Caraten

Carvedilol

HTN; angina pectoris; impaired left ventricular function following MI; heart failure.

HTN Initially 12.5 mg once daily, then increase to 25 mg once daily after 2 days. Alternatively, 6.25 mg bid, then increase to 12.5 mg bid after 1-2 wk. May be further increased to 50 mg once daily or bid for at least 2-wk interval. Elderly 12.5 mg once daily. Angina pectoris Initially 12.5 mg bid, then increase to 25 mg bid after 2 days. Impaired left ventricular function following MI Initially 6.25 mg bid, then increase to 12.5 mg bid after 3-10 days & followed by target dose of 25 mg bid. Heart failure Initially 3.125 mg bid. If tolerated, may be doubled to 6.25 mg bid after 2 wk, then increase gradually at intervals not <2 wk to max tolerated dose. Patient w/ severe heart failure weighing <85 kg Max: Not >25 mg bid, mild to moderate heart failure weighing >85 kg Max: 50 mg bid.

Should be taken with food: Take w/ food to minimise risk of orthostatic hypotension.

Hypersensitivity eg, SJS, anaphylactic reaction, angioedema. 2nd & 3rd degree AV block; severe bradycardia; bronchial asthma or related bronchospastic condition; status asthmaticus resulting in death; cardiogenic shock; decompensated heart failure requiring IV inotropic therapy; sick sinus syndrome. Severe hepatic impairment.

Discontinue temporarily in CHF patients w/ worsening cardiac failure or fluid retention. History of serious hypersensitivity reactions & those undergoing desensitization therapy. Reversible renal function deterioration in chronic heart failure patients w/ low BP (systolic BP <100 mmHg), ischemic heart & diffuse vascular disease, &/or underlying renal insufficiency. COPD; DM; peripheral vascular disease; peripheral circulatory disorders eg, Raynaud's phenomenon; history of psoriasis; suspected pheochromocytoma & Prinzmetal's variant angina. Possible reduced lacrimation in contact lenses wearers. May obscure symptoms of thyrotoxicosis; induce bradycardia. Patients undergoing general surgery. Closely monitor during initiation & up-titration & reduce dose if bronchospasm occurs during treatment. Monitor ECG & BP in patients receiving verapamil- or diltiazem-type of Ca channel blockers or other antiarrhythmics. Combination w/ digitalis glycosides. May impair ability to drive or operate machinery. Hepatic insufficiency. Pregnancy & lactation. Childn. Elderly.

Hypotension; dizziness, fatigue; hyperglycemia; diarrhea, wt gain; weakness. Bradycardia, syncope, peripheral & generalized edema, angina, dependent edema, AV block, CVA, HTN, hyper-/hypovolemia, postural hypotension, palpitation; headache, depression, fever, hypoesthesia, hypotonia, insomnia, malaise, somnolence, vertigo; hypercholesterolemia, hypertriglyceridemia, DM, gout, hyperkalemia, hyperuricemia, hypoglycemia, hyponatremia; nausea, vomiting, abdominal pain, melena, periodontitis, wt loss, impotence; anemia, decreased prothrombin, purpura, thrombocytopenia; increased alkaline phosphate, γ-glutamyl transferase & transaminases; back pain, arthralgia, arthritis, muscle cramps, paresthesia; blurred vision, increased BUN, non-protein nitrogen & creatinine, albuminuria, glycosuria, hematuria, renal insufficiency.

Concomitant use w/ dabigatran etexilate; methacholine; topotecan. Increased level/effect of direct-acting α-/β-agonist, α₁-blocker, α₂-agonist, amifostine, antihypertensive, antipsychotic (phenothiazine), cardiac glycosides, colchicine, cyclosporin, dabigatran etexilate, digoxin, hypotensive agent, insulin, systemic & topical lidocaine, methacholine, midodrine, P-gp substrate, rituximab, rivaroxaban, sulfonylurea, topotecan. Increased level/effect by acetylcholinesterase inhibitor, aminoquinoline (antimalarial), amiodarone, anilidopiperidine opioid, phenothiazine, non-dihydropyridine Ca channel blocker, cimetidine, moderate/strong CYP2C9 or CYP2D6 inhibitors, darunavir, diazoxide, dipyridamole, disopyramide, dronedarone, herbs w/ hypotensive properties, MAOIs, pentoxifylline, P-gp inhibitors, phosphodiesterase-5 inhibitor, propafenone, propoxyphene, prostacyclin analogue, quinidine, reserpine, SSRIs. Decreased level/effect of β₂-agonist, theophylline derivatives. Decreased level/effect by barbiturate, herbs w/ hypertensive properties, methylphenidate, NSAIDs, peginterferon α-2b, P-gp inducers, rifampicin derivatives, yohimbine.

Beta-Blockers

C07AG02 - carvedilol ; Belongs to the class of alpha and beta blocking agents. Used in the treatment of cardiovascular diseases.

D