Karvil 6.25/Karvil 12.5/Karvil 25

Management of essential HTN & angina pectoris. As adjunct to standard therapy in symptomatic heart failure.

HTN Initially 6.25 mg bid for 7-14 days, then increase to 12.5 mg bid. May further increase, if necessary, at intervals of at least 2 wk, to 50 mg once daily or in divided doses. Elderly 12.5 mg once daily. Heart failure Initially 3.125 mg bid. If tolerated, increase after 2 wk to 6.25 mg bid. Gradually increase at intervals of not <2 wk to max dose. Patient w/ mild to moderate heart failure weighing >85 kg Max dose: 50 mg bid, severe heart failure or weighing <85 kg Max dose: 25 mg bid. Angina pectoris Initially 12.5 mg bid. Increase after 2 days to 25 mg bid. Left ventricular dysfunction following MI Initially 6.25 mg bid. If tolerated, increase after 3-10 days to 12.5 mg bid & then to a target dose of 25 mg bid.

Should be taken with food.

Hypersensitivity. Patients w/ NYHA class IV decompensated cardiac failure requiring IV inotropic therapy, bronchial asthma or related bronchospastic conditions, 2nd or 3rd degree AV block, sick sinus syndrome (unless permanent pacemaker is in place), cardiogenic shock or severe bradycardia. Not recommended in patients w/ clinically manifested hepatic impairment.

Patients w/ history of serious hypersensitivity reactions & those undergoing desensitization therapy; COPD w/ a bronchospastic component who are not receiving oral or inhaled medication; peripheral vascular disease; may mask manifestations of hypoglycemia particularly tachycardia in patients subject to spontaneous hypoglycemia or diabetic patients; may mask clinical signs of hyperthyroidism eg, tachycardia. Should not be discontinued abruptly in patients w/ ischemic heart disease; may induce bradycardia; lower starting dose should be used to decrease syncope or hypotension; avoid driving or hazardous tasks where injury could result to avoid risk of syncope; worsening of cardiac failure or fluid retention may occur; may lead to worsening hyperglycemia in CHF patients w/ diabetes; careful monitoring of ECG & BP in patients receiving concomitant therapy w/ Ca channel blockers of the verapamil or diltiazem type or other antiarrhythmic drugs; caution in patients suspected of having pheochromocytoma, in patients suspected of having Prinzmetal's variant angina; possibility of reduced lacrimation in wearers of contact lenses. Risk of cardiac & pulmonary complications in neonate in postnatal period. Pregnancy & lactation.

Postural hypotension, dizziness & headache; dyspnea, bronchospasm, bradycardia, malaise & asthenia. Hyperuricemia, hypoglycemia, hyponatremia, increased alkaline phosphatase, glycosuria, somnolence, impotence, abnormal renal function & albuminuria.

May potentiate hypotensive effects w/ general anesth & anesth that cause myocardial depression eg, ether, cyclopropane & trichloroethylene. Can precipitate bradycardia & heart block w/ antiarrhythmic drugs & other drugs affecting cardiac conduction. Reduced plasma conc w/ rifampicin. Increased plasma conc w/ fluoxetine, digoxin & cyclosporin. Enhanced antihypertensive effect w/ other antihypertensive drugs; can potentiate severe orthostatic hypotension following initial dose of prazosin & can exacerbate rebound HTN following w/drawal of clonidine. Hypotension, bradycardia, conduction defect & heart failure in concomitant use w/ Ca channel blockers. Reported to increase plasma conc of digoxin, cyclosporin.

Beta-Blockers

C07AG02 - carvedilol ; Belongs to the class of alpha and beta blocking agents. Used in the treatment of cardiovascular diseases.

Rx