Carvestad 12.5 Stella Treatment of hypertension, heart failure, angina (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Carvedilol
Ingredient Stella

Ingredient

Composition information	Content
Carvedilol	12.5mg

Uses

indications

Carvestad 12.5 Stella drug is indicated in the following cases:

High blood pressure. The main biological activity of Carvedilol is to inhibit the receptor competition β on the heart muscle (receptor β1), lung stalks and blood vessel smooth muscles (receptors β2) and inferior to α receptors, on vascular smooth muscle.

Carvedilol has no internal sympathetic enhancement activity (Owner β1) and only has weak membrane stability (local anesthesia).

The vasodilation impact due to a total border resistance is reduced through the receptor inhibitors of Carvedilol and the sympathetic reduction plays a major role in the hypotension effect of the drug.

Carvedilol reduces peripheral blood vessel resistance and home blood pressure into the effect of vasodilation, the drug has the effect of relaxing both arteries and veins.

pharmacokinetics

Carvedilol absorbs well through the digestive tract but is a first -time metabolic substance, absolutely used about 25%. The peak concentration of plasma is reached from 1 to 2 hours after drinking. The drug is highly soluble in lipids. More than 98% Carvedilol binds to plasma proteins. The drug is strongly metabolized through the liver, mainly by Cytochrom P450, ISOENZYM CYP206, CYP2C9 and metabolites are mainly excreted through bile. Selling time is about 6 to 10 hours. Carvedill accumulated in animal milk.

Before taking Carvestad 12.5 Stella Treatment of hypertension, heart failure, angina (3 blisters x 10 tablets)

How to use

oral tablets. Take the tablet with a glass of water.

Dosage

Carvedilol 12.5 is used orally. Carvedilol's dose must be suitable for each patient and adjust the dose according to the blood pressure response and tolerance of each patient.

Hypertension:

The starting dose of 12.5 mg x 1 time/day, increasing to 25 mg x 1 time/day after 2 days. Or the starting dose of 6.25 mg x 2 times/day, increasing to 12.5 mg x 2 times/day after 1-2 weeks. If necessary, the dose can be increased to 12.5 mg x 1 time/day after at least 2 weeks or divided into several doses. The dose of 12.5 mg x 1 time/day may be suitable for older patients.

Angina:

Starting dose 12.5 mg x 2 times/day, after 2 days increased to 25 mg x 2 times/day.

heart failure:

Starting dose of 3,125 mg x 2 times/day, used with food to reduce the risk of hypotension. If tolerated, the dose should be doubled after 2 weeks (6.25 mg x 2 times/day) and then gradually increased, with a distance of less than 2 weeks, to the maximum dose of tolerance, this dose must not exceed 25 mg x 2 times/day (severe heart failure or left ventricular ventricles after myocardial infarction:

Starting dose 6.25 mg x 2 times/day, increasing the dose after 3-10 days, if tolerated, increased to 12.5 mg x 2 times/day and then increased to the target dose of 25 mg x 2 times/day. The lower starting dose may be used for symptoms.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Symptoms:

Overdose can cause severe hypotension, slow heart, heart failure, heart shock and cardiac arrest. Respiratory problems, bronchial spasms, vomiting, loss of autonomy and body convulsions may occur.

Treatment:

Patients need to be placed in their lying position, monitoring and treating under special care conditions. Stomach lavage or pharmacological vomiting can be used immediately after swallowing. The following substances can be used:

Excessive slow heart: Atropin, 2 mg intravenously. The substance has a sympathetic effect (Dobutamine, Isoprenaline, Adrenaline) is used at doses depending on the body and efficiency. In case of resistance to treatment, the heart rate air conditioner can be used.

For bronchospasmic symptoms, beta sympathetic medications (misting or intravenously) or aminophylline intravenously intravenously. In the case of convulsions, it is recommended that the heart should be slow, diazepam or clonazepam.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double doses to compensate for missed dose.

Side Effects

Most of the mild side effects. The most common and serious side effects are related to receptor inhibition activity β. The heaviest among them is heart failure, cardiac arrest, bronchospasm. The uncomfortable side effects include a fatigue and cold numbness.

Heart effects include slow rhythm and hypotension, heart failure or cardiac arrest may appear early in patients with cardiovascular disorders. Reducing peripheral circulation can lead to limb cold numbness and may worsen peripheral vessels such as Raynaud's syndrome.

Effects on the central nervous system include headache, agarwood, dizziness, hallucinations, confusion, then dysppea, nightmares.

Fatigue is a field side effect of receptor inhibitors β.

