Carvedil 6.25 mg 28 tablets
For adjunctive therapy secondary to severe chronic heart failure (II- IV functional class classification NYHA).
Carvedil 6.25 mg 28 tablets
Carvedil 6.25 mg is used:
- For the treatment of high blood pressure without reason clarified (Essence-cial hypertension)
- A disease of the arteries supplying blood to the heart (chronic angina)
- For additional therapy secondary to severe chronic heart failure (II- IV functional class classification NYHA).
2 What you should consider before taking Carvedil 6.25 mg?
2.1 Do not take Carvedil 6.25 mg:
- If you suffer from severe heart failure requiring treatment with intravenous medications that increase the force of contraction of the heart muscle (NYHA class IV heart failure requiring parenteral inotropic therapy)
- If you suffer from respiratory disease characterized by narrowing of bronchi (chronic obstructive pulmonary disease associated with bronhoobstruktsiya)
- If you suffer from severe impairment of liver function
- If you suffer from asthma
- If you suffer from disorders of impulse conduction of pre-mad chambers of the heart (second and third degree AV block)
- If your heart rate at rest is below 50 beats per minute (severe bradycardia)
- If you suffer from any sinus node disease (sick sinus syndrome assembly including sino-atrial block)
- If you are in the cardio-vascular shock
- If your blood pressure is very low (systolic blood pressure below 85 mmHg)
- If you suffer from Prinzmetal variant angina (a rare form of angina ?)
- If you suffer from untreated hormone-dependent tumor of the adrenal me-doula (pheochromocytoma)
- If you are allergic to carvedilol or any of the excipients
- If your blood is very acidic pH (metabolic acidosis)
- If you suffer from severe narrowing artery disease and toes
- If you are currently treated with intravenous verapamil or diltiazem.
2.2 Special warnings when taking Carvedil 6.25 mg:
Special precautions which must be taken into account, especially in patients with cardiac failure
In patients with chronic heart failure, Carvedil 6.25 mg can be used as adjunctive therapy to the existing therapy with other drugs (ACE inhibitors, digitalis gpikozidi and / or ca-zodilatatori). Therapy should be initiated in hospital and monitored by a doctor. Treatment should not be initiated before the patient is stabilized with other drugs for at least 4 weeks.
Patients with severe heart failure, shortage of water and salts, ghee-riatrichni patients and patients with low blood pressure should be monitored for at least two hours after the first dose Carvedil 6.25 mg or increasing the dose due to the possibility of a sharp drop in blood pressure . Please discuss this with your doctor.
Symptoms of heart failure may worsen at the beginning of treatment or when increasing the dose of Carvedil 6.25 mg. If this happens, your doctor may increase the dose of diuretic (water tablets). However, it is sometimes necessary to reduce the dose or stopping Carvedil 6.25 mg. Your doctor will increase the dose of Carvedil, until symptoms of heart failure or symptoms of low blood pressure are not ovladeni.Patsienti with heart failure and low blood pressure (Sisto-person blood pressure below 100 mmHg) may experience a temporary worsening of renal function during treatment with Carvedil 6.25 mg. This is especially true for patients with additional diseases, such as coronary heart disease, atherosclerosis and / or existing depressed renal function. Renal function should be carefully monitored in these patients during the adjustment of the dose of Carvedil 6.25. If renal function deteriorates significantly, the dose of carvedilol should be reduced or treatment stopped.
Carvedil 6.25 mg should be used with caution in patients with chronic heart failure treated with digitalis as digitalis and Carvedil may extend conduction time of the pulses from the atria minutes to the chambers of the heart.
Other warnings Carvedil 6.25 mg ic whole beta-blockers: Patients with respiratory diseases and a tendency to bronchospasm (chronic obstructive pulmonary disease) should be closely monitored during initiation of treatment and during dose adjustments. Dose Carvedil 6.25 mg should be reduced if you have symptoms of bronchospasm. Discuss with your doctor if you suffer from bronchial zabolyavane.Patsienti with diabetes mellitus (diabetes) should regularly monitor blood sugar levels and if necessary to adjust the dose of medication to reduce blood sugar during therapy Carvedil 6.25 mg and especially in case in dosage. Blood glucose should be measured during prolonged starvation.
Carvedil can mask or suppress the symptoms of overactive thyroid zhleza.Carvedil can cause a slow heart rate (bradikar-Dia). If your heart rate is below 55 beats per minute, your doctor may reduce the dose of Carvedil 6.25 mg.Ednovremennoto using Carvedil 6.25 mg of calcium channel blockers of the verapamil and diltiazem (medicines to reduce blood pressure) or other medicines to treat changes in heart rhythm (antiarrhythmics), especially amiodarone requires careful monitoring of blood pressure and ECG. Simultaneous intravenous administration of these drugs should be izbyagva.Vnimanie must be paid Carvedil when used together with the ba-histidine (medicine depressing production of hydrochloric acid), because of the possibility to increase the effects of Carvedil 6.25 mg.Horata using contact lenses should given the possibility of reduced lacrimation (tear reduced).
