Carvedilol pills 12.5mg, 30pcs

Composition

1 tablet contains:

Active ingredient:

carvedilol 12.5 mg

Pharmacological action

of Alpha-and beta-blockers

Indications

• Arterial hypertension (in monotherapy and in combination with diuretics)
• Chronic heart failure (as part of combination therapy)
• Coronary heart disease: stable angina pectoris.

Contraindications

• Hypersensitivity to carvedilol or other components of the drug,
• acute and chronic decompensated heart failure
• requiring intravenous inotropic funds,
• severe liver failure,
• atrioventricular block II to III century,
• bradycardia (less than 50 beats/min),
• the syndrome of weakness of the sinus node,
• hypotension (systolic blood pressure less than 85 mm Hg. Hg),
• cardiogenic shock,
• bronchial asthma,
• chronic obstructive pulmonary disease,
• age to 18 years (efficacy and safety not established).

With caution: Bronchospastic syndrome, chronic bronchitis, emphysema of the lungs, Prinz Metal angina, thyrotoxicosis, occlusive diseases of peripheral vessels, pheochromocytoma, psoriasis, renal failure, atrioventricular block I degree, extensive surgery and general anesthesia, diabetes mellitus, hypoglycemia, depression, myasthenia gravis.

Side effects

Immune system disorders: very rare-hypersensitivity.

From the hematopoietic system: frequent-anemia; rare-thrombocytopenia; very rare-leukopenia.

From the nervous system: very frequent-dizziness, headache; infrequent-pre-fainting, syncope, paresthesia.

From the side of the organ of vision: frequent-visual disturbances, reduced lacrimation (dry eyes), eye irritation.

From the cardiovascular system: very frequent-heart failure in the period of increasing the dose, a pronounced decrease in blood pressure; frequent-bradycardia, edema, hypervolemia, fluid retention, orthostatic hypotension, peripheral circulatory disorders (cold extremities, peripheral vascular diseases, exacerbation of intermittent claudication syndrome and Raynaud’s syndrome); infrequent – AV block II-III degree, angina pectoris.

From the respiratory system: frequent – shortness of breath, pulmonary edema, asthma in predisposed patients, bronchitis, pneumonia, upper respiratory tract infections; rare-nasal congestion.

From the digestive system: frequent – nausea, diarrhea, vomiting, dyspepsia, abdominal pain; infrequent-constipation, dry mouth.

From the liver and biliary tract: very rare – increased activity of ALT, AST and GGT.

From the skin and subcutaneous tissues: infrequent-skin reactions (for example, allergic exanthema, dermatitis, urticaria, pruritus, psoriasis-like and lichen-like skin lesions, alopecia); very rare-erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis.

From the musculoskeletal system: frequent-pain in the extremities.

From the urinary system: frequent-urinary tract infections, impaired urination, renal failure and impaired renal function in patients with diffuse vasculitis and / or impaired renal function; very rare – urinary incontinence in women (reversible after discontinuation of the drug).

From the genitals and breast: infrequent-erectile dysfunction.

From the side of metabolism and nutrition: frequent-hypercholesterolemia, hyperglycemia or hypoglycemia in patients with diabetes mellitus.

General disorders: very common – asthenia, increased fatigue; frequent-weight gain.

Dizziness, fainting, headache and asthenia are usually mild and occur more frequently at the beginning of therapy with Carvedilol Zentiva.

When using the drug in patients with chronic heart failure and low blood pressure (systolic blood pressure

The presence of beta-blocking properties in the drug does not exclude the possibility of manifestation of latent diabetes mellitus, decompensation of existing diabetes mellitus, or suppression of the contrinsular system.

Interaction

Carvedilol may potentiate the effect of other concomitant antihypertensive agents or drugs that have a hypotensive effect (nitrates).

When carvedilol and diltiazem are used together, cardiac conduction disorders and hemodynamic disorders may develop. With simultaneous use of carvedilol and digoxin, the concentration of the latter increases and the time of atrioventricular conduction may increase.

Carvedilol can potentiate the effects of insulin and oral hypoglycemic agents, while the symptoms of hypoglycemia (especially tachycardia) can be masked, so regular monitoring of blood sugar levels is recommended in diabetic patients.

Inhibitors of microsomal oxidation (cimetidine) enhance, and inducers (phenobarbital, rifampicin) weaken the hypotensive effect of carvedilol.

Drugs that reduce the content of catecholamines (reserpine, monoaminooxidase inhibitors)increase the risk of hypotension and severe bradycardia.

Concomitant use of cyclosporine increases the concentration of the latter (correction of the daily dose of cyclosporine is recommended). Concomitant use of clonidine may potentiate the antihypertensive and heart rate-reducing effects of carvedilol.

General anesthetics enhance the negative inotropic and hypotensive effects of carvedilol.

