Coryol 6.25mg Krka treatment for hypertension, congestive heart failure, angina (4 blisters x 7 tablets)

Dosage form Box of 4 blisters x 7 tablets
Specifications Carvedilol
Ingredient Krka, D.D., Novo Mesto

Ingredient

Thành phần cho 1 viên

Composition information	Content
Carvedilol	6.25mg

Uses

indications

Coryol 6.25mg indications for treatment in the following cases:

Hypertension, can be used alone or in combination with other drugs, especially with thiazid diuretics. Angiotensin diuretics and enzyme inhibitors to reduce the progression of the disease (have been shown by the mortality rate, cardiovascular treatment time at the hospital, or it is necessary to adjust the treatment of other treatments).

angina pain. Sympathetic beta, both isomorphic s (-) and r (+) antagonistic alphal system with equal effect.

Therefore, Carvedilol is a neuromuscular antagonist fluid through many mechanisms, inhibiting B-adrenergic (B-Blocker) not selective. Eastern drugs have a selective vasodilatema properties œï-adrenergie.

Carvedilol has two main mechanisms of anti -hypertension. A mechanism of action is to dilate the machine, mainly due to the selective blocking of the alphal body, thus reducing the boundary blood vessel resistance.

Carvedilol also has a non -selective congestion effect. Vascular dilatation and receptor blockers occur in the same dosage level. Also see the effect of channel blockers - Calei light.

Carveditol does not have the effect of the dominance - beta, but only has a stable effect.

Clinical research has witnessed the alphal and beta receptor receptor, causing the heart frequency to decrease or unchanged when resting, maintaining the fraction of the accumulation and blood flow in the kidneys and peripheral.

Dynamic pharmacokinetics

absorption

The drug is absorbed quickly after taken, with absolute bioavailability of about 25-35% due to a significant proportion that is transformed into the liver.

The concentration of drugs in plasma is proportional to willow use. When used with food, the absorption rate of the drug slowed down but bioavailability has no significant difference. Using drugs with food can reduce the risk of hypotension.

distribution

widely distributed drugs in the blood and tissues. The associated ratio with plasma proteins is more than 98%, mainly with albumin.

Carvedilol is a semi -lipid coal chat (lipophilic) with an integral distribution in the state of the 115L X4P weighing, distributing mainly into external tissues. The clearance of the drug from plasma 1 500-700 ml/minute.

transformation

The drug is widely metabolized. Carvedilol is metabolized mainly by the process of oxidation of aromatic and combined with glucuronie acid.

Metabolic substances after oxidation continue to be connected to glucuronie and sulfate acid to be reversed from the body. Demethylation and hydroxylation reactions in the phenol round have created 3 metabolites with intermittent bran.

Based on preclinical studies, 4’-hydroxyphenyl metabolites clutches are 13 times stronger than Carvedilol.

Compared to Carvedilol, these 3 metabolites have a weaker vasodilation effect. Their concentration in plasma is about 1/10 of Carvedilol and has the same pharmacokinetic properties similar to the mother. The main CYP P450 enzymes are responsible for specializing in both forms of the isomers in the human liver microsom system, CYP 2D6 and CYP 2D9.

Elimination

Carvedilol is excreted mainly through the honey. The clearance of the drug from plasma is 500-700 ml/min.

The overall selling time of the drug is 7-10 hours in which the isomers R (+) is 5-9 hours of isomers s (-) is 7-11 hours.

Before taking Coryol 6.25mg Krka treatment for hypertension, congestive heart failure, angina (4 blisters x 7 tablets)

How to use

To reduce the potential of the risk of decreased vertical blood pressure, Coryol is recommended to drink with food.

Dosage

In the treatment of hypertension:

The first dose of 12.5 mg, taken once a day; increased to 25 mg after 2 days, drink once a day. fruit.

In the treatment of chest pain:

The first dose of 12.5 mg, taken 2 times a day; After 2 days of increasing to 25 mg, 2 times a day.

In the treatment of heart failure:

Dosage recommended 3,125 mg oral 2 times a day for 2 weeks. After that, the dose may increase, if tolerated, up to 6.25 mg, taken 2 times a day. The disease is using glycosides to support cardiac, diuretics, and/or enzyme inhibitors, which must be stabilized with the dose of those drugs. The risk of compensation and/or reducing the highest severe blood pressure in the first 30 days of treatment

ILAND HEART:

Take the dose of 6.25 - 25 mg/time, taken 2 times a day.

Adjust the dose in people with liver failure: Contraindications.

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

Symptoms of Carvedilol poisoning include heart disorder, central nervous system poisoning. It is important, ha Glucose Huyt and Tangkali blood. The most common symptom of heart is hypotension, slow heart rate.

Atrial block, free -hearted disorder in ventricular and heart shock can occur when serious overdose, especially with membrane inhibitors.

The central nervous impact includes convulsions, coma and common respiratory extraction with propranolol and with other fat -soluble and inhibiting medications.

Treatment

Therapy includes treatment of seizures, hypoglycemia, hyperkalemia and hypoglycemia.

Slow pacemaker and decreased blood pressure with atropine, isoproterenol, or with a pacemaker that can use Glucagon.

