Pricard
Generic Name
Carvedilol
Manufacturer
Renata Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| pricard 25 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Pricard (Carvedilol) is a beta-blocker used to treat hypertension (high blood pressure), chronic stable angina pectoris, and mild to severe chronic heart failure. It works by blocking beta- and alpha-adrenoceptors, leading to a reduction in heart rate, blood pressure, and myocardial oxygen demand.
Uses & Indications
Dosage
Adults
Hypertension: Initially 12.5 mg once daily, increased to 25 mg once daily after 2 days. Max 50 mg/day. Heart Failure: Initially 3.125 mg twice daily, slowly titrated up to a maximum of 25 mg twice daily for patients <85 kg, or 50 mg twice daily for patients >85 kg.
Elderly
Consider lower initial doses and slower titration, especially in heart failure.
Renal_impairment
No dose adjustment is generally required, but close monitoring is advisable.
How to Take
Take orally, preferably with food to increase absorption and reduce the risk of orthostatic hypotension. Do not crush or chew tablets.
Mechanism of Action
Carvedilol is a non-selective beta-adrenergic blocker with alpha-1 blocking activity. It reduces heart rate and cardiac output, lowers systemic vascular resistance, and inhibits renin release. This dual action contributes to its antihypertensive and cardioprotective effects.
Pharmacokinetics
Onset
Approximately 1 hour for blood pressure reduction.
Excretion
Primarily excreted via the bile into the feces (approximately 60-65%), with less than 16% excreted in urine.
Half life
Approximately 6-10 hours.
Absorption
Well absorbed after oral administration, with an absolute bioavailability of approximately 25-35% due to extensive first-pass metabolism. Food increases bioavailability.
Metabolism
Extensively metabolized in the liver, primarily by CYP2D6 and CYP2C9, to various metabolites, some of which are active.
Side Effects
Contraindications
- Bronchial asthma or related bronchospastic conditions
- 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 or severe decompensated heart failure requiring intravenous inotropic therapy
- Severe bradycardia
- Severe hepatic impairment
Drug Interactions
Digoxin
May increase digoxin levels and enhance bradycardic effects.
Cimetidine
May increase carvedilol bioavailability.
Rifampicin
May reduce carvedilol plasma concentrations by inducing CYP2D6 and CYP2C9.
Insulin and oral hypoglycemics
Beta-blockers may mask symptoms of hypoglycemia and potentiate their effects.
Calcium channel blockers (e.g., verapamil, diltiazem)
Increased risk of AV conduction disturbances or heart failure.
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. Bronchospasm, vomiting, and generalized convulsions may also occur. Management involves supportive care, including gastric lavage, activated charcoal, and symptomatic treatment for specific effects (e.g., atropine for bradycardia, vasopressors for hypotension).
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 unknown whether Carvedilol is excreted in human milk; caution is advised during breastfeeding.
Side Effects
Contraindications
- Bronchial asthma or related bronchospastic conditions
- 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 or severe decompensated heart failure requiring intravenous inotropic therapy
- Severe bradycardia
- Severe hepatic impairment
Drug Interactions
Digoxin
May increase digoxin levels and enhance bradycardic effects.
Cimetidine
May increase carvedilol bioavailability.
Rifampicin
May reduce carvedilol plasma concentrations by inducing CYP2D6 and CYP2C9.
Insulin and oral hypoglycemics
Beta-blockers may mask symptoms of hypoglycemia and potentiate their effects.
Calcium channel blockers (e.g., verapamil, diltiazem)
Increased risk of AV conduction disturbances or heart failure.
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. Bronchospasm, vomiting, and generalized convulsions may also occur. Management involves supportive care, including gastric lavage, activated charcoal, and symptomatic treatment for specific effects (e.g., atropine for bradycardia, vasopressors for hypotension).
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 unknown whether Carvedilol is excreted in human milk; caution is advised during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, depending on storage conditions.
Availability
Available in pharmacies and hospitals nationwide
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Key trials like the COPERNICUS trial and the US Carvedilol Heart Failure Study established Carvedilol's efficacy in heart failure and post-MI left ventricular dysfunction, demonstrating significant reductions in mortality and hospitalizations.
Lab Monitoring
- Blood pressure and heart rate (regularly)
- Renal function (e.g., serum creatinine, BUN) in patients with heart failure or pre-existing renal impairment
- Liver function tests (baseline and periodically, especially in suspected hepatic impairment)
- Blood glucose levels (in diabetic patients)
Doctor Notes
- Titrate dose slowly, especially in heart failure patients, to avoid adverse events.
- Monitor for signs of worsening heart failure during initiation or dose titration.
- Caution with patients prone to bronchospasm, diabetes, or peripheral vascular disease.
Patient Guidelines
- Take with food to minimize the risk of orthostatic hypotension.
- Do not stop taking Carvedilol abruptly, as this can worsen your condition. Consult your doctor for gradual dose reduction.
- Monitor your blood pressure and heart rate regularly as advised by your doctor.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
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 or fatigue, especially at the start of treatment or when changing dose. Exercise caution when driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as approved by your doctor.
- Avoid smoking and limit alcohol consumption.
- Manage stress effectively through relaxation techniques.
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