Carvedilol | Carvedilol-Teva tablets 6.25 mg 30 pcs.
Special Price
$16.49
Regular Price
$25.00
In stock
SKU
BID466771
Release form
Tablets.
Tablets.
Release form
Tablets.
Packing
30 pcs.
Pharmacological action
Carvedilol has a vasodilating, antianginal, antiarrhythmic effect. Blocks alpha1-, beta1- and beta2-adrenergic receptors. It does not have its own sympathomimetic activity, has membrane stabilizing properties. Carvedilol has an antioxidant effect, eliminating free oxygen radicals.
Contraindications
Hypersensitivity, chronic obstructive pulmonary disease, severe liver failure, severe bradycardia, sick sinus syndrome, AV block II and III degree (except for patients with a pacemaker), decompensated heart failure, pulmonary hypertension or cardiogenic shock, hypotension, pregnancy, breastfeeding, age under 18 (safety and effectiveness in people under 18 years not established).
Special instructions
In the case of a decrease in heart rate to 55 beats / min, the drug should be discontinued. In persons suffering from allergies or undergoing desensitization, taking carvedilol can increase allergy sensitivity. Persons using contact lenses should be warned that the drug reduces lacrimation. Upon completion of the treatment with Carvedilol, Sandoz simultaneously with clonidine first gradually reduces the dosage of clonidine and then first cancels clonidine, and then carvedilol. If you need to use Carvedilol Sandoz during lactation, you should stop breastfeeding. During the treatment period, it is necessary to exclude the intake of alcohol. With the progression of circulatory failure during treatment, it is recommended to increase the dose of diuretics, in case of renal failure, a dose adjustment should be made taking into account the indicators of the functional state of the kidneys. If surgery is necessary using general anesthesia, the anesthesiologist should be warned about previous treatment with carvedilol. It should be borne in mind that the drug can mask the symptoms of thyrotoxicosis and hypoglycemia, therefore it is recommended to regularly monitor the level of glucose in the blood and, if necessary, adjust the doses.
Composition
1 tab. contains carvedilol 6.25 mg.
Dosage and administration
Carvedilol is taken orally, after a meal, with a small amount of liquid. The dose is selected individually. Arterial hypertension: the recommended dose in the first 7-14 days is 12.5 mg / day in the morning after breakfast or divided into 2 doses of 6.25 mg, then - 25 mg / day once in the morning or divided into 2 doses of 12.5 mg. After 14 days, the dose can be increased again. A Stable angina pectoris: the initial dose is 12.5 mg 2 times a day, after 7-14 days under the supervision of a doctor, the dose can be increased to 25 mg 2 times a day. After 14 days, with insufficient effectiveness and good tolerability of the drug, the dose can be further increased. The total daily dose should not exceed 100 mg (50 mg 2 times a day), over the age of 70 years - 50 mg / day (25 mg 2 times a day). When skipping the next dose, Carvedilol should be taken as soon as possible, however, if the time is approaching for the next dose, then only take it, without doubling. If it is necessary to cancel Carvedilol, the Obolensk dose reduction should be carried out gradually within 1-2 weeks.
Side effects of
Carvedilol is well tolerated at recommended doses, but side effects are possible in some cases.
From the digestive system: nausea, dry mouth, abdominal pain, diarrhea or constipation, vomiting, increased activity of hepatic transaminases.
From the nervous system: headache, dizziness, feeling tired, loss of consciousness, muscle weakness (usually at the beginning of treatment), sleep disturbance, depression, paresthesia.
On the part of the sensory organs: decreased lacrimation.
From the genitourinary system: impaired renal function, edema, impaired urination.
From the side of hematopoiesis: leukopenia, thrombocytopenia.
Allergic reactions: urticaria, itching, rash, onset and / or exacerbation of psoriasis, sneezing, nasal congestion, bronchospasm, shortness of breath (in predisposed patients), very rarely anaphylactoid reaction.
From the CCC side: bradycardia, orthostatic hypotension, angina pectoris, AV block, progression of circulatory failure (cold extremities), progression of heart failure, exacerbation of intermittent claudication syndrome, Raynaud's syndrome.
Endocrine Disorders: weight gain.
Other: pain in the extremities, flu-like symptoms.
As with other drugs blocking alpha-adrenergic receptors, latent current diabetes mellitus may appear or its symptoms may intensify.
