30 tablets
Oral
6.25mg, 12.5mg, 25mg
Carvilol® Carvedilol
6.25 and 25 mg coated tablets – 12.5 mg scored coated tablets
Please note that this medicine has been prescribed to treat your current condition, so do not use it in similar cases or recommend it to others.
General instructions:
If you are allergic to carvedilol, foods, preservatives, and dyes, inform your doctor.
If you are taking any other medication, be sure to inform your doctor because your dosage may need to be adjusted.
If you have liver disease or a history of this disease, inform your doctor.
Use with caution in the following cases:
Asthma, bronchitis, bradycardia, diabetes, hyperthyroidism, severe renal failure.
See your doctor regularly to check the progress of treatment and avoid stopping the medication arbitrarily.
Get used to taking your medicine on time and regularly. If you forget to take a dose, take it as soon as possible, but do not double the dose if it is almost time for your next dose.
Be careful when driving or operating machinery that requires alertness, as you may feel sleepy, dizzy, or lightheaded.
Be careful and tell your doctor if you need any surgery (including dental procedures) or emergency treatment.
Always have enough medicine available.
Dosage and method of administration:
Take the medicine with food so that it is absorbed slowly.
The amounts listed below are average amounts and may vary from person to person, so the exact amount of medicine to be taken will be determined by your doctor.
Adults:
Congestive heart failure: 3.125 mg orally, 2 times a day for 2 weeks. If the patient tolerates it, the dose may be increased to 6.25 mg 2 times a day.
Blood pressure: 6.25 mg orally, twice daily, then increased to 12.5 mg, twice daily after 7 to 14 days.
Children under 18 years of age:
The safety and efficacy of this drug have not been established.
Use in pregnancy and lactation:
Human studies have not been conducted, and animal studies have shown that this drug and its metabolites pass into breast milk and have caused death.
Side effects:
Symptoms that require medical attention:
Increased sensitivity to allergens, bradycardia (slow heart rate), chest pain, seizures, respiratory distress, edema, fainting, syncope, weight gain, fever, blood in the urine, liver disorders (yellow skin and eyes), depression.
Side effects that require medical attention if persistent and bothersome:
Back pain, diarrhea, weakness and fatigue, abdominal pain, joint pain, headache, dizziness and drowsiness, muscle pain, nausea, sore throat, vomiting, runny nose.
Storage conditions:
Keep the medicine out of reach of children.
Store the medicine at a temperature below 30 degrees Celsius, away from direct light and moisture, and in the original box until use.
Avoid storing and using expired medicine.
Packaging:
This medicine is produced and supplied in the form of tablets containing 6.25, 12.5 and 25 mg of carvedilol in boxes of 30 by Afashimi Pharmaceutical Company.
Carvedilol reduces the workload of the heart by reducing the heart rate and controls blood pressure. It is used to prevent heart attacks and as an adjunct in the treatment of heart failure. However, this drug should not be used during a heart attack.
Uses of Carvedilol
Antihypertensive, adjunctive drug in the treatment of heart failure (non-selective beta[B] antagonist, 1α antagonist)
Carvedilol is prescribed in the treatment of hypertension, angina pectoris, and as an adjunctive drug in the treatment of heart failure.
Mechanism of action of Carvedilol
A- Antihypertensive effect: The drug reduces cardiac output and tachycardia by blocking beta receptors, and dilates blood vessels and reduces peripheral resistance by blocking alpha receptors. The drug also has antioxidant properties.
B- Therapeutic effect in heart failure: The drug reduces blood pressure, pulmonary artery pressure, systemic vascular resistance, and heart rate.
Carvedilol is well absorbed from the gastrointestinal tract after oral administration. Due to extensive first-pass metabolism, the bioavailability of the drug is about 25%. The half-life of the drug is between 6-10 hours and more than 98% is bound to plasma proteins. The drug is metabolized by the hepatic cytochrome P450 enzyme system (especially CYP2D6 and CYP2C9).
General Interaction Profile:
– CYP1A2 Substrate
– CYP2C9 Substrate
– CYP2D6 Substrate
– P-gp Substrate
– P-gp Inhibitor (Moderate)
– Antihypertensive Agent
– Bradycardia Exacerbation
– Hyperglycemia Exacerbation
– Hypoglycemia Exacerbation
– Interference with the effect of radiolabeled norepinephrine analogs
– PR interval prolongation
Class X Interactions (Avoidance):
Beta-2 Agonists, Bromperidol, Fexofenadine, Fluctafenine, Lasmiditan, Pazopanib, Rimegpent, Rivastigmine, Topotecan, Vincristine (liposomal)
Drug Effects Reduced by Carvedilol:
Beta-2 Agonists, Epinephrine (Nasal, Oral Inhalation and Systemic, Racemic), Theophylline Derivatives
Drug Effects Reduced by Carvedilol:
Amphetamines, Barbiturates, Brigatinib, bromperidol, dexmethylphenidate, hypertensive herbs, lumacaftor and ivacaftor, methylphenidate, nonsteroidal anti-inflammatory drugs, peginterferon alfa-2b, P-gp/ABCB1 inducers, rifampin, rifamycin derivatives, yohimbine
Drug effects enhanced by carvedilol:
Afatinib, alpha-1 blockers, alpha-2 agonists, amifostine, atypical antipsychotics [second generation], betrixaban, bilastine, bradycardia-inducing drugs, brentuximab vedotin, bromperidol, bupivacaine, cardiac glycosides, celiprolol, ceritinib, cholinergic agonists, colchicine, cyclosporine (systemic), dabigatran etexilate, digoxin, disopyramide, doxorubicin (conventional dosage form), Duloxetine, edoxaban, ergot derivatives, everolimus, fexinidazole, fingolimod, pollen extracts of allergenic plants (extract of 5 grasses), blood pressure lowering drugs, insulins, ivabradine, lacosamide, larotrectinib, lefamulin, levodopa-containing products, lidocaine (topical and systemic), mepivacaine, methacholine, naldemedine, naloxegol, nitroprusside, pazopanib, parhexyline, P-gp/ABCB1 substrates, pholcodine, procalopride, ranolazine, rifaximin, silodosin, siponimod, sulfonylureas, talazoparib, tegaserod, topotecan, abrogpent, ventocalx, vincristine (liposomal)
Increased effects of carvedilol by drugs:
Abiraterone acetate, acetylcholinesterase inhibitors, ajmaline, Alfuzosin, alpha-2 agonists, aminoquinolones (antimalarials), amiodarone, antipsychotics (phenothiazines), asunaprevir, barbiturates, benperidol, brigatinib, brimonidine (topical), calcium channel blockers (non-dihydropyridine), cimetidine, clobazam, cobicistat, CYP2C9 inhibitors (moderate), CYP2D6 inhibitors (moderate and strong), dacomitinib, darunavir, diazoxide, digoxin, dipyridamole, disopyramide, drondarone, erdaftifini, fluctafenine, blood pressure-lowering herbs, imatinib, lasmiditan, lormetazepam, lumacaftor and ivacaftor, lumefantrine, methoxyflurane, midodrine, molsidomine, naftopidil, nicardipine, nicergoline, Nicorandil, nifedipine, obinutuzumab, panobinostat, peginterferon alfa-2b, pentoxifylline, parhexyline, P-gp/ABCB1 inhibitors, phosphodiesterase 5 inhibitors, propafenone, prostacyclin analogs, quinagolide, quinine, ranolazine, regorafenib, reserpine, rivastigmine, ruxolitinib, selective serotonin reuptake inhibitors, terlipressin, tofacitinib
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