Universal reference book for medicines

Active ingredient: carvedilol

Type: Beta 1 -, beta 2 -adrenergic blocker.
Alpha 1- adrenoblocker
Manufacturer: F.Hoffmann-La Roche (Switzerland) manufactured by Roche (Italy)
Composition, form of production and packaging
Tablets of
light brown color, round, marble, with a risk on both sides and marking "BM H3".

1 tab.

carvedilol 12.5 mg

Excipients: lactose, sucrose, polyvidon K25, crospovidone, colloidal silicon anhydrous, iron oxide yellow (E172), iron oxide red (E172), magnesium stearate.

10 pieces.
- blisters (1) - packs of cardboard.
10 pieces.
- blisters (3) - packs of cardboard.
10 pieces.
- blisters (5) - packs of cardboard.
10 pieces.
- blisters (10) - packs of cardboard.
Tablets from white to pale yellowish-beige, round, slightly marble, with a risk on both sides and labeling "BM D5".

1 tab.

carvedilol 25 mg

Excipients: lactose, sucrose, polyvidon K25, crospovidone, colloidal silicon anhydrous, iron oxide yellow (E172), iron oxide red (E172), magnesium stearate.

10 pieces.
- blisters (1) - packs of cardboard.
10 pieces.
- blisters (3) - packs of cardboard.
10 pieces.
- blisters (5) - packs of cardboard.
10 pieces.
- blisters (10) - packs of cardboard.
Tablets are yellow, round, slightly marble, with a risk on both sides and labeled "BM F1".

1 tab.

carvedilol 6.25 mg

Excipients: lactose, sucrose, polyvidon K25, crospovidone, colloidal silicon anhydrous, iron oxide yellow (E172), iron oxide red (E172), magnesium stearate.

10 pieces.
- blisters (1) - packs of cardboard.
10 pieces.
- blisters (3) - packs of cardboard.
10 pieces.
- blisters (5) - packs of cardboard.
10 pieces.
- blisters (10) - packs of cardboard.

The product description was approved by the manufacturer for the 2009 print edition.


Instructions for the medical use of the drug introduced by the Order of the Federal Service for Supervision in the field of health and social development of 21.10.05 в„–56.

Carvedilol is a blocker?
1 -,? 1 , - and? 2- adrenoreceptors, has an organoprotective effect, is a powerful antioxidant that removes free oxygen radicals, has an antiproliferative effect against smooth muscle cells of the vessel walls. Carvedilol is a racemic mixture of R (+) and S (-) stereoisomers, each of which has the same a-adrenoblocking and antioxidant properties. The beta-adrenergic blocking effect of carvedilol is non-selective and is due to the levorotatory S (-) stereoisomer.
Carvedilol has no internal sympathomimetic activity and, like propranolol, has membrane-stabilizing properties.
Blocking beta-adrenoreceptors, it reduces the activity of the renin-angiotensin-aldosterone system, reducing the release of renin, so fluid retention (characteristic of selective alpha-adrenoblockator) occurs rarely.
Selectively blocking?
1- adrenoreceptors, carvedilol reduces the overall peripheral vascular resistance.
Carvedilol does not adversely affect the lipid profile, maintaining a normal ratio of high and low density lipoproteins (HDL / LDL).


Arterial hypertension.
In patients with arterial hypertension, carvedilol lowers blood pressure (BP) due to a combined blockade? - and? 1- adrenoreceptors. Reduction of blood pressure is not accompanied by a simultaneous increase in the total peripheral vascular resistance, which is observed with the use of nonselective beta-blockers. The heart rate decreases somewhat. Kidney blood flow and kidney function in patients with hypertension persist. It was shown that carvedilol does not change the shock volume and reduces the overall peripheral vascular resistance; does not impair blood supply to organs and peripheral blood flow, including skeletal muscles, forearms, lower limbs, skin, brain and carotid arteries. Coldness of limbs and increased fatigue during exercise are rare. The hypotensive effect of carvedilol in hypertension persists for a long time.
Ischemic heart disease .
In patients with coronary heart disease, carvedilol has anti-ischemic and antianginal effects (an increase in the total duration of exercise, the time until the development of depression of the ST segment 1 mm in depth and the time before the attack of angina pectoris) that persist with prolonged therapy.Carvedilol significantly reduces myocardial oxygen demand and the activity of the sympathoadrenal system. Also reduces preload (pulmonary wedge wedge pressure and pulmonary capillary pressure) and postnagruzku (general peripheral vascular resistance).
Chronic heart failure .
Carvedilol reduces the mortality of patients with chronic heart failure of any stage and functional class and is well tolerated (studies of COPERNICUS, COMET). Carvedilol significantly reduces the need for hospitalization for cardiovascular reasons, it increases the ejection fraction and reduces symptoms in patients with chronic heart failure of ischemic and non-ischemic genesis. The effects of carvedilol are dose-dependent.