Drug interaction
Catecholamine depleting agents (reserpine, MAO inhibitors), may cause severe bradycardia and arterial hypotension. The simultaneous administration of ACE inhibitors, thiazide diuretics, and vasodilators administered simultaneously with carvedilol can lead to a sharp drop in blood pressure. Enhances the action of insulin and sulfonylurea derivatives (while masking or weakening the severity of symptoms of hypoglycemia, reducing the breakdown of liver glycogen to glucose). When administered orally with insulin or hypoglycemic drugs, the blood glucose level should be monitored. Inhibitors of the CYP2D6 isoenzyme (quinidine, fluoxetine, propafenone) can increase the concentration of the R (+) enantiomer of carvedilol. Joint use with antiarrhythmic drugs (especially class I) and BMKK (verapamil, diltiazem) can provoke severe arterial hypotension and heart failure. Intravenous administration of these drugs along with carvedilol is contraindicated. It increases the concentration of digoxin, which requires monitoring of its concentration, because simultaneous administration with cardiac glycosides can lead to AV block. General anesthetics enhance the negative inotropic and hypotensive effects. Phenobarbital and rifampicin accelerate metabolism and reduce the concentration of carvedilol in plasma. Microsomal oxidation inhibitors (cimetidine), diuretics and ACE inhibitors increase the concentration and enhance the hypotensive effect of carvedilol. Carvedilol delays cyclosporin metabolism.
Overdose
Symptoms: marked decrease in blood pressure (SBP 80 mmHg or lower), expressed bradycardia (less than 50 beats / min), impaired respiratory function (bronchospasm, etc.), chronic circulatory failure, cardiogenic shock, cardiac arrest.
Treatment: For the first two hours, induce vomiting and rinse the stomach. An overdose requires intensive treatment, monitoring of vital functions is necessary .. The patient should be in a position with raised legs, i.e. in the position of Trendelenburg. Beta-blocking antidotes are orciprenaline or isoprenaline 0.5–1 mg iv and / or glucagon in a dose of 1–5 mg (maximum dose 10 mg). Severe hypotension is treated with parenteral administration of fluid and repeated administration of adrenaline at a dose of 5-10 mg (or its intravenous infusion at a rate of 5 μg / min). With excessive bradycardia, iv atropine is prescribed at a dose of 0.5–2 mg. To maintain cardiac activity: intravenously (within 30 s) glucagon is administered, followed by continuous infusion at a rate of 2–5 mg / h. If the peripheral vasodilating effect predominates (warm limbs, in addition to significant arterial hypotension), it is necessary to prescribe norepinephrine at 5–10 μg in the form of an iv infusion - 5 μg / min. For relief of bronchospasm, beta-adrenergic agonists are prescribed (in the form of an aerosol or iv) or aminophylline iv. If convulsions develop, slow administration of diazepam or clonazepam is recommended. In severe cases of intoxication, when shock symptoms dominate, treatment should continue until the patient's condition stabilizes, taking into account T1 / 2 carvedilol, which is 6–10 hours.
Storage conditions
At a temperature not exceeding 25 РC.
pharmacy terms
for prescription
Form of Treatment
tablets
Teva Pharmaceutical Enterprises Ltd., Poland
Tablets.
Packing
30 pcs.
Pharmacological action
Carvedilol has a vasodilating, antianginal, antiarrhythmic effect. Blocks alpha1-, beta1- and beta2-adrenergic receptors. It does not have its own sympathomimetic activity, has membrane stabilizing properties. Carvedilol has an antioxidant effect, eliminating free oxygen radicals.
Contraindications
Hypersensitivity, chronic obstructive pulmonary disease, severe liver failure, severe bradycardia, sick sinus syndrome, AV block II and III degree (except for patients with a pacemaker), decompensated heart failure, pulmonary hypertension or cardiogenic shock, hypotension, pregnancy, breastfeeding, age under 18 (safety and effectiveness in people under 18 years not established).
Special instructions
In the case of a decrease in heart rate to 55 beats / min, the drug should be discontinued. In persons suffering from allergies or undergoing desensitization, taking carvedilol can increase allergy sensitivity. Persons using contact lenses should be warned that the drug reduces lacrimation. Upon completion of the treatment with Carvedilol, Sandoz simultaneously with clonidine first gradually reduces the dosage of clonidine and then first cancels clonidine, and then carvedilol. If you need to use Carvedilol Sandoz during lactation, you should stop breastfeeding. During the treatment period, it is necessary to exclude the intake of alcohol. With the progression of circulatory failure during treatment, it is recommended to increase the dose of diuretics, in case of renal failure, a dose adjustment should be made taking into account the indicators of the functional state of the kidneys. If surgery is necessary using general anesthesia, the anesthesiologist should be warned about previous treatment with carvedilol. It should be borne in mind that the drug can mask the symptoms of thyrotoxicosis and hypoglycemia, therefore it is recommended to regularly monitor the level of glucose in the blood and, if necessary, adjust the doses.
Composition
1 tab. contains carvedilol 6.25 mg.
Dosage and administration
Carvedilol is taken orally, after a meal, with a small amount of liquid. The dose is selected individually. Arterial hypertension: the recommended dose in the first 7-14 days is 12.5 mg / day in the morning after breakfast or divided into 2 doses of 6.25 mg, then - 25 mg / day once in the morning or divided into 2 doses of 12.5 mg. After 14 days, the dose can be increased again. A Stable angina pectoris: the initial dose is 12.5 mg 2 times a day, after 7-14 days under the supervision of a doctor, the dose can be increased to 25 mg 2 times a day. After 14 days, with insufficient effectiveness and good tolerability of the drug, the dose can be further increased. The total daily dose should not exceed 100 mg (50 mg 2 times a day), over the age of 70 years - 50 mg / day (25 mg 2 times a day). When skipping the next dose, Carvedilol should be taken as soon as possible, however, if the time is approaching for the next dose, then only take it, without doubling. If it is necessary to cancel Carvedilol, the Obolensk dose reduction should be carried out gradually within 1-2 weeks.
