Xelcard
Generic Name
Carvedilol
Manufacturer
Popular Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| xelcard 5 mg tablet | ৳ 5.00 | ৳ 50.00 |
| xelcard 10 mg tablet | ৳ 6.50 | ৳ 65.00 |
Description
Overview of the medicine
Xelcard (Carvedilol) is a non-selective beta-adrenergic blocker with alpha1-blocking activity. It is primarily used to treat essential hypertension, chronic stable angina pectoris, and moderate to severe heart failure.
Uses & Indications
Dosage
Adults
For hypertension, initial dose is 12.5 mg once daily for two days, then increased to 25 mg once daily. For angina, initial dose is 12.5 mg twice daily for two days, then increased to 25 mg twice daily. For heart failure, initial dose is 3.125 mg twice daily for two weeks, gradually increased as tolerated.
Elderly
Lower initial doses may be considered for elderly patients, especially in heart failure, and titrated carefully.
Renal_impairment
No dose adjustment is generally required in patients with renal impairment, but caution is advised in severe cases.
How to Take
Administer orally with food to reduce the risk of orthostatic hypotension and to increase absorption.
Mechanism of Action
Carvedilol blocks beta-1, beta-2, and alpha-1 adrenergic receptors. Beta-blockade reduces heart rate and myocardial contractility, while alpha-1 blockade causes vasodilation, leading to a reduction in peripheral vascular resistance and blood pressure.
Pharmacokinetics
Onset
Onset of action typically occurs within 1 hour.
Excretion
Excreted mainly via the bile into feces; a small portion is excreted renally.
Half life
Terminal elimination half-life is approximately 7 to 10 hours.
Absorption
Rapidly absorbed after oral administration, with an absolute bioavailability of approximately 25-35% due to extensive first-pass metabolism.
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
- Severe hepatic impairment
- Second- or third-degree AV block (unless a permanent pacemaker is in place)
- Severe bradycardia (<50 bpm)
- Cardiogenic shock or decompensated heart failure requiring IV inotropic therapy
Drug Interactions
Digoxin
Concomitant use may increase digoxin concentrations.
Rifampicin
May significantly reduce plasma concentrations of carvedilol.
CYP2D6 Inhibitors (e.g., Quinidine, Fluoxetine)
May increase carvedilol plasma concentrations.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, heart failure, cardiogenic shock, and bronchospasm. Treatment involves symptomatic and supportive measures, including atropine for bradycardia, glucagon for myocardial depression, and vasopressors for hypotension.
Pregnancy & Lactation
Pregnancy Category C. Not recommended during pregnancy unless 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
- Severe hepatic impairment
- Second- or third-degree AV block (unless a permanent pacemaker is in place)
- Severe bradycardia (<50 bpm)
- Cardiogenic shock or decompensated heart failure requiring IV inotropic therapy
Drug Interactions
Digoxin
Concomitant use may increase digoxin concentrations.
Rifampicin
May significantly reduce plasma concentrations of carvedilol.
CYP2D6 Inhibitors (e.g., Quinidine, Fluoxetine)
May increase carvedilol plasma concentrations.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, heart failure, cardiogenic shock, and bronchospasm. Treatment involves symptomatic and supportive measures, including atropine for bradycardia, glucagon for myocardial depression, and vasopressors for hypotension.
Pregnancy & Lactation
Pregnancy Category C. Not recommended during pregnancy unless 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
36 months
Availability
Available in pharmacies nationwide
Approval Status
Approved by FDA/DGDA
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of carvedilol in the management of hypertension, angina pectoris, and chronic heart failure, leading to its broad clinical use.
Lab Monitoring
- Regular monitoring of blood pressure and heart rate.
- Periodic assessment of liver and renal function, especially in patients with pre-existing impairment.
- Blood glucose monitoring in diabetic patients.
Doctor Notes
- Careful titration is crucial for heart failure patients to avoid exacerbation of symptoms.
- Monitor blood pressure, heart rate, and fluid status regularly.
- Advise patients against abrupt withdrawal.
Patient Guidelines
- Take Xelcard exactly as prescribed by your doctor, usually with food.
- Do not stop taking Xelcard abruptly without consulting your doctor, as this may worsen your condition.
- Report any symptoms like dizziness, lightheadedness, or slow heart rate to your doctor.
- Avoid drinking alcohol as it may enhance the blood pressure-lowering effect.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. However, 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
Xelcard may cause dizziness or fatigue, especially at the start of treatment or when the dose is increased. Patients should be advised not to drive or operate machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular, moderate exercise as advised by your doctor.
- Quit smoking and limit alcohol intake.
- Practice stress-reducing techniques.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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