Carvesyl 6.25mg Shinpoong Deawoo treatment for high blood pressure, angina (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Carvedilol
Ingredient Heart failure, high blood pressure, angina

Ingredient

Composition informationContent
Carvedilol6.25mg

Uses

Indications

Treatment of primary blood pressure.

Treatment of chronic stable angina.

Support for the treatment of chronic to severe to severe heart failure.

Pharmacokology

Carvedilol is a Racemic mixture that has an indispensable blocking effect Beta-adrenergic but has a selective effect on Alpha-adrenergic.

Carvedilol has two main mechanisms of anti -hypertension effects: vasodilation, mainly due to Alpha receptor selection, thus reducing peripheral blood vessel resistance and non -selective beta receptor blockers. Vascular dilatation and receptor blockers occur in the same dosage level.

pharmacokinetics

absorption:

Carvedilol is quickly absorbed after drinking. In healthy people, the maximum concentration in plasma is achieved after drinking about 1 hour. Carvedilol's absolute bioavailability in humans is about 25%. There is a correlation between the dose and carvedilol levels in plasma. Food does not affect bioavailability or maximum concentration in plasma, although the time needed to achieve maximum concentration in prolonged plasma.

Distribution:

Carvedilol is very fat. The ability to bind to plasma protein is about 98% to 99%. The distribution volume is about 2 l/ kg and increases in cirrhosis patients.

Metabolism:

Carvedilol is strongly metabolized to create metabolites excreted mainly through bile. The first metabolism is about 60-75%. Carvedilol is strongly metabolized in the liver, mainly glucuronid reaction. The reduction of methyl and hydrogenation of phenol cycles creates 3 active metabolites that have the effect of blocking beta receptors.

Era:

Half lifetime elimination of Carvedilol is about 6 hours. The clearance in plasma is about 500-700 ml/ min. Elimination mainly through bile and excreted through feces. A small part excreted through the kidneys in the form of different metabolites.

Before taking Carvesyl 6.25mg Shinpoong Deawoo treatment for high blood pressure, angina (3 blisters x 10 tablets)

How to use

Take oral, take medicine with water. In patients with heart failure, it is recommended to use carvedilol at meals to make the absorption more slowly and reduce the risk of hypotension.

Dosage

primary hypertension

Carvedilol may be used for monomers or in combination with other antihypertensive drugs, especially thiazid diuretics.

Maximum dose recommends 25mg x 1 time, and 50 mg/ day.

Adults:

Start 12.5 mg/ time/ day for the first two days.

Then, 25 mg x 1 time/ day or start 6.25mg x 2 times/ day for 1-2 weeks, then 12.5 mg x 2 times/ day. If necessary, increase the dose slowly, at least two weeks apart.

Elderly:

Start 12.5 mg x 1 time/ day. However, if not responded, the dose may slowly increase at least two weeks apart.

Chronic stable angina

Recommendations 2 times/ day.

Adults:

Start 12.5 mg x 2 times/ day for two days.

Then, up to 25 mg x 2 times/ day. If necessary, increase the dose of at least two weeks apart.

Maximum dose of 50 mg 2 times/ day.

Elderly:

Start 12.5 mg x 2 times/ day for the first two days.

Then, increase the dose up to 25 mg 2 times/ day.

heart failure:

Start 3,125mg x 2 times/ day for 2 weeks. If this dose is tolerated, the dose may increase slowly with 6.25 mg x 2 times/ day apart at least two weeks apart.

The dose may increase slowly within a period of two weeks or less. The dose is increased to the maximum dose of tolerance.

Maximum dose is recommended 25 mg x 2 times/ day for patients with weight less than 85 kg or severe heart failure, and 50 mg x 2 times/ day for patients with weight over 85 kg, with non -serious heart failure conditions.

kidney failure:

No dose adjustment in kidney failure.

Medium liver dysfunction

Dose adjustment requirements:

Children and teenagers under 18 years old:

Do not recommend use.

Elderly:

Elderly patients are often more sensitive to drugs, so careful monitoring. Especially patients with coronary artery disease should be reduced the dose slowly.

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? There may also be respiratory problems, bronchospasm, vomiting, confusion and all epilepsy.

Treatment: In addition to general supportive treatment, it is necessary to monitor and check the signs of survival, under special care conditions if necessary.

Atropin can be used for excessive slow heart rate, supporting the ventricular function by intravenous glucagon intravenous, sympathetic drugs (Dobutamin, Noprenaline). Consider using phosphodiesterase to increase myocardial contraction. If the bradycardia does not respond to the drug, use a pacemaker.

If bronchial spasm, intravenous or sympathetic typhoon, or aminophyllin injected slowly or intravenously. In the case of convulsions, slow intravenous intravenous or clonazepam is recommended.

Carvedilol binds high protein. Therefore, it cannot be removed by dialysis.

In case of severe overdose with symptoms of shock, supportive treatment must be continued for a long time, until the patient's condition is stable.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

Common, ADR> 1/100

  • Systemic: headache, muscle aches, fatigue, shortness of breath.

