HealthCare

Carvedilol –brand name Coreg and Coreg CR is an arylethanolamine nonspecific fl-adrenoreceptor antagonist with beta blocking activity. It is a beta blocker group of drugs having anti hypertension effect partly by reducing total peripheral resistance and vasodilatation. It blocks adreno receptors and inhibits J-adreno receptor-mediated compensatory mechanisms.

Carvedilol is widely used for the treatment of hypertension and congestive heart failure.
Dosage for hypertension is initially 6.25 mg twice daily. If tolerated well after 7-14 days, increase to 12.5mg twice daily if needed. If needed again increase the dose up to 25 mg twice daily, after 7-14 days. Maximum total daily dose is 50mg.

In case of congestive heart failure start the dosage with 3.125 mg twice daily for 2 weeks. If tolerated raise to 6.25mg twice daily and then double the dose every 2 weeks to the level tolerated by patients. Maximum dose is 25mg and 50mg for patients weighing less than 85 kgs and more than 85 kgs respectively.

Contraindications of Carvedilol include hypersensitivity; Patients with NYHA class IV decompensated cardiac failure requiring IV inotropic therapy, bronchial asthma, second or third-degree AV block, Sick Sinus syndrome, cardiogenic shock or severe bradycardia, severe hepatic impairment and lactation.

Special Precautions: Before starting the Carvedilol treatment, laboratory confirmation of liver injury is very much essential. Abrupt withdrawal of 3-blockers may result in exacerbation of the symptoms of hyperthyroidism. During the initiation of therapy, avoid driving or operating machinery. Safety of Carvedilol is not established during pregnancy. as well as in Children. Side effects of Carvedilol include increased sweating, fatigue, oedema, bradycardia, hypotension (including postural), hyperglycaemia, hypercholesterolemia, bronchitis, insomnia, impotency, skin reactions, tinnitus, anaemia and even sudden death.

Drug interactions of Carvedilol: Rifampicin decrease while cimetidine increase the AUC & Cmax of carvedilol. Increase in Steady-state AUC and trough concentration of digoxin. Catecholamine-depleting agents & beta-receptors blockers results in hypotension or severe bradycardia.