CARVILEX 25 mg. 30 tablets

CARVILEX WHAT IS AND WHAT IT IS USED
Carvilex belongs to a group of medicines called "beta-blockers" but has an alpha blocker. Through its beta-blocking activity, it reduces blood pressure, heart rate and cardiac output. By blocking alpha adrenergic receptors, it causes expansion and decreased peripheral vascular resistance. Due to these effects, carvedilol resulted in a decrease of the voltage of the myocardium and influence the symptoms of angina, decreased blood pressure, and in patients with heart failure, improves the pumping function of the heart and increases the ejection fraction of the left kamera.Karvileks used to treat :
• Mild, moderate or severe heart failure as an adjunct to standard treatment (diuretics, digitalis, ACE inhibitors and other vasodilators);
• Hypertension (high blood pressure), alone or in combination with other antihypertensive agents;
• Prophylactic treatment of stable angina pectoris.
 
2 WHAT YOU NEED TO KNOW BEFORE CARVILEX
Carvilex not apply to:
• Allergy to carvedilol or to any of the excipients;
• Bronchial asthma and / or obstructive diseases of the respiratory system;
• Decompensated heart failure with marked fluid retention requiring intravenous administration of drugs that stimulate the work of the heart muscle (inotropic therapy);
• Severe hypotension (drop in systolic blood pressure below 85 mmHg)
• Cardiogenic shock;
• Severe bradycardia (slow heart rate below 50 beats / minute);
• On violations was in cardiac impulse conduction (syndrome sick sinus or P-nd and III-grade AB block);
• Severe hepatic insufficiency
• Metabolic acidosis (a disorder of the acid condition of the body);
* Pheochromocytoma (endocrine active tumor of the adrenal glands), unless adequately controlled by medications block alpha activity.
When taking this medicine, you should consider:
Caution should be exercised and medical supervision during treatment with Carvilex in the following cases: In patients with chronic heart failure early in therapy and when increasing the dose may show a worsening of heart failure or fluid retention. If such symptoms occur, the dose of diuretic should be adjusted, as the dose of carvedilol should not be increased to stabilize the condition. Sometimes it may be necessary to reduce the dose of carvedilol treatment or temporarily discontinued. Such episodes do not preclude subsequent successful rise dozata.Pri hypertensive patients who have chronic heart failure with diuretics and / or ACE inhibitors, carvedilol should be used with caution (since digoxin and carvedilol may delay implementation AB) .Karvedilol should be used with caution in patients with diabetes mellitus as early signs and symptoms of hypoglycemia (low blood sugar) can be obscured or altered. In patients with congestive heart failure and diabetes implementation of carvedilol can worsen glycemic control. Therefore, in diabetic patients when initiating or adjusting therapy with carvedilol, should be carried out continuous monitoring of blood sugar and need to adjust the dose of glucose-lowering medications. In the treatment of patients with congestive heart failure, and low blood pressure (systolic below 100 mmHg), ischemic heart disease, vascular disease and / or accompanying renal failure may occur reversibly deterioration of renal function. This requires regular monitoring of indicators of kidney function and need a dose reduction or discontinuation of treatment. Wearing contact lenses should be advised of the possibility of reduced salzootdelyane.Lechenieto carvedilol should not be stopped abruptly, particularly in patients with ischemic heart disease. This should be done gradually (1-2 weeks), the dose is reduced by half in three days. In patients with peripheral vascular disease (Raynaud's syndrome), carvedilol should be used with caution, because it as a beta-blocker can provoke or aggravate symptoms of arterial insufficiency. However, as carvedilol also has alfablokirashti properties, this effect is largely otslaben.Kakto and other beta-blockers, carvedilol may mask the symptoms of thyrotoxicosis (svrahfunktsiya thyroid). If treatment with carvedilol cause a reduction in heart rate below 55 beats / min, the dose should be carefully namali.Osobeno should be administered carvedilol in patients with a history of severe allergic reactions and in those undergoing treatment desenzibilizirashto since beta blockers may increase the severity of anaphylactic reactions and weaken the response of allergic tests. Patients with evidence of onset of PSORIASIS associated with treatment with beta-blockers should not take carvedilol only after an assessment of the benefit / risk.Pri patients with pheochromocytoma (tumor of endocrine active nadbybrechnite glands) should be initiated by treatment with alpha-blocker prior to administration of a beta-blocker (incl. carvedilol) .Products with non-selective beta-blocking activity may provoke chest pain in patients with angina of Prinzmetal type. Therefore, although carvedilol has alpha-blocking activity, it should be used with caution in these patsienti.Poradi risk of aggravation of bronchial obstruction, patients with a tendency to bronchospastic reactions generally should not take carvedilol. The treatment is carried out with a minimum effective dose, the occurrence of bronchial obstruction, treatment with carvedilol immediately cease
 