How to take, course of use and dosage

Inside, regardless of food intake. Strictly follow your doctor’s instructions. Without prior consultation with your doctor, you should not stop Carvedilol treatment or change its dosage. If it is necessary to cancel the drug, the dose reduction should occur gradually over 1 to 2 weeks. If there is no therapeutic effect from treatment or if the condition worsens, consult your doctor.

Arterial hypertension. The dose is selected individually. For the first 7-14 days, the recommended dose of Carvedilol is 12.5 mg (1 tablet of 12.5 mg), taken in the morning after breakfast. The dose can be divided into two doses of 6.25 mg of Carvedilol (1/2 tablet of 12.5 mg). Further treatment should be given with Carvedilol at a dose of 25 mg (1 tablet of 25 mg) in the morning or divided into two doses of 12.5 mg of the drug (1 tablet of 12.5 mg). If necessary, the doctor may increase the dose again after 14 days. Take this medicine after a meal with a small amount of liquid.

Stable angina pectoris. The initial dose of Carvedilol is 12.5 mg (1 tablet of 12.5 mg) twice a day. After 7-14 days, under the supervision of a doctor, the dose of Carvedilol can be increased to 25 mg (1 tablet of 25 mg) twice a day. After 14 days, if there is insufficient efficacy and good tolerability, the dose of Carvedilol can be further increased.

The total daily dose of Carvedilol for angina pectoris should not exceed 50 mg of the drug (2 tablets of 25 mg), prescribed 2 times a day. If you are over 70 years of age, then the daily dose of Carvedilol should not exceed 25 mg (1 tablet of 25 mg) twice a day. If you have missed the next dose, then you should take the drug as soon as possible. However, if the time for the next dose is already approaching, then you should only take it, without doubling it. You should take the drug regularly. If you have not taken the drug for more than 2 weeks, you should resume treatment with the lowest doses.

Chronic heart failure. The dose is selected individually, under the careful supervision of a doctor. The recommended starting dose is 3.125 mg twice daily for 2 weeks. With good tolerability, the dose is increased at intervals of at least 2 weeks to 6.25 mg 2 times a day, then l2.5 mg 2 times a day, then to 25 mg 2 times a day. The dose should be increased to the maximum that is well tolerated by the patient. In patients with a body weight of less than 85 kg, the target dose is 50 mg per day; in patients with a body weight of more than 85 kg, the target dose is 75-100 mg per day.

If treatment is interrupted for more than 2 weeks, then its resumption begins with a dose of 3.125 mg 2 times a day, followed by an increase in the dose.

Overdose

Symptoms:

low blood pressure (accompanied by dizziness or fainting), bradycardia. Shortness of breath may occur due to bronchospasm and vomiting. In severe cases, cardiogenic shock, respiratory disorders, confusion, and conduction disorders are possible.

Treatment:

it is necessary to monitor and correct vital signs, if necessary – in the intensive care unit. Treatment is symptomatic. Intravenous use of m-holinoblokatorov (atropine), adrenomimetics (epinephrine, norepinephrine) is advisable.

Special instructions

Therapy should be carried out for a long time and should not be abruptly stopped, especially in patients with coronary heart disease, as this can lead to a worsening of the course of the underlying disease. If necessary, the dose reduction should be gradual, within 1-2 weeks.

At the beginning of carvedilol therapy or when increasing the dose of the drug, patients, especially the elderly, may experience an excessive decrease in blood pressure, especially when getting up. It is necessary to adjust the dose of the drug.In patients with chronic heart failure, when selecting the dose, it is possible to increase the symptoms of heart failure, the appearance of edema. At the same time, the dose of carvedilol should not be increased, it is recommended to prescribe large doses of diuretics until the patient’s condition stabilizes.

Continuous monitoring of the electrocardiogram and blood pressure is recommended with simultaneous use of carvedilol and slow calcium channel blockers, phenylalkylamine derivatives (verapamil) and benzodiazepine (diltiazem), as well as with Class I antiarrhythmics.

It is recommended to monitor renal function in patients with chronic renal insufficiency, arterial hypotension and chronic heart failure.

In the case of surgical intervention using general anesthesia, the anesthesiologist should be warned about previous carvedilol therapy.

Carvedilol does not affect the concentration of glucose in the blood and does not cause changes in the glucose tolerance test in patients with non-insulin-dependent diabetes mellitus.

Avoid using ethanol during treatment.

Patients with pheochromocytoma should be prescribed alpha-blockers before starting therapy. Patients who wear contact lenses should be aware that the drug may cause a decrease in lacrimation.

It is not recommended to drive a car at the beginning of therapy and when increasing the dose of carvedilol. You should refrain from other activities related to the need for high concentration of attention and rapid psychomotor reactions.

Form of production

Tablets

Storage conditions

Store in a dry place, protected from light, at a temperature not exceeding 25° C.

Active ingredient

Carvedilol

Conditions of release from pharmacies

By prescription

Dosage form

Tablets