Side effects of
Carvedilol is well tolerated at recommended doses, but side effects are possible in some cases.
From the digestive system: nausea, dry mouth, abdominal pain, diarrhea or constipation, vomiting, increased activity of hepatic transaminases.
From the nervous system: headache, dizziness, feeling tired, loss of consciousness, muscle weakness (usually at the beginning of treatment), sleep disturbance, depression, paresthesia.
On the part of the sensory organs: decreased lacrimation.
From the genitourinary system: impaired renal function, edema, impaired urination.
From the side of hematopoiesis: leukopenia, thrombocytopenia.
Allergic reactions: urticaria, itching, rash, onset and / or exacerbation of psoriasis, sneezing, nasal congestion, bronchospasm, shortness of breath (in predisposed patients), very rarely anaphylactoid reaction.
From the CCC side: bradycardia, orthostatic hypotension, angina pectoris, AV block, progression of circulatory failure (cold extremities), progression of heart failure, exacerbation of intermittent claudication syndrome, Raynaud's syndrome.
Endocrine Disorders: weight gain.
Other: pain in the extremities, flu-like symptoms.
As with other drugs blocking alpha-adrenergic receptors, latent current diabetes mellitus may appear or its symptoms may intensify.
Drug interaction
Catecholamine depleting agents (reserpine, MAO inhibitors), may cause severe bradycardia and arterial hypotension. The simultaneous administration of ACE inhibitors, thiazide diuretics, and vasodilators administered simultaneously with carvedilol can lead to a sharp drop in blood pressure. Enhances the action of insulin and sulfonylurea derivatives (while masking or weakening the severity of symptoms of hypoglycemia, reducing the breakdown of liver glycogen to glucose). When administered orally with insulin or hypoglycemic drugs, the blood glucose level should be monitored. Inhibitors of the CYP2D6 isoenzyme (quinidine, fluoxetine, propafenone) can increase the concentration of the R (+) enantiomer of carvedilol. Joint use with antiarrhythmic drugs (especially class I) and BMKK (verapamil, diltiazem) can provoke severe arterial hypotension and heart failure. Intravenous administration of these drugs along with carvedilol is contraindicated. It increases the concentration of digoxin, which requires monitoring of its concentration, because simultaneous administration with cardiac glycosides can lead to AV block. General anesthetics enhance the negative inotropic and hypotensive effects. Phenobarbital and rifampicin accelerate metabolism and reduce the concentration of carvedilol in plasma. Microsomal oxidation inhibitors (cimetidine), diuretics and ACE inhibitors increase the concentration and enhance the hypotensive effect of carvedilol. Carvedilol delays cyclosporin metabolism.
Overdose
Symptoms: marked decrease in blood pressure (SBP 80 mmHg or lower), expressed bradycardia (less than 50 beats / min), impaired respiratory function (bronchospasm, etc.), chronic circulatory failure, cardiogenic shock, cardiac arrest.
Treatment: For the first two hours, induce vomiting and rinse the stomach. An overdose requires intensive treatment, monitoring of vital functions is necessary .. The patient should be in a position with raised legs, i.e. in the position of Trendelenburg. Beta-blocking antidotes are orciprenaline or isoprenaline 0.5–1 mg iv and / or glucagon in a dose of 1–5 mg (maximum dose 10 mg). Severe hypotension is treated with parenteral administration of fluid and repeated administration of adrenaline at a dose of 5-10 mg (or its intravenous infusion at a rate of 5 μg / min). With excessive bradycardia, iv atropine is prescribed at a dose of 0.5–2 mg. To maintain cardiac activity: intravenously (within 30 s) glucagon is administered, followed by continuous infusion at a rate of 2–5 mg / h. If the peripheral vasodilating effect predominates (warm limbs, in addition to significant arterial hypotension), it is necessary to prescribe norepinephrine at 5–10 μg in the form of an iv infusion - 5 μg / min. For relief of bronchospasm, beta-adrenergic agonists are prescribed (in the form of an aerosol or iv) or aminophylline iv. If convulsions develop, slow administration of diazepam or clonazepam is recommended. In severe cases of intoxication, when shock symptoms dominate, treatment should continue until the patient's condition stabilizes, taking into account T1 / 2 carvedilol, which is 6–10 hours.
Storage conditions
At a temperature not exceeding 25 РC.
pharmacy terms
for prescription
Form of Treatment
tablets
Teva Pharmaceutical Enterprises Ltd., Poland
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