Medicine Information

Liorel

Name: Liorel
Brand: Liorel
Rating: 4.5 (117 reviews)

Tablet5 mgBeta-adrenoceptor blocker (non-selective) with alpha-1 blocking activityATC: C07AG02

Generic Name

Carvedilol

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
liorel 5 mg tablet	৳ 4.53	৳ 45.30

Description

Overview of the medicine

Carvedilol is a beta-blocker and alpha-1 blocker used to treat essential hypertension, chronic stable angina pectoris, and symptomatic chronic heart failure.

Uses & Indications

Essential hypertension

Chronic stable angina pectoris

Symptomatic chronic heart failure (as adjunct therapy)

Dosage

Adults

Hypertension: Typically 6.25 mg twice daily initially, increasing to 12.5-25 mg twice daily. Angina: Typically 12.5 mg twice daily initially, increasing to 25-50 mg twice daily. Heart Failure: Starting dose 3.125 mg twice daily for 2 weeks, then gradually increased. The 5 mg tablet can be used as part of a titrated regimen as prescribed by a physician.

Elderly

For elderly, the dose should be initiated at the lower end of the dosing range and titrated carefully under medical supervision.

Renal_impairment

No dosage adjustment generally required for mild to moderate renal impairment, but caution is advised in severe renal impairment.

How to Take

Take orally, preferably with food, to slow absorption and reduce the risk of orthostatic hypotension.

Mechanism of Action

Carvedilol blocks beta-1, beta-2, and alpha-1 adrenergic receptors. Beta-blockade reduces heart rate and myocardial contractility, leading to decreased cardiac output and blood pressure. Alpha-1 blockade causes vasodilation, further lowering peripheral vascular resistance and blood pressure.

Pharmacokinetics

Onset

Antihypertensive effect seen within 2-4 hours, full effect takes 1-2 weeks.

Excretion

Primarily excreted via bile into feces, with a small amount excreted in urine.

Half life

Approximately 7-10 hours.

Absorption

Rapid and extensively absorbed, but low bioavailability (25-35%) due to first-pass metabolism. Peak plasma concentrations reached within 1-2 hours.

Metabolism

Extensively metabolized in the liver, primarily by CYP2D6 and CYP2C9, into several active and inactive metabolites.

Side Effects

Contraindications

Bronchial asthma or related bronchospastic conditions
Second or third-degree AV block (without a pacemaker)
Sick sinus syndrome (without a pacemaker)
Severe bradycardia (<50 bpm)
Cardiogenic shock or decompensated heart failure requiring IV inotropes
Severe hepatic impairment
Known hypersensitivity to carvedilol or any component of the formulation

Drug Interactions

Digoxin

Increased digoxin levels.

Rifampicin

Decreased carvedilol levels.

Insulin or oral hypoglycemic agents

May mask symptoms of hypoglycemia and potentiate hypoglycemic effect.

Calcium channel blockers (e.g., Verapamil, Diltiazem)

Increased risk of AV conduction disturbances and heart failure.

CYP2D6 inhibitors (e.g., Fluoxetine, Paroxetine, Quinidine)

Increased carvedilol levels.

Storage

Store below 30°C in a dry place, away 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 measures, gastric lavage, administration of atropine for bradycardia, glucagon for hypotension/heart failure, and vasopressors if needed.

Pregnancy & Lactation

Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Carvedilol is excreted in breast milk; therefore, breastfeeding is not recommended.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets30 tablets50 tablets

Shelf Life

Typically 2-3 years from manufacturing date

Availability

Available in pharmacies, hospitals, and clinics

Approval Status

Approved by FDA and local regulatory authorities (e.g., DGDA)

Patent Status

Patent expired; generic versions available

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials have established carvedilol's efficacy and safety for hypertension, angina, and heart failure. Ongoing post-market surveillance monitors long-term effects and new indications.

Lab Monitoring

Blood pressure
Heart rate
Liver function tests (especially in patients with pre-existing hepatic impairment)
Renal function tests (for patients with severe renal impairment)

Doctor Notes

Titrate dose slowly, especially in heart failure patients, to avoid worsening symptoms.
Monitor blood pressure and heart rate regularly.
Caution with patients with obstructive airway disease, diabetes, peripheral vascular disease, and pheochromocytoma.
Advise patients not to stop therapy abruptly.

Patient Guidelines

Do not stop taking this medicine abruptly without consulting your doctor.
Take with food to minimize dizziness and lightheadedness.
Report any unusual symptoms like slow heart rate, swelling, or difficulty breathing to your doctor.
Avoid driving or operating machinery until you know how this medicine affects you, as it may cause dizziness.

Missed Dose Advice

If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Driving Precautions

This medicine may cause dizziness or fatigue, especially when starting treatment or increasing the dose. Avoid driving or operating heavy machinery until you know how it affects you.