Application of Carvilex and intake of foods and drinks:
No evidence of a need for a special diet or restrictions on certain types of food and beverages during treatment with this product. It is recommended Carvilex be taken after meals to slow absorption, and to prevent orthostatic effect (a sharp drop in blood pressure when standing up).
 
pregnancy
Before taking any medicine, consult your doctor or farmatsevt.Poradi hazard to the fetus and newborn, pregnant are advised not to take this medicine except in exceptional cases where the expected benefit to the mother justifies the risk the fetus.
breastfeeding
Before taking any medicine, consult your doctor or farmatsevt.Karvedilol and its metabolites are excreted in human milk. Therefore, during the treatment with carvedilol breastfeeding is not recommended.
 
Driving and using machines
At the beginning of treatment Carvilex and change regimens may experience an excessive reduction of blood pressure and a temporary dizziness and vertigo, which can affect the ability to drive and use mashini.Vazhna information about some of the ingredients of Carvilex: This medicinal product contains lactose as an excipient, which makes it unsuitable for patients with lactase intolerance.
 
Taking other medicines:
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, even if they have not been prescribed by your lekar.Pri concomitant administration of carvedilol with other medicinal products can be observed the following reactions:
Carvedilol may potentiate the effect of other antihypertensive (blood pressure lowering) drugs. Co-administration with drugs that deplete catecholamines (eg. Reserpine and MAO inhibitors) may lead to hypotension and / or severe bradycardia.
With concomitant administration of carvedilol with calcium channel blockers such as diltiazem and verapamil may occur conduction abnormalities with the development of extreme bradycardia (strong decrease in heart rate), and atrioventricular block (disturbed conducting cardiac impulses). When given in combination with calcium channel blockers of the dihydropyridine type are at risk of excessive fall in blood pressure
Concomitant use of antiarrhythmic drugs (class IA and IC), administered intravenously, can cause significant inhibition of myocardial function. Upon oral administration of antiarrhythmic agents caution is required with frequent clinical monitoring and electrocardiographic monitoring.
Carvedilol may potentiate the effects of insulin or oral hypoglycemic agents. Signs of low blood sugar may be obscured or diminished. This requires regular monitoring of blood zahar.Ednovremennata use of carvedilol digoxin may lead to increased serum concentrations of digoksina.Sapatstvashto carvedilol treatment with cardiac glycosides may prolong AV проводимост.Едновременното administration of carvedilol increases the risk of hypotension and bradycardia. When treatment is necessary with these products should be suspended first cease taking carvedilol and after a few days and klonidin.Tsimetidin increases the serum concentrations of carvedilol and rifampicin them namalyava.Po during anesthesia should be paying attention to each other growing negative effect on cardiac function and lower blood pressure carvedilol and some anesthetics. Co-administration of carvedilol and cyclosporine can lead to elevated plasma concentrations of cyclosporin, and it is therefore desirable regular monitoring of plasma levels and, if necessary adjusting the dose of cyclosporin.
 