QRS is expanded due to membrane inhibitor's poisoning that can be used in hypertonic sodium bicarbonate.

For multiple doses of active carbon, hemorrhage can only help eliminate surface - beta with small distribution, with half a long life, or low internal clearance (acebutolol, atenolol, nadolol, sotalol).

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

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 dose to compensate for missed dose.

Side Effects

Coryol has been considered to be safe for patients with heart failure (mild, medium and severe) or in hypertension. However, some reports have recorded unwanted effects that can be encountered when ding coryol.

Most of the unwanted effects are temporary and after a while. Most of these effects occur at the beginning of treatment. Unexpected effects are mainly related to pharmacological and dose mechanisms.

The most common is dizziness (about 10%) and headache (about 5%).

Common, ADR> 1/100

Body: headache, muscle aches, fatigue, shortness of breath.

circulatory: dizziness, posture hypotension.

Digestive: nausea.

Uncommon, 1/100> ADR> 1/1 000

Circulation: Slow heart rate.

Digestive: diarrhea, abdominal pain.

rare, ADR

Blood: platelets, leukopenia.

Circulating: poor air -conditioning, fainting.

Central nerve: depression, sleep disorders, paresthesia.

Digestive: vomiting, constipation.

Skin: urticaria, itching, psoriasis.

Liver: Increased liver transaminase.

Eyes: Reduce tears, irritation.

Respiratory: stuffy nose.

Notify the doctor with unwanted effects when using the drug.

Instructions on how to handle ADR

Can minimize the risk of heart rate slow and other unwanted effects by starting treatment at low doses, then gradually increasing the dose, monitoring the diastolic blood pressure and heart frequency, and taking carvedilol with food.

Need to reduce the dose if the circuit frequency drops below 55 cycles per minute. Avoid stopping the drug suddenly.

Patients must avoid standing up suddenly or standing still for a long time; Need to rest if you feel dizzy or go and consult a physician about the dose reduction

Warnings

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

Contraindicated

Coryol drug 6.25mg contraindicated in the following cases:

Sound congestive heart failure (NYHA level III - IV) has not been treated with a regimen. Drugs.

Be cautious when using

Carvedilol carefully used in patients with congestive heart failure treated with digitalin, diuretics, or angiotensin enzyme inhibitors because of the co -effect that causes hypotension or/atrial transmission - ventricular may be slowed.

Be careful in patients with diabetes with no or difficult to control, because beta receptor blockers can cover symptoms of blood glucose.

Must stop treatment when there is signs of liver damage. Caution must be used in people with peripheral artery diseases, people with anesthesia, people with contaminated syndrome.

If the patient does not tolerate other anti -hypertension drugs, caution can be used with very small doses of carvedilol for people with hypertension with chronic obstructive pulmonary disease.

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

Consider the risk of arrhythmia, if using carvedilol simultaneously with anesthetic smell. The risk must be considered if combined with carvedilol with anti -arrhythmia group I.

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

The impact of drugs on drivers and operating machinery

is like other anti -hypertension drugs, Carvedilol reduces alertness, affecting the ability to drive or operate the patient's machines. This phenomenon occurs especially when starting or changing treatment and when drinking alcohol.

used for pregnant and lactating women

pregnancy

Carvedilol has caused clinical harms in the fetus. Only use this medication during pregnancy if the expected benefit is greater than the risk that may occur and as usual, not used in the last three months of pregnancy or almost giving birth.

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

Breastfeeding period

Carvedilol can excrete in breast milk. There is no risk of unwanted effect in breastfeeding.

Drug interaction

like other sympathetic beta inhibitors, carvedilol may increase the effect of drugs for hypertension or adverse effects to cause hypotension.

Like other beta inhibitors, should be cautious when using carvedilol with arrhythmia or calcium antagonists like Verapamil or Diltiazem. Some cases of conduction disorders when using Carvedilol copper with diltiazem.

Therefore, intravenously, calcium inhibitors and anti -arrhythmia during treatment with Carvedilol. When stopping carvedilol with clonidin, carvedilol should be stopped a few days before gradually decreasing the clonidin dose.

When using Carvedilol and Digoxin, the peak concentration is in a stable state of digoxin with an increase of about 16% in hypertension patients. Digoxin concentration should be enhanced at the beginning of treatment, adjusting the dose or stopping carvedilol.

Carvedilol's interaction with CYP2D6 inhibitors like Quinidine. Fluoxetin and paroxetin have not been studied, but these drugs are probably increasing the concentration of optical isomers R (+) of carvedilol in the blood.

Carvedilol can increase the hypoglycemic effect of insulin and oral hypoglycemic drugs. Symptoms of hypoglycemia may be covered or reduced (especially fast heart symptoms).

Be careful when taking the drug in patients taking enzyme induction drugs such as rifampicin, due to the decrease in serum concentration of carvedilol, or enzyme inhibitors such as cimetidine, due to the increasing carved in the serum concentration of carvedilol. It should be when anesthesia is needed because of the synonymous effect that reduces the heart muscle contraction between carvedilol and anesthesia.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

To be out of reach of children.

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