Carvista 6.25 mg

Description

Indications
Carvista is prescribed for the management of mild to severe heart failure, whether of ischemic or cardiomyopathic origin. It is used in conjunction with other heart failure medications such as digitalis, diuretics, and ACE inhibitors to reduce disease progression, as measured by a reduction in cardiovascular death, hospitalization, or the need to modify heart failure medications. Carvista may be an option for patients who cannot tolerate ACE inhibitors and for those who are not on digitalis, hydralazine, or nitrate therapy.

Please use this medicine only under the supervision of a registered healthcare provider.

Pharmacology
Carvista contains Carvedilol, a dual-action cardiovascular agent. It primarily acts as a non-selective antagonist of β-adrenergic receptors, with additional significant antagonistic activity on α-adrenergic receptors. Carvedilol also exhibits antiproliferative properties and scavenges free radical oxidants. These mechanisms are beneficial in the treatment of hypertension, angina pectoris, and congestive heart failure, aiding in heart function and improving cardiovascular outcomes.

Dosage & Administration

• For Hypertension:
  Initiate with 12.5 mg once daily. After 2 days, increase to 25 mg once daily. If necessary, increase further to 50 mg daily in single or divided doses at intervals of at least 2 weeks. For elderly patients, starting with 12.5 mg daily may provide sufficient control.

• For Angina Pectoris:
  Begin with 12.5 mg twice daily for the first 2 days, then increase to 25 mg twice daily. The maximum recommended dose for elderly patients is 50 mg daily in divided doses.

• For Heart Failure:
  Start with 3.125 mg twice daily with food. Gradually increase the dose every 2 weeks as tolerated: to 6.25 mg, then 12.5 mg, and finally 25 mg twice daily. For patients weighing less than 85 kg, the maximum dose is 25 mg twice daily, while for those over 85 kg, it can go up to 50 mg twice daily.

Always follow your healthcare provider’s dosage instructions.

Drug Interactions

• Digoxin: Co-administration with Carvista can elevate digoxin levels significantly after 24 hours. Monitoring digoxin levels is recommended when adjusting Carvista doses.

• Rifampin: When used in conjunction with rifampin, Carvista’s plasma concentration may decrease by up to 60%.

• Warfarin: Carvista does not affect warfarin’s plasma protein binding in vitro.

• Clonidine: When combined with β-blockers like Carvista, clonidine withdrawal can lead to a sharp rise in blood pressure, though Carvista’s α-blocking action may help mitigate this effect.

Contraindications
Carvista should not be used in patients with:

• Decompensated heart failure requiring intravenous inotropic therapy
• Bronchial asthma or bronchospastic conditions
• Second or third-degree AV block
• Sick sinus syndrome (unless a pacemaker is implanted)
• Cardiogenic shock or severe bradycardia

Side Effects
Common side effects include:

• Postural hypotension
• Dizziness
• Fatigue
• Gastrointestinal issues like nausea, vomiting, and abdominal discomfort
• Bradycardia
• Occasionally, symptoms like cold extremities, peripheral edema, impotence, and changes in vision may occur. Rarely, angina, AV block, and exacerbation of conditions like psoriasis or Raynaud’s phenomenon may be observed.

Pregnancy & Lactation
Carvista is contraindicated during pregnancy as animal studies have shown it crosses the placental barrier. There is no available data on its safety for pregnant women. Carvedilol is also excreted in breast milk, so it is not recommended for breastfeeding mothers. Safety and efficacy in children have not been established.

Precautions & Warnings

• Hepatic Impairment: Use caution in patients with liver disease.
• Heart Failure: Monitor clinical status for 2-3 hours after initiating treatment or increasing the dose to ensure heart failure or renal function is not worsening.

Therapeutic Class

• Alpha adrenoceptor blocking drugs
• Beta-adrenoceptor blocking drugs (Beta-blockers)

Storage Conditions
Store Carvista below 30°C, in a dry place, away from light and moisture. Keep out of the reach of children.

Please use this medication under the guidance of a registered healthcare provider.