3 HOW TO TAKE CARVILEX
Always Carvilex according to the instructions of the attending lekar.V depending on the complaints, the doctor will determine the appropriate treatment for your illness doza.Tabletkite Carvilex taken orally chewed along with sufficient liquid after hrana.Zastoyna heart failure: Treatment should only be initiated under supervision of a physician after careful evaluation of the state of patsienta.Dozata should be individually determined at the beginning of treatment and a change in the dosage regimen. Before starting treatment with carvedilol doses applied respectively digitalis, ACE inhibitor or a diuretic should be stabilized. It is recommended prior to initiation of therapy with carvedilol to minimize fluid retention.
adults
The recommended starting dose of carvedilol is 3,125 mg, twice daily for two weeks. In patients who tolerate this dose, the dose may be increased to 6.25; 12.5 or 25 mg, two times a day at intervals of at least two weeks. The dose should be increased to the highest level tolerated patsienta..Maksimalnata dose in patients with mild to moderate heart failure is 25 mg twice daily for patients weighing less than 85 kg and 50 mg twice daily for more than 85 kg. during the increase of the dose in patients with systolic blood pressure <100 mmHg may result in deterioration of renal and / or heart function. Therefore, before any increase in dose, these patients should be evaluated by a physician for renal function and symptoms of worsening heart failure or peripheral vascular expansion. Transient worsening heart failure or vasodilation, fluid retention should be treated with the correct dose of applied diuretics or ACE inhibitors or with dose reduction or even suspension of treatment with carvedilol. Following a dose increase is done after stabilization sastoyanietoAko treatment is interrupted for more than two weeks, it should be resumed again at a dose of 3,125 mg twice a day, rising and must be made as described above nachin.Patsienti Elderly Like adults.
children
Safety and effectiveness in patients below the age of 18 years have not been established.
Hypertension: It is recommended that administration once a day.
adults
The dosage should be individualized. The recommended starting dose of carvedilol was 12,5 mg, taken once in the morning after food. After 7 to 14 days, the dose may be increased to 25 mg in the morning. If there is no sufficient effect, after a period of 14 days, the dose can be increased up to a maximum of 50 mg once daily or divided into two priema.Patsienti stricken vazrastPreporachitelnata starting dose is 12,5 mg per day. If the answer is inadequate, the dose may be increased to a maximum recommended dose of 50 mg once daily or in two divided doses. Dose escalation should be performed at intervals of at least two weeks.
children
Safety and effectiveness in patients below the age of 18 years is not ustanovena.Lechenie стенокардияВъзрастниПрепоръчителната starting dose of carvedilol twice daily after meals 12,5 mg for the first two days. Then, the recommended dose is 25 mg once daily.
Elderly
The dose should not exceed twice the 25 mg daily.
children
Safety and effectiveness in patients below the age of 18 years is not ustanovena.Patsienti with liver zabolyavaneKarvedilol is contraindicated in patients with impaired hepatic function.
Patients with underlying renal disease
No adjustment of the dose, whereas systolic blood pressure> 100mmHg.
Duration of treatment
Treatment with carvedilol is generally continuous. It does not have to be interrupted abruptly, and gradually over a few days to a reduction of the administered dose. This is particularly important in patients with concomitant coronary bolest.Ako have the impression that the effect of the application of Carvilex is strong or too weak, talk to your doctor or pharmacist.
 
If you take more than the prescribed dose Carvilex:
When taking a higher dose than prescribed immediately consult a doctor! Most common symptoms of overdose include hypotension (low blood pressure with dizziness, vertigo and rarely syncope) and bradycardia (slow heart rate). They can result from heart failure, cardiogenic shock and cardiac arrest (cardiac arrest). Overdose are possible occurrence of dyspnea (shortness of breath), bronchospasm (increased breathing resistance), vomiting, impaired cardiac conduction disturbance of consciousness to coma and generalized convulsions.
Treatment is symptomatic:
- In very slow pulse: atropine 0.5 to 2 mg intravenously.
- To maintain cardiovascular activity: intravenous administration of catecholamines (adrenaline, dopamine, dobutamine, orciprenaline).
- If bradycardia unresponsive to medication should be given a temporary pacemaker.
- If bronchospasm should be applied beta-mimetics or intravenous aminophylline - When seizures: slow intravenous diazepam or клоназепам.Продължителността of treatment depends on the degree of intoxication. In severe intoxication with symptoms of shock, supportive treatment should be continued for sufficient, as can be expected prolongation of radiation from the body of karvedilol.Pri manifestations of symptoms of overdose, immediately contact a doctor! If you forget to use Carvilex If you miss a dose, take it at the next regular intake without increasing the dose.
 
4 POSSIBLE SIDE EFFECTS
Like all medicines, Carvilex can cause adverse reaktsii.Te usually observed in the initial application or when increasing the dose more frequently in patients with chronic heart failure, as a rule are prehodni.Pri chronic heart failure
• Cardiovascular system:
- Common: bradycardia (slow heart rate), orthostatic hypotension (low blood pressure when standing up), hypotension (low blood pressure), edema (including generalized, peripheral, stagnation and genital edema, swelling of the legs, fluid overload) .- not Uncommon: syncope (including presyncope), conduct disorder cardiac impulse (AB-block II and III degree), progression of heart failure - mainly by increasing the dose.
• Metabolic:
- Frequent: weight gain, increased serum cholesterol, high or low blood sugar, worsening of glucose control in patients with diabetes mellitus.
• Central nervous system:
- Very common: dizziness, headache, weakness, usually mild, such as occur early in treatment.
• Blood:
- Rarely, thrombocytopenia (low platelet count in the blood).
- In rare cases, leucopenia (reduced amount of leukocytes in the blood).
• Gastrointestinal system:
- Common: nausea, vomiting, and diarrhea.
• Skin and appendages:
- Dermatitis and increased sweating. • Other:
- Frequent; Dexterity.