Pricard
Generic Name
Carvedilol
Manufacturer
Square Pharmaceuticals Ltd.
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 25 mg Tablet contains Carvedilol, a beta-blocker and alpha-blocker used to treat high blood pressure, angina pectoris, and heart failure. It works by relaxing blood vessels and slowing heart rate, improving blood flow and reducing the heart's workload.
Uses & Indications
Dosage
Adults
Hypertension: Initially 6.25 mg twice daily; may be increased to 12.5 mg twice daily, then to 25 mg twice daily (max 50 mg/day). Chronic Heart Failure: Initially 3.125 mg twice daily for 2 weeks; dose may be doubled every 2 weeks up to 25 mg twice daily for patients weighing <85 kg, or 50 mg twice daily for patients weighing >85 kg.
Elderly
No specific dosage adjustment usually required unless severe renal or hepatic impairment is present.
Renal_impairment
No dosage adjustment needed for mild-to-moderate renal impairment. For severe renal impairment, monitor closely and adjust as needed.
How to Take
Take orally, with food to slow the rate of absorption and reduce the incidence of orthostatic effects. Do not crush or chew extended-release tablets.
Mechanism of Action
Carvedilol is a non-selective beta-adrenergic blocker and an alpha1-adrenergic blocker. It reduces heart rate, myocardial contractility, and systemic vascular resistance. Its alpha1-blocking activity leads to vasodilation, while its beta-blocking activity helps in controlling heart rate and reducing myocardial oxygen demand. It also has antioxidant and antiproliferative properties.
Pharmacokinetics
Onset
Approximately 1 hour for blood pressure lowering effect.
Excretion
Primarily excreted via bile into feces (about 60-65%), with a small amount excreted via urine (about 16%).
Half life
Approximately 7-10 hours.
Absorption
Rapidly absorbed from the GI tract; extensive first-pass metabolism reduces bioavailability to about 25-35%. Peak plasma concentrations occur in 1-2 hours.
Metabolism
Extensively metabolized in the liver, primarily by CYP2D6 and CYP2C9, into several active and inactive metabolites.
Side Effects
Contraindications
- Severe symptomatic bradycardia
- Second or third-degree atrioventricular (AV) block (unless a permanent pacemaker is in place)
- Sick sinus syndrome (unless a permanent pacemaker is in place)
- Cardiogenic shock
- Decompensated heart failure requiring intravenous inotropic therapy
- Severe hepatic impairment
- Bronchial asthma or related bronchospastic conditions
Drug Interactions
Digoxin
Increased Digoxin concentrations; monitor digoxin levels.
Rifampin
Decreased Carvedilol plasma concentrations.
Clonidine
May potentiate blood pressure and heart rate lowering effects; if discontinuing, Carvedilol should be stopped first.
Cimetidine
Increased Carvedilol plasma concentrations.
Cyclosporine
Increased cyclosporine concentrations; monitor cyclosporine levels.
Fluoxetine/Paroxetine
Strong CYP2D6 inhibitors may increase Carvedilol levels.
Insulin/Oral Hypoglycemics
Increased hypoglycemic effect; beta-blockers may mask symptoms of hypoglycemia.
Calcium Channel Blockers (e.g., Diltiazem, Verapamil)
Potential for additive effects on AV conduction and/or heart rate.
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, cardiac insufficiency, cardiogenic shock, and cardiac arrest. Treatment is symptomatic and supportive; includes atropine for bradycardia, glucagon, IV fluids, vasopressors, and inotropes as needed.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Carvedilol is excreted in human milk; nursing mothers should not take Carvedilol due to potential for serious adverse reactions in breastfed infants.
Side Effects
Contraindications
- Severe symptomatic bradycardia
- Second or third-degree atrioventricular (AV) block (unless a permanent pacemaker is in place)
- Sick sinus syndrome (unless a permanent pacemaker is in place)
- Cardiogenic shock
- Decompensated heart failure requiring intravenous inotropic therapy
- Severe hepatic impairment
- Bronchial asthma or related bronchospastic conditions
Drug Interactions
Digoxin
Increased Digoxin concentrations; monitor digoxin levels.
Rifampin
Decreased Carvedilol plasma concentrations.
Clonidine
May potentiate blood pressure and heart rate lowering effects; if discontinuing, Carvedilol should be stopped first.
Cimetidine
Increased Carvedilol plasma concentrations.
Cyclosporine
Increased cyclosporine concentrations; monitor cyclosporine levels.
Fluoxetine/Paroxetine
Strong CYP2D6 inhibitors may increase Carvedilol levels.
Insulin/Oral Hypoglycemics
Increased hypoglycemic effect; beta-blockers may mask symptoms of hypoglycemia.
Calcium Channel Blockers (e.g., Diltiazem, Verapamil)
Potential for additive effects on AV conduction and/or heart rate.
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, cardiac insufficiency, cardiogenic shock, and cardiac arrest. Treatment is symptomatic and supportive; includes atropine for bradycardia, glucagon, IV fluids, vasopressors, and inotropes as needed.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Carvedilol is excreted in human milk; nursing mothers should not take Carvedilol due to potential for serious adverse reactions in breastfed infants.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory bodies worldwide (e.g., FDA, DGDA)
Patent Status
Generic available (original patent expired)
WHO Essential Medicine
YesClinical Trials
Carvedilol has undergone extensive clinical trials demonstrating its efficacy and safety in hypertension, angina, and heart failure, including the US Carvedilol Heart Failure Trials Program and the COMET trial.
Lab Monitoring
- Blood pressure
- Heart rate
- Renal function (BUN, creatinine)
- Liver function (ALT, AST)
- Blood glucose (especially in diabetics)
Doctor Notes
- Ensure gradual titration of Carvedilol, especially in heart failure patients, to minimize adverse effects.
- Monitor for signs of worsening heart failure, bradycardia, hypotension, and liver dysfunction.
- Educate patients on the importance of adherence and not discontinuing abruptly.
- Consider potential drug interactions, particularly with other cardiovascular agents.
Patient Guidelines
- Take Pricard 25 mg Tablet exactly as prescribed by your doctor.
- Do not stop taking this medicine abruptly without consulting your doctor, as it can worsen your condition.
- Take with food to reduce dizziness or lightheadedness.
- Monitor your blood pressure and heart rate regularly as advised by your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, 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
Carvedilol may cause dizziness or fatigue, especially at the start of treatment or when the dose is increased. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Adopt a healthy lifestyle including a balanced diet, regular exercise, and maintaining a healthy weight.
- Limit sodium intake and avoid excessive alcohol consumption.
- Quit smoking to improve cardiovascular health.
- Manage stress effectively through relaxation techniques.
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