1 tablet 12.5mg

90 cents

  • Hypertension

  • Acute myocardial infarction

  • Secondary prevention in patients with coronary artery disease

  • Angina

  • Rate control

PO/NG:
Dilatrend tablets 6.25mg (yellow), 12.5mg (light brown), 25mg (white to pale yellowish beige)
When administered with food, the rate of absorption is slowed. Carvedilol should be taken with food to minimize the risk of hypotension.


ADULT DOSE
PO/NG:
Commence at 3.125mg BD and increase gradually as required

PAEDIATRIC DOSE
0.08mg/kg 12 hrly; if tolerated, increase gradually to a maximum of 0.5-0.75mg/kg 12 hourly

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY
Dose as in normal renal function

Non selective beta blocker and alpha-1 blocker. Carvedilol is rapidly absorbed following oral administration. Following oral administration, the apparent mean terminal elimination half-life of carvedilol generally ranges from 7-10 hours.

CONTRAINDICATIONS:

  • Bronchial asthma (two cases of death from status asthmaticus have been reported in patients receiving single doses of carvedilol)

  • Second- or third-degree AV block, sick sinus syndrome or severe bradycardia (unless a permanent pacemaker is in place),

  • Cardiogenic shock

  • Clinically manifest hepatic impairment

  • Hypersensitivity to any component of the product.


WARNINGS
Cardiac Failure
Sympathetic stimulation is necessary in supporting circulatory function in congestive heart failure, and beta blockade carries the potential hazard of further depressing myocardial contractility and precipitating more severe failure.
Discontinuation of therapy
Discontinuation of therapy in a patient with coronary artery disease may lead to rebound angina, arrhythmia or myocardial infarction.
Diabetes and Hypoglycaemia
Beta blockers may mask tachycardia occurring with hypoglycaemia.
Thyrotoxicosis
Beta-adrenergic blockade may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism. Abrupt withdrawal of beta blockade might precipitate a thyroid storm.

PRECAUTIONS
General
Carvedilol may aggravate peripheral arterial circulatory disorders.
Nonallergic Bronchospasm (e.g., chronic bronchitis and emphysema)
Patients with bronchospastic disease should, in general, not receive beta-blockers. Carvedilol may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. It is prudent, if carvedilol is used, to use the smallest effective dose. In clinical trials of patients with congestive heart failure, patients with bronchospastic disease were enrolled if they did not require oral or inhaled medication to treat their bronchospastic disease.

Laboratory Tests:
No tests additional to standard ICU tests are required

Drug/Laboratory Test Interactions:
None known.

Clonidine:
Concomitant administration of clonidine with carvedilol agents may potentiate blood-pressure- and heart-rate-lowering effects due to both agents possessing alpha²-blocking properties.
Cyclosporin:
On the average, the required dose of cyclosporin reduces by about 20% after initiation of carvedilol therapy. Close monitoring of cyclosporin levels is warranted.
Digoxin:
Digoxin concentrations are increased by about 15% when digoxin and carvedilol are administered concomitantly. Both digoxin and carvedilol slow AV conduction. Therefore, increased monitoring of digoxin is recommended when initiating, adjusting or discontinuing carvedilol.
Rifampin:
Rifampin reduces plasma concentrations of carvedilol by about 70%.

Body as a whole:
Fatigue
Cardiovascular System:
Bradycardia, Hypotension, Syncope, Angina
Gastrointestinal System:
Diarrhoea, Nausea, Vomiting
Musculoskeletal System:
Arthralgia
Respiratory System:
Cough
Nervous System:
Dizziness, Headache

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