Patients with a history of severe hypersensitivity reactions and patients undergoing allergen specific immunotherapy (hiposensitivna therapy) may experience worsening of allergic (anaphylactic) reactions.
Patients with psoriasis have to use Carvedil 6.25 mg with particular attention because of the possibility of deterioration of the symptoms of cutaneous zabolyavane.Carvedil 6.25 mg should be used with caution in patients with peripheral vascular disease (eg Raynaud's phenomenon) as beta-blockers, like carvedilol may worsen the symptoms of the disease.
If you know that you are slow metabolisers of debrisoquine, you should be closely monitored especially in early treatment. Because there is not enough clinical experience, Carvedil 6.25 mg should not be used in patients with high blood pressure (secondary hypertension or unstable), drop in blood pressure upon standing (orthostatic hypotension), acute inflammatory disease of the heart (with hemodynamic disorder) narrowing of the heart valves, severe arterial vascular disease of the legs or simultaneous use of alpha-1 blocker or alpha-2 blocker.
In patients with tumor adrenal medulla (pheochromocytoma), alpha-blocker medication should be initiated prior to initiation of therapy with carvedilol. Should be carefully monitored these patients when taking Carvedil 6.25 mg.
Carvedil 6.25 mg should be used with caution in patients with impaired impulse conduction from the atria to the cameras (first degree AV block) .Vnimanie must be paid at the same time using some anesthetics because of increased risk of a drop in blood pressure.
Like other beta-blockers, Carvedil 6.25 mg should not be stopped suddenly. This is especially true for patients with coronary heart disease. Treatment with Carvedil 6.25 mg should be withdrawn gradually over a period of 2 weeks, the dose was reduced by half an interval of 3 days. Discuss this with your doctor.
The safety and efficacy have not been established in children and adolescents under 18 years of age. Carvedil 6.25 mg should be used in this group of patients.
Geriatric patients may be more sensitive to the effects of Carvedil 6.25 mg and should be carefully monitored.
Carvedil should be used during pregnancy only after careful assessment of the benefit / risk ratio.
Beta-blockers reduce placental perfusion, which can lead to intra-uterine fetal death and stillbirth. In addition, can be adverse effects on the fetus and newborn (especially low blood sugar - hypoglycemia and slow heart rate - bradycardia). There is an increased risk of cardiac and respiratory complications in the newborn period slednatalniya. Treatment should be stopped 2-3 days before the expected birth, but if this is not possible, the infant should be monitored during the first 2-3 days of life.
Carvedil accumulates in breast milk, even in larger concentrations than in maternal blood. Therefore should not breast-feed during treatment with Carvedil 6.25 mg.
e) Effects on ability to drive and use machines
Use of this medication requires regular medical examinations. There are different individual reactions that reduce the ability of active attention and quick reactions required for driving, operating machinery or unsafe work. This is especially true at the start of treatment when increasing the dose, add new medication or if it is used simultaneously with alcohol.
f) Important information about some of the ingredients Carvedil 6.25 mg
This medicine contains lactose and sucrose. If you know you have an intolerance to lactose and sucrose should not take Carvedil 6.25 tdpredi you consult your lekar.2.3 Interactions with other lekarstvaMolya, tell your doctor or pharmacist if you are taking or have recently taken any other medicines, even those not prescribed by a doctor.
Interactions with medicines to treat abnormal heart rhythm (antiarrhythmics)
Co-administration of Carvedil 6.25 mg of calcium channel blockers (such as verapamil, diltiazem), amiodarone or class I antiarrhythmic drugs requires careful monitoring of blood pressure and ECG. There are cases of a slow heart rate (bradycardia), cardiac arrest and ventricular fibrillation, soon after beta-blocker therapy in patients receiving concomitant amiodarone. Concomitant use of Class IV or class fa 1c antiarrhythmics is associated with an increased risk of cardiac therapy ??????????????.?????????????? Carvedil 6.25 mg medicines to reduce blood pressure, reserpine, guanethidine, methyldopa, guanfacine and monoamine oxidase inhibitors (except MAO-B inhibitor ) may lead to further delays in heart rate. Your doctor should closely monitor your cardio-vascular funktsiya.Nyakoi medicines that reduce high blood pressure (dihydropyrazol pyridine as nifedipine) Co-administration of dihydropyridines and Carvedil 6.25 mg requires careful monitoring because there are cases of heart failure and severe hipotoniya.Lekarstva expanding coronary arteries (nitrates) These drugs and Carvedil 6.25 mg mutually reinforcing effects of reducing blood nalyagane.Sardechni glycosides, medicines to treat heart failure (digoxin and digitoxin) Concomitant use with Carvedil 6.25 mg may enhance the effects cardiac glycosides. Blood levels of glycoside should be measured prior to initiation of therapy, a change in the dose or discontinuation of therapy Carvedil 6.25 mg.
Other medications for reducing blood pressure Carvedil 6.25 mg may enhance the effects of other drugs for lowering blood pressure (such as alpha-1 receptor antagonists) and drugs whose side effect is a decrease in blood pressure (barbitu-tions, phenothiazines, tricyclic antidepressants , vasodilators).
