breath or swelling of ankles/feet, to your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Carvedilol may cause dizziness, lightheadedness, or fatigue, especially at the start of treatment or when changing dosage. Patients should be cautioned about operating vehicles or machinery until they determine how the drug affects them.
Lifestyle Advice
- Adopt a heart-healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Maintain a healthy weight.
- Limit alcohol consumption and avoid smoking.
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