    • Circulation: dizziness, posture hypotension. digestive: nausea.

    Uncommon, 1/1000

  • Systemic: Slow pace.
    • digestive: diarrhea, abdominal pain.

    Rare ADR

  • Blood: platelets, leukopenia.
  • Perpetual: poor air conditioning, fainting.
    • Central Neurology: depression, sleep disorders, paresthesia. digestive: vomiting, constipation. skin: urticaria, itching, psoriasis.

    Liver: Increase liver transaminase.

  • eyes: Reduce tears, irritation.
  • Respiratory: Stuffy nose.

    • Instructions on how to handle ADR:

    When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

    Warnings

    contraindicated

    Carvesyl drugs contraindicated in the following cases:

  • Sensitive to any ingredients of the drug.

    • Heart failure IV.

    Chronic obstructive pulmonary disease.

  • Liver dysfunction.
  • Bronchial asthma.
  • Atrial block, degree II or III.
  • Severe level of heart rate (
  • Pathological sinus syndrome (Sinus block block).
  • Cardioma.
  • Hydropulation (systolic blood pressure below 85 mmHg).
  • Prinzmetal angina.
  • Chromium -preferred cells have not been treated.
  • Metabolic acidosis.
  • Severe peripheral artery circulation disorders.
  • Simultaneous treatment with Verapamil or Diltiazem.

    • Be cautious when using

    Patients with congestive heart failure treated with digitalin, diuretics, enzyme inhibitors that transferred angiotensin because the atrial transmission may be slower.

    Patients with diabetes are not controlled or difficult to control, because beta receptor blockers can cover symptoms of blood glucose.

    Stop treatment when there is signs of liver damage.

    People with peripheral vascular disease, anesthetic patients, who have an increase in thyroid function.

    Patients do not tolerate other anti -blood pressure drugs, can be used with very small doses of carvedilol for people with bronchospasm.

    Avoid stopping the drug suddenly, to stop the drug for 1-2 weeks.

    Use Carvedilol and anesthetic to consider the risk of arrhythmia.

    Must consider the risk if combining Carvedilol with anti -arrhyths group I.

    Not yet determined the safety and effectiveness of Carvedilol in children.

    The ability to drive and operate machinery

    Carvedilol does not affect the ability to drive or operate machinery. However, unwanted effects: headache, dizziness, hypotension can affect.

    Pregnancy

    Carvedilol has caused clinical damage in pregnancy. Only use this medication during pregnancy if the expected benefit is greater than the risk may occur. Do not use in the last three months of pregnancy or near birth.

    Unwanted effects with fetuses such as slow heartbeat, lowering blood pressure, respiratory inhibition, reducing glucose - blood and reducing body temperature in infants may be used by pregnancy.

    breastfeeding period

    carvedilol can excrete in breast milk. There is no risk of unwanted effects in breastfeeding.

    Interactive drug

    anti -arrhyths

    Simultaneously used with Diltiazem, Verapamil and/or Amiodadron causing conduction disorders.

    Concentrated with reserpine, guanethidin, methyldopa, guafacin and Mao inhibitors (eliminating Mao-B inhibitors) may increase the effect of reducing heart rate.

    dihydropyridine

    There have been reports on heart failure and hypotension, so it should be closely monitored when using dihydropyridine and carvedilol.

    nitrate

    Increased hypotension effect.

    heart glycosides

    Carvedilol increases the concentration of digoxin when taken at the same time.

    Other anti -blood pressure drugs

    Carvedilol may increase the effects of other antihypertensive drugs (al-respeptor antagonists) and drugs that have side effects on simultaneous use such as barbiturat, phenothiazine, three-ring antidepressants, vasodilators and alcohol.

    cyclosporin

    Increased cyclosporin levels were discovered after starting treatment with carvedilol in 21 patients with kidney transplant with chronic grafted graft.

    Diabetes drugs include insulin

    The hypoglycemic effect of insulin and oral diabetes medications may increase.

    Clonidin

    In case of stopping both Carvedilol and Clonidin, Carvedilol should stop a few days before gradually stop clonidin.

    Inhalation anesthesia

    Be cautious in case of use with anesthesia due to force, slow heart rate and hypotension.

    nsaids, estrogen va corticosteroid

    Carvedilol's hypotension is reduced by salt and water retention.

    Induction drugs or enzyme inhibitors Cytochrome P450

    rifampicin, barbiturat, cimetidin, ketoconazole, fluoxetin, haloperidol, verapamil, erythromycin: closely monitor during simultaneous treatment with carvedilol.

    Rifampicin reduces carvedilol plasma concentrations by 70%.

    cimetidine increases auc of about 30% but does not change CMAX.

    Parasma drugs Alpha and Beta

    There is a risk of high blood pressure and excessive heart rate.

    ergotamine

    Increased vascular contraction.

    neurotransmitter

    Increased neuromable inhibition.

    Storage

    Temperature does not exceed 30 ° C.

    Other drugs

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