Drugs suppress the immune response (cyclosporine)
Concomitant use of cyclosporine and Carvedil 6.25 mg may induce a raise en blood levels of cyclosporine.
Drugs to reduce blood sugar (antidiabetic agents, including insulin)
Carvedil 6.25 tdmozhe to enhance the reduction of blood sugar. Symptoms of low blood sugar (hypoglycemia) can be masked. Patients with diabetes need to regularly check your blood sugar levels.
In case of discontinuation of clonidine and Carvedil, Carvedil 6.25 mg should be stopped several days before starting the gradual withdrawal of clonidine.
Anesthetics (inhalational anesthetics)
Anaesthetic agents may enhance the reduction of blood pressure by Carvedil 6.25 mg during anesthesia. Please tell anestezio-logos that take Carvedil 6.25 mg.
Drugs for the treatment of rheumatic diseases and pain (non-steroidal anti-inflammatory), oestrogens and corticosteroids antihypertensive effect of Carvedil 6.25 mg reduced due to retention of water and sodium (side effect of these drugs).
Drugs are metabolized by the same enzyme systems in the liver (cytochrome P450)
The following medicines may influence the effects of Carvedil 6.25 mg: second-fampitsin (antibiotic), barbiturates (to help you sleep medicines) s-metidin (medicine depressing production of hydrochloric acid) ketokona-sol (a medicine for fungal infections), fluoxetine (an antidepressant ) halo peridot (antipsychotic), verapamil (a medicine to treat abnormal heart rhythms), erythromycin (an antibiotic). Patients taking any of these medicines together with Carvedil 6.25 mg should be carefully monitored.
When these drugs are used concomitantly with carvedilol, an increased risk of high blood pressure and slow heart rate (severe bradycardia).
Antimigraine drugs (ergotamine)
When these drugs are used concomitantly with carvedilol, the risk of a rise in blood pressure due to narrowing of the blood vessels.
Carvedil 6.25 mg increases muscle-relaxing effect.
2.4 When Carvedil 6.25 mg is administered with food or drink
Alcohol: Carvedil 6.25 mg may enhance the effects of alcohol.
3 How to take Carvedil 6.25 mg?
Always take Carvedil 6.25 mg as just follow the instructions of your doctor. Counsel with your doctor or pharmacist if anything you do not understand.
3.1 Method of administration
For oral use
The tablets should be taken with sufficient voda.Ne need to take the tablets with food.
Patients with heart failure, however, should not take Carvedil 6.25 mg with food to slow absorption, thereby reducing the risk of a sharp drop in blood pressure on standing (postural hypotension).
There are other tablets Carvedil in doses that are not covered by Carvedil 6.25 mg.
3.2 If your doctor has prescribed another dose to treat high blood pressure without a specific cause (essential hypertension) is:
For the treatment of hypertension, Carvedil 6.25 mg may be used alone or in combination with other blood pressure lowering drugs, and especially water tablets (thiazide) .Preporachva to once daily dosing; maximum single dose is 25 mg and the maximum daily dose - 50 mg.
VazrastniPreporachvanata starting dose is 2 tablets Carvedil 6.25 mg (equivalent to 12.5 mg carvedilol) once daily for the first 2 dni.Lechenieto can then continue with 25 mg carvedilol once daily; there are appropriate dosage tablets Carvedil for this purpose. If necessary, the dose may be escalated gradually in the range of not less than 2 weeks.
The recommended starting dose for the treatment of hypertension is two tablets Carvedil 6.25 mg (equivalent to 12.5 mg carvedilol) once daily. This dose may suffice for long-term therapy. If this dose does not achieve adequate control of blood pressure, it is necessary to gradually increase the dosage in the range of not less than 2 weeks.
For the treatment of diseases of the arteries supplying blood to the heart (angina chronic): Recommended dosage '2 times daily.
The recommended starting dose for the treatment of hypertension is 2 tablets Carvedil 6.25 mg (equivalent to 12.5 mg carvedilol) 2 times daily for the first 2 days. Then treatment should be continued at 25 mg two times a day; there are appropriate dosage tablets Carvedil for this purpose. If necessary, the dose may be escalated gradually in an interval of at least 2 weeks up to a maximum recommended daily dose of 100 mg, divided into 2 daily administration.
The recommended starting dose for the treatment of hypertension is 2 tablets Carvedil 6.25 mg (equivalent to 12.5 mg carvedilol) 2 times daily for the first 2 days. Then treatment can be continued at 25 mg 2 times a day; there are appropriate dosage tablets Carvedil this tsel.Kato adjunctive therapy for the treatment of moderate to severe chronic heart failure: Treatment of moderate to severe chronic heart failure, Carvedil 6.25 mg was used as an adjunctive therapy to standard therapy of other drugs lowering blood pressure (ACE inhibitors, digitalis, and / or vasodilators) .Patsientite to be treated with Carvedil to be clinically stable (without change of NYHA classification and not hospitalized for heart failure), the primary therapy must be stabilized for at least four weeks before the start of therapy Carvedil 6.25 mg.