Generic name: Carvedolol

Classification

Beta-Blockers

Indications

Listed in Dosage.

Dosage

Essential hypertension Initially 12.5 mg once daily for 1st 2days. Maintence: 25 mg once daily. If necessary. may ncrease at intervals of 2 wk to a total daily dose of 50 mg given once daily or in divided dosed (bid). Treatment of againa pectoris Initially 12.5 mg bid for 1st 2 days. Maintenance: 25 mg bid. May increase at intervals of 2 wk to a total daily dose of 100 mg given in divided doses (bid). Elderly Max: 50 mg given in divided doses (bid). Treatment of symptomatic CHF Initially 3.125 mg bid for 2 wk. May increase at intervals of 2 wk to 6.25 mg bid, followed by 12.5 mg bid & titrate dose accordingly.

Contraindications

Class IV decompensated heart failure requiring IV inotropic support; asthma; COPD w/ bronchospastic component; liver dysfunction; 2nd & 3rd degree AV block; severe brandycardia (<50bpm); cardiogenic shock; sick sinus syndrome; severe hypotension; pregnancy & lactation. Childn <18 yr.

Precautions

Markedly reduced heart performance; secondary or labile hypertension; complete bundle branch block; peripheral vascular disease; impaired renal function; recent heart attack; tendency to hypotension; diabetes mellitus; phaeochromocytoma; psoriasis; Prinzmetal's variant angian; concurrent therapy w' digitalis, diuretics &/or ACE inhibitor. Patients undergoing general surgery. May obscure syptoms of thyrotoxicosis. May affect ability to drive or operate machinery. Gradual w/drawal over 1-2 wk.

Adverse Reactions

Dizziness, headache, fatigue, bradycardia, postural hypotension, hypotension, astham/dyspnea, GI upset, skin reactions, changeds in serum transaminases, thrombocytopenia, leucopenia, manifestataion of latent diabetes mellitus, pain in the extremities.

Interactions

Simultaneous therapy w/ other BP-lowering drung, reserping, guanethiding, methyldopa, clonidine, guanfacine, nifedipine, Ca antagonists of the verapamil or diltiazem type, antiarrhythmics, cardiac glycosides, barbiturates, phenothiazines, tricyclic antidepressants, vasodilators, & alcohol may cause an intensified BP &/or heart rate loweing effects. May enhance effect of insulin or oral hypoglycemics & sign of hypoglycemia may be masked. Rifampicin reduces its BP-lowering effects.