Carvedilolum

Description
Non-selective β and α1 adrenoblocker.
Indications
Arterial hypertension; angina pectoris; symptomatic
chronic heart failure (in combination with diuretics,
digoxin or ACE inhibitors).
Contraindications
Bronchial asthma, obstructive respiratory
disease; decompensated heart failure,
Prinzmetal angina, severe bradycardia, hypotension,
sick sinus syndrome, II
or III degree atrioventricular block, cardiogenic
shock; pheochromocytoma (if not already treated with α
adrenoblockers); AV block.
Dosage
Adults. Oral. Arterial hypertension:
initially 12.5 mg once a day, after 2 days increase
to 25 mg once a day, if necessary continue
(not more often than every 2 weeks) increasing up to 50 mg per
day (1-2 times). Angina pectoris: initially 12.5 mg
twice a day, after 2 days increase to
25 mg twice a day. Heart failure:
initially 3.125 mg twice a day (with meals),
later (not more often than every 2 weeks) increase to
6.25 mg twice a day, then to 12.5 mg twice
a day, then to 25 mg twice a day and (if weighing
≥ 85 kg) to 50 mg twice a day.
Elderly. Arterial hypertension: 12.5
mg per day may be sufficient.
CKD. Reduce the dose.
Adverse reactions
Most common: orthostatic hypotension, bradycardia;
dizziness, headache, fatigue; gastrointestinal
disturbances.
Others: peripheral circulation disorders, peripheral
edema, limb pain; worsened
intermittent claudication, worsened Raynaud phenomenon;
dry mouth; dry eyes, irritation,
impaired vision; impotence, urinary disturbances;
flu-like symptoms; angina pectoris, atrioventricular block; allergic skin
reactions; worsened psoriasis; nasal congestion,
shortness of breath; mood swings, disturbed sleep;
paresthesia; onset or worsening of heart
failure; altered liver enzyme levels;
thrombocytopenia, leukopenia.
Pregnancy
Risk category – CM (D – when used in the II and III
trimesters).
Breastfeeding
No data available. According to the APA, breastfeeding is possible.
Warnings
Use with caution in compensated heart failure,
diabetes mellitus or severe
myasthenia, if there has been a previous hypersensitivity
reaction. When heart failure is present,
before increasing the dose, check if it has worsened
and whether kidney function has deteriorated; when starting treatment
or increasing the dose, monitor the patient’s clinical condition
for 2-3 hours. Do not stop suddenly (especially in patients
with angina pectoris).

Source | Drug Guide | Lithuanian University of Health Sciences | Institute of Physiology and Pharmacology | Doctor of Medical Sciences Rimas Jankūnas, Doctor of Medical Sciences Arvydas Milašius | Clinic of Internal Diseases | Doctor of Medical Sciences Palmira Leišytė