After ingestion, carvedilol is rapidly absorbed.
The maximum concentration in the blood plasma (C max ) is reached after about 1 hour. Absolute bioavailability of carvedilol is approximately 25%.

Carvedilol has a high lipophilicity.
About 98-99% of carvedilol binds to blood plasma proteins. Its volume of distribution is approximately 2 l / kg.

Carvedilol undergoes biotransformation in the liver with the formation of a number of metabolites - 60-75% of the absorbed drug is metabolized at the first "passage" through the liver.
The existence of intestinal-hepatic circulation of the starting material is shown.
As a result of demethylation and hydroxylation of the phenolic ring, 3 metabolites are formed (their concentrations are 10 times lower than the concentration of the starting material) with beta-adrenoblocking activity (in the 4'-hydroxyphenol metabolite it is approximately 13 times stronger than in carvedilol itself).
3 active metabolites have weaker vasodilating properties than carvedilol. Two of the hydroxycarbazole metabolites of carvedilol are extremely powerful antioxidants, and their activity in this respect is 30-80 times greater than that of carvedilol.

The half-life of carvedilol is about 6 hours, the plasma clearance is about 500-700 ml / min.
Excretion occurs mainly with feces, the main way of excretion is through bile. A small portion of the dose is excreted through the kidneys in the form of various metabolites.
Pharmacokinetics in special groups of patients

Patients with impaired renal function .
With prolonged therapy with carvedilol, the intensity of renal blood flow is maintained, glomerular filtration does not change.
In patients with arterial hypertension with renal insufficiency, the area under the concentration-time curve, half-life and maximum plasma concentrations do not change.
Renal excretion of an unchanged drug in patients with renal insufficiency decreases, however, changes in pharmacokinetic parameters are moderately expressed.
Carvedilol is an effective drug for the treatment of patients with arterial hypertension of renal genesis ("renal hypertension"), including in patients with chronic renal failure, as well as in patients on hemodialysis or who underwent kidney transplantation.
Carvedilol causes a gradual decrease in blood pressure both on the day of dialysis and on days without dialysis, and its hypotensive effect is comparable to that in patients with normal renal function. During dialysis, carvedilol is not excreted, because it does not pass through the dialysis membrane, probably due to strong binding to plasma proteins.
Patients with impaired liver function .
In patients with cirrhosis of the liver, the systemic bioavailability of the drug is increased by 80% due to a decrease in the expression of metabolism during the first "passage" through the liver. Consequently, carvedilol is contraindicated in patients with clinically manifested impairment of liver function (see "Contraindications.") Patients elderly and senile. Age does not affect the pharmacokinetics and tolerability of carvedilol in patients with arterial hypertension. Children. Data on the pharmacokinetics of the drug in patients under 18 years of age are currently limited.
Patients with diabetes mellitus.
In patients with type 2 (insulin-dependent) diabetes mellitus and arterial hypertension, carvedilol did not affect the fasting blood glucose concentration after fasting, the level of glycosylated hemoglobin (HbA1), or the dose of hypoglycemic drugs. In some clinical studies, it has been shown that carvedilol, insulin-dependent diabetes mellitus, does not cause changes in the glucose tolerance test. In patients with arterial hypertension without diabetes mellitus, who had insulin resistance (syndrome X), carvedilol improves insulin sensitivity. Similar results were obtained in patients with arterial hypertension and type 2 diabetes mellitus (insulin-dependent).

arterial hypertension .
Essential arterial hypertension (in the form of monotherapy or combination therapy with other antihypertensive agents, for example, blockers of "slow" calcium channels or diuretics).
- ischemic heart disease (including in patients with unstable angina and painless myocardial ischemia).

chronic heart failure .
Treatment of mild, moderate and severe chronic heart failure ischemic or non-ischemic genesis (to reduce the number of complications - admission for cardiovascular causes, and mortality, and improve health and slow the progression of the disease), when used in combination with ACE inhibitors, diuretics and, sometimes, by digitalis preparations (standard therapy).
Dilatrend can be prescribed in addition to standard therapy, and patients who do not receive digitalis preparations, vasodilators, or nitrates.


Inside, squeezed with enough liquid.

