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carvedilol

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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 23:04 (external edit)