Karvedil

Indications

Carvedilol is used to treat high blood pressure, long-term chest pain caused by narrowed heart arteries (stable angina), and heart failure, where it is added to other heart failure medicines. It is also used after a heart attack in some patients.

How It Works

It is a beta blocker that also blocks alpha-1 receptors. It slows the heart rate and reduces the force of each beat, and also widens blood vessels. Together these lower blood pressure, reduce the heart's workload and, in heart failure, help the heart work more efficiently over time.

Dosage and Administration

• High blood pressure, adults: usually 12.5 mg once a day for the first 2 days, then 25 mg once a day. The doctor may increase it gradually if needed.
• Angina: usually started at 12.5 mg twice a day and adjusted by the doctor.
• Heart failure: started at a very low dose (3.125 mg twice a day) and increased slowly, usually every 2 weeks, as prescribed by the doctor.

Take with food to reduce dizziness. Do not stop taking it suddenly; your doctor will reduce the dose gradually over 1 to 2 weeks if it needs to be stopped. Not for children unless prescribed.

Interactions

Taking it with Verapamil or Diltiazem can slow the heart too much. It can increase Digoxin and Ciclosporin levels. Stopping Clonidine while on Carvedilol can cause a dangerous rise in blood pressure. It may hide the warning signs of low blood sugar in people on insulin or diabetes tablets. Amiodarone and Fluoxetine can increase its effect, Rifampicin can reduce it, and pain medicines like Ibuprofen can weaken its blood pressure effect.

Contraindications

• Asthma or other conditions with wheezing (bronchospasm).
• Very slow heart rate, certain heart rhythm problems (second or third degree heart block, sick sinus syndrome) without a pacemaker.
• Severe or unstable heart failure needing medicines through a drip, or shock caused by heart failure.
• Severe liver disease.
• Allergy to Carvedilol.

Side Effects

Common: dizziness or light-headedness (especially when standing up), tiredness, slow pulse, headache, weight gain, swelling of the legs, cold hands and feet, and stomach upset. These are more likely at the start or after a dose increase.

Get urgent medical help if you faint, have a very slow pulse, wheezing or difficulty breathing, chest pain, rapidly worsening swelling or shortness of breath, or swelling of the face, lips or throat, or a severe skin reaction.

Pregnancy and Lactation

Use in pregnancy only if the doctor decides it is needed; it may cause slow heartbeat and low blood sugar in the newborn. Breastfeeding is not recommended while taking it; talk to your doctor.

Precautions and Warnings

Stand up slowly. Tell your doctor if you have diabetes, an overactive thyroid, kidney problems, poor circulation in the legs, psoriasis or a history of severe allergic reactions. Tell your surgeon or dentist you take it before an operation. Contact lens wearers may notice dry eyes. Do not drive if you feel dizzy.

Overdose

Overdose can cause very low blood pressure, very slow heartbeat, breathing difficulty, collapse and fits. Seek emergency medical help.

Therapeutic Class

Beta blocker with alpha-1 blocking action (antihypertensive and heart failure medicine).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.