carvedilol
Table of Contents
Carvedilol
see also beta blockers
Summary:
- long term Rx with carvedilol was shown to reduce mortality in systolic heart failure as well as reducing symptoms & improving well-being. Carvedilol also has anti-oxidant, antiproliferative & anti-endothelin properties.
- introduced in Australia in 1997-98
- Carvedilol is a beta blocker with:
- direct vasodilating actions (including selective alpha adrenergic antagonism) which offset its negative inotropic effect and thus is used in pts with mild-moderate (NYHA Class II & III) congestive cardiac failure.
- membrane stabilising properties & other effects (antioxidant)
- but NO intrinsic sympathomimetic effects
- In pts with CCF:
- acute effects were:
- reduced: BP, pulm.art.press, pulm.cap.wedge press., heart rate;
- minimal change to: cardiac output, SV index & systemic vascular resistance
- chronic effects:
- as for acute effects but SV index increased
- decreased LV size
Dose:
- stabilise pt's CCF FIRST then start slow as may initially worsen symptoms for 1st 3-10wks
- 3.125mg bd for 2wks then double dose every 2wks after assessing pt
- optimal dose is 25mg bd for pts < 85kg or 50mg bd for pts > 85kg
- take with food to reduce risk of orthostatic effects
carvedilol.txt · Last modified: 2008/09/14 13:04 by 127.0.0.1