Side effects on the digestive system such as nausea and vomiting, diarrhea, constipation and abdominal bumps.

Hypoglycemia, hyperglycemia, change of triglycerides and cholesterol in the blood.

skin rash, itching, severe psoriasis, hair loss.

Discount in tears, vision and ulcer.

Carvedilol metabolizes strongly through the liver and should not be used for patients with liver failure. Acute renal failure and abnormalities are seen in patients with heart failure due to whole vascular disease and/ or kidney failure.

Preventing and increasing plasma transaminase concentration occurs in carved users for 6 months.

Notify the physician the unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Carvestad 12.5 Stella drugs contraindicated in the following cases:

Hypersensitivity to the active ingredients or any ingredients of the drug. Use intravenous medication therapy.

liver failure.

Be cautious when using

generally the use of beta receptor inhibitors should not be delayed until the patient becomes resistant to other drugs.

Carefully monitor blood pressure during the initial treatment or adjust the next carvedilol dose. Should avoid a loss of blood pressure or stroke.

The sudden stopping of Carvedilol can worsen symptoms of angina and/or early myocardial infarction and ventricular arrhythmia in patients with coronary artery disease or may cause early storms in patients with thyroid poisoning. But patients using Carvedilol (especially patients with ischemia) should be warned that they do not stop suddenly or stop completely without consulting the doctor.

Kidney: Nephrotic function should be monitored in patients with swollen heart failure with low blood pressure (systolic blood pressure lower than 100 mmHg), ischemic heart disease and total vascular disease, and/or kidney failure during Carvedilol treatment, especially in the initial treatment period. If the renal function is detected, the carvedilol or horizontal dose should be reduced.

Respiratory: Carvedilol should only be used for patients with bronchospasm when patients do not respond or intolerant to other high blood pressure drugs, and when used in these patients, they need to be cautious and use the lowest doses with clinical effects to minimize the inhibition of endogenous and exogenous beta receptors of the drug.

Endocrine system: Due to the beta receptor inhibitor activity covers some signs of hypoglycemia, in patients with congestive heart failure and diabetes, blood sugar should be monitored at the beginning of treatment with Carvedilol or stop or adjust the dose, because Carvedilol can deteriorate blood sugar.

The effect of the drug on the ability to drive and operate machinery

as well as other drugs that change blood pressure, patients use carvedilol should be cautious should not drive or operate machinery if you feel dizzy or related symptoms. Especially when starting or changing the way of treatment and use with alcohol.

Use drugs for women during pregnancy and lactation

Pregnant women

There is no specific research on pregnant women. Carvedilol is only used for pregnant women after having carefully considered the benefits and risks to the fetus.

breastfeeding women

Do not know if the drug is excreted through breast milk or not.

Drug interaction

Catecholamine inhibitors (reserpin and Monoamine oxidase inhibitors): Patients who use simultaneous drugs with receptor inhibitors β and a Catecholamine inhibitors need to be monitored by signs of hypotension and/or serious slow heart rate.

Clonidin: Sharing clonidin with receptor inhibitors β capable of lowering blood pressure and slow heart rate. When you want to stop using β and clonidin, you should stop the beta receptor inhibitors first. Clonidin can stop a few days later by reducing the dose slowly.

Digoxin: Digoxin concentration increases by about 15% when used simultaneously digoxin and carvedilol simultaneously. Both Digoxin and Carvedilol slow down the atrial transmission. Therefore, it is necessary to increase monitoring of digoxin levels when starting the dose adjustment or stop using Carvedilol.

reserpin: Rifampin (600 mg daily for 12 days) reduces AUC and CMAX of Carvedilol by about 70%.

cimetidine: cimetidine (1g/day) increases the AUC of carvedilol about 30% without changing CMAX.

Calcium inhibitors: If taking carvedilol with calcium inhibitors such as the form of Verapamil or Diltiazem, patients need to be monitored ECG and blood pressure.

insulin or oral hypoglycemic drugs: because of the receptor inhibitor (beta), the carvedilol can increase the hypoglycemia of insulin and oral hypoglycemic drugs. Therefore, for patients who are taking insulin or oral hypoglycemic drugs, need to monitor blood glucose regularly.

Food: Food works less on the oral bioavailability of Carvedilol but can reduce the absorption rate, leading to reducing and prolonging the reach of the peak in plasma. Therefore, to reduce the risk of hypotension, should use carvediol with food.

Storage

In closed packaging, cool places, avoid light, temperatures below 30⁰C.

To be out of reach of children, read the user manual carefully before use.

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