Vastocor
Generic Name
Carvedilol
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| vastocor 10 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Vastocor (Carvedilol) is an alpha- and beta-adrenergic blocking agent used to treat essential hypertension, stable mild to moderate heart failure, and left ventricular dysfunction following myocardial infarction.
Uses & Indications
Dosage
Adults
For hypertension, initially 6.25 mg twice daily, may be increased to 12.5-25 mg twice daily. For heart failure, initially 3.125 mg twice daily, gradually titrated up to a maximum of 25 mg twice daily (or 50 mg twice daily for patients > 85 kg).
Elderly
No specific dosage adjustment required, but caution is advised due to potential increased sensitivity. Titrate carefully.
Renal_impairment
No dosage adjustment needed for mild to moderate renal impairment. Use with caution in severe impairment.
How to Take
Take orally, preferably with food, to reduce the risk of orthostatic hypotension.
Mechanism of Action
Carvedilol selectively blocks alpha-1 adrenergic receptors and non-selectively blocks beta-1 and beta-2 adrenergic receptors. Alpha-1 blockade causes vasodilation, reducing peripheral vascular resistance. Beta-blockade reduces heart rate, myocardial contractility, and cardiac output.
Pharmacokinetics
Onset
Antihypertensive effects typically begin within 1-2 hours, full effect may take weeks.
Excretion
Primarily excreted via bile into the feces (approximately 60-65% of the dose).
Half life
Approximately 7-10 hours.
Absorption
Rapidly absorbed, approximately 25-35% bioavailability. Peak plasma concentrations are reached within 1-2 hours.
Metabolism
Extensively metabolized in the liver, primarily via CYP2D6 and CYP2C9 enzymes.
Side Effects
Contraindications
- Bronchial asthma or related bronchospastic conditions
- Second- or third-degree AV block (unless a permanent pacemaker is in place)
- Severe bradycardia (<50 beats/min)
- Sick sinus syndrome (unless a permanent pacemaker is in place)
- Cardiogenic shock or decompensated heart failure requiring IV inotropic therapy
- Severe hepatic impairment
- Known hypersensitivity to carvedilol or any component of the formulation
Drug Interactions
Digoxin
May increase digoxin concentrations.
Rifampicin
May decrease carvedilol plasma concentrations.
Insulin and Oral Hypoglycemics
Beta-blockers may mask symptoms of hypoglycemia and potentiate glucose-lowering effects.
Calcium Channel Blockers (e.g., Verapamil, Diltiazem)
Additive effects on AV conduction and myocardial contractility.
CYP2D6 inhibitors (e.g., Quinidine, Fluoxetine, Paroxetine)
May increase carvedilol plasma concentrations.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include severe hypotension, bradycardia, heart failure, cardiogenic shock, and bronchospasm. Management involves supportive therapy, including intravenous fluids, atropine for bradycardia, glucagon, and vasopressors if 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 breast milk; therefore, breastfeeding is not recommended.
Side Effects
Contraindications
- Bronchial asthma or related bronchospastic conditions
- Second- or third-degree AV block (unless a permanent pacemaker is in place)
- Severe bradycardia (<50 beats/min)
- Sick sinus syndrome (unless a permanent pacemaker is in place)
- Cardiogenic shock or decompensated heart failure requiring IV inotropic therapy
- Severe hepatic impairment
- Known hypersensitivity to carvedilol or any component of the formulation
Drug Interactions
Digoxin
May increase digoxin concentrations.
Rifampicin
May decrease carvedilol plasma concentrations.
Insulin and Oral Hypoglycemics
Beta-blockers may mask symptoms of hypoglycemia and potentiate glucose-lowering effects.
Calcium Channel Blockers (e.g., Verapamil, Diltiazem)
Additive effects on AV conduction and myocardial contractility.
CYP2D6 inhibitors (e.g., Quinidine, Fluoxetine, Paroxetine)
May increase carvedilol plasma concentrations.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include severe hypotension, bradycardia, heart failure, cardiogenic shock, and bronchospasm. Management involves supportive therapy, including intravenous fluids, atropine for bradycardia, glucagon, and vasopressors if 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 breast milk; therefore, breastfeeding is not recommended.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months
Availability
Available in pharmacies and hospitals
Approval Status
Approved by DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensively studied in numerous clinical trials for its efficacy in hypertension, heart failure, and post-myocardial infarction left ventricular dysfunction, demonstrating significant benefits in reducing morbidity and mortality.
Lab Monitoring
- Blood pressure monitoring
- Heart rate monitoring
- Liver function tests (periodically)
- Blood glucose (in diabetic patients)
Doctor Notes
- Gradual dose titration is crucial, especially in patients with heart failure, to avoid exacerbation of symptoms.
- Monitor for signs of fluid retention and worsening heart failure during initiation and dose adjustments.
- Educate patients on symptoms of hypotension and bradycardia.
Patient Guidelines
- Do not stop taking this medicine abruptly without consulting your doctor.
- Take this medicine with food.
- Monitor your blood pressure and heart rate regularly.
- Report any signs of worsening heart failure or breathing difficulties.
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 continue your regular dosing schedule. Do not double the dose.
Driving Precautions
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
- Maintain a healthy diet low in saturated fats and sodium.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption.
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