Essential hypertension.
The recommended initial dose is 12.5 mg once a day for the first 2 days, then 25 mg once a day. If necessary, in the future, the dose can be increased at intervals of at least 2 weeks, bringing to the highest recommended dose of 50 mg once a day (or divided into two doses).
Ischemic heart disease .
The recommended initial dose is 12.5 mg twice a day for the first 2 days, after that - 25 mg twice a day. If necessary, the dose can then be increased at intervals of at least 2 weeks, bringing to the highest daily dose of 100 mg divided into 2 doses.
Chronic heart failure.
The dose is selected individually, careful monitoring of the doctor is necessary. In patients receiving digitalis preparations, diuretics and ACE inhibitors, their doses should be stabilized before treatment with Dilatrend.
The recommended initial dose is 3.125 mg 2 times / day for 2 weeks.
With good tolerability, the dose is increased at intervals of at least 2 weeks, to 6.25 mg 2 times / day, then to 12.5 mg 2 times / day, then to 25 mg 2 times / day. The dose should be increased to the maximum, which is well tolerated by the patient. The recommended maximum dose is 25 mg 2 times / day for all patients with severe chronic heart failure and for patients with mild to moderate chronic heart failure with a body weight of less than 85 kg. In patients with mild and moderate chronic heart failure and a body weight of more than 85 kg - the recommended maximum dose is 50 mg 2 times / day.
Before each dose increase, the doctor should examine the patient to identify a possible increase in symptoms of heart failure or vasodilation.
With a transient increase in the symptoms of heart failure or fluid retention, the dose of diuretics should be increased, although sometimes it is necessary to reduce the dose of Dilatrend or temporarily cancel it.
If treatment with Dilatrendom is interrupted for more than 1 week, then its appointment is resumed in a smaller dose, and then increased in accordance with the above recommendations.
If treatment with Dilatrendom is interrupted for more than 2 weeks, it should be resumed at a dose of 3.125 mg 2 times / day, then the dose is selected in accordance with the recommendations given above.
Symptoms of vasodilation can be eliminated by reducing the dose of diuretics.
If symptoms persist, you can reduce the dose of an ACE inhibitor (if the patient takes it), and then, if necessary, a dose of Dilatrend. In such a situation, the dose of Dilatrend should not be increased until symptoms of worsening heart failure or arterial hypotension stabilize.
Doses for special groups of patients

Impaired renal function .
Existing data on pharmacokinetics in patients with varying degrees of renal dysfunction (including renal failure) suggest that patients with moderate and severe renal insufficiency do not need Dilatrend dose adjustment.
Patients of advanced age.
Data that would dictate the need for dose adjustment are not available.

Unwanted reactions, occurring with a frequency of? 10%, are regarded as very frequent.
Unwanted reactions, occurring with a frequency of between? 1% and <10%, are regarded as frequent. Undesirable reactions that occur with a frequency of? 0.1% to <1%, are regarded as infrequent. Undesirable reactions that occur with a frequency of? 0.01% to <0.1%, are regarded as rare. Unwanted reactions occurring with a frequency of <0.01%, including individual cases, are regarded as very rare.
Undesirable reactions in patients with chronic heart failure

Central nervous system.
very frequent - dizziness, headache - usually light and occurring more often at the beginning of treatment; asthenia (including, increased fatigue), depression.
The cardiovascular system.
frequent - bradycardia, postural hypotension, marked decrease in blood pressure, edema (including generalized, peripheral, depending on the position of the body, edema of the perineum, swelling of the lower extremities, hypervolemia, fluid retention). Infrequent-syncopal conditions (including presyncopal ones), atrioventricular blockade and heart failure during the period of dose increase.
Gastrointestinal tract: frequent - nausea, diarrhea, vomiting.

The system of hematopoiesis : rare - thrombocytopenia.
Very rare - leukopenia.
Metabolic disorders: frequent - weight gain, hypercholesterolemia;
in patients with already existing diabetes - hyperglycemia or hypoglycemia, decompensation of carbohydrate metabolism.
Other: frequent - visual impairment.
Rare - renal failure and impaired renal function in patients with diffuse vasculitis and / or renal dysfunction.
Undesirable reactions in patients with arterial hypertension and coronary heart disease

The nature of side effects of Dilatrend from the cardiovascular system in the treatment of hypertension and prolonged therapy of coronary heart disease is similar to that of heart failure, but their frequency is somewhat less.

Central nervous system: frequent - dizziness, headache and general weakness, usually light and arising, in particular, at the beginning of treatment.
Infrequent - decreased mood, sleep disturbances, paresthesia.
Cardiovascular system: frequent: bradycardia, postural hypotension, syncopal conditions, especially at the beginning of therapy.
Infrequent - violations of peripheral circulation (cold extremities, exacerbation of the syndrome of "intermittent" lameness and Raynaud's syndrome), AV blockade, angina (chest pain), symptoms of heart failure and peripheral edema.
Respiratory organs: frequent - bronchospasm and shortness of breath in predisposed patients;
rare - nasal congestion.
Gastrointestinal tract: frequent - dyspeptic disorders (including nausea, abdominal pain, diarrhea);
infrequent - constipation, vomiting.
Skin: infrequent - skin reactions (allergic rash, dermatitis, hives and itching).

Laboratory indicators : very rare - increased activity of "liver" transaminases - alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase, thrombocytopenia and leukopenia.

Other: frequent - pain in the limbs, reducing tear and eye irritation.
Infrequent - decreased potency, impaired vision. Rare - dry mouth and urination disorders. Very rare - skin allergic reactions (exanthema, urticaria, itching, rashes), exacerbation of psoriatic rashes, sneezing, nasal congestion, bronchospasm, dyspnea (in predisposed patients), flu-like syndrome.
The presence of beta-adrenoblocking properties in the preparation does not exclude the possibility of manifestation of latent diabetes, decompensation of already existing diabetes mellitus or oppression of the contrinular system


- hypersensitivity to carvedilol or any component of the drug;

- acute and decompensated chronic heart failure, requiring intravenous inotropic drugs;

- clinically significant impairment of liver function;

- age to 18 years (the effectiveness and safety of Dilatrend are not established);

- Pregnancy;

- AV blockade II and III degree (except for patients with an artificial pacemaker), pronounced bradycardia (less than 50 beats per minute);

- syndrome of weakness of the sinus node;

- severe arterial hypotension (systolic blood pressure less than 85 mm Hg);

- cardiogenic shock;

- anamnestic indications of bronchospasm and bronchial asthma.
With caution
use in patients with chronic obstructive pulmonary disease (COPD), depression, myasthenia gravis, hypoglycemia, AV-blockade I extent thyrotoxicosis, with extensive surgery and general anesthesia, Prinzmetal angina, diabetes, occlusive peripheral vascular disease, pheochromocytoma, renal insufficiency, psoriasis .

Beta-blockers reduce placental blood flow, which can lead to fetal death and premature birth. Furthermore, in the fetus and newborn undesirable reactions may occur (particularly hypoglycemia and bradycardia, complications of the heart and lungs). Animal studies have not revealed his teratogenicity.
Enough experience with Dilatrend in pregnant women do not. Carvedilol is contraindicated during pregnancy, except in cases where the potential benefits of its use outweigh the potential risks for the woman and the fetus.
In animals, carvedilol and its metabolites pass into breast milk. Data on excretion of the drug from breast milk is not, so it should not be used during lactation.

With caution used drug for renal insufficiency.

Contraindications to clinically significant hepatic dysfunction.

Contraindicated under the age of 18 years (Dilatrend efficacy and safety have not been established).

The data that would have dictated the need for dose adjustment, no.

Chronic heart failure. Patients with chronic heart failure during dose adjustment may Dilatrend marked increase in symptoms of heart failure or fluid retention. In the event of such symptoms is necessary to increase the dose of diuretics and not to increase the dose of Dilatrend to stabilize the patient's condition. Sometimes it is necessary to reduce the dose of Dilatrend and, in rare cases, temporarily stop the drug. Such episodes do not preclude further dose of Dilatrend correct selection. Dilatrend used with caution in combination with cardiac glycosides (possibly excessive deceleration AV-conduction).
Renal function in patients with chronic heart failure.When assigning Dilatrend patients with chronic heart failure and low blood pressure (systolic blood pressure less than 100 mm Hg. V.), Ischemic heart disease, and diffuse vascular changes and / or renal insufficiency noted reversible renal impairment. Dose is adjusted depending on renal function.
Chronic obstructive pulmonary disease (COPD). Patients with chronic obstructive lung disease (including with bronchospastic syndrome) not receiving oral or inhaled anti-asthma drugs, Dilatrend administered only if the possible benefits of its use outweigh the potential risks. In the presence of the initial inclination to bronchospastic syndrome when receiving Dilatrend respiratory distress syndrome can occur as a result of increasing airway resistance. At the beginning of the reception, and by increasing the dose of Dilatrend in these patients should be carefully observed, reducing the dose of the drug with the appearance of initial symptoms of bronchospasm.
Diabetes. Precautions drug prescribed to patients with diabetes because it can mask or reduce the symptoms of hypoglycemia (especially tachycardia). In patients with heart failure and diabetes may be associated with the use of Dilatrend decompensation of carbohydrate metabolism.
Peripheral vascular disease . Caution is needed in the appointment of Dilatrend to patients with peripheral vascular disease (including Raynaud's syndrome) as beta-blockers may exacerbate the symptoms of arterial insufficiency.
Thyrotoxicosis . Like other beta-blockers, Dilatrend can reduce the severity of symptoms of hyperthyroidism.
General anesthesia and major surgery. Caution is required in patients undergoing surgery under general anesthesia, because of the possibility of summation of the negative effects of Dilatrend and anesthetics.
Bradycardia. Dilatrend may cause bradycardia, a decrease in heart rate below 55 bpm Dilatrend dose should be reduced.
Hypersensitivity . Care should be taken when appointing Dilatrend persons with a history indications of severe hypersensitivity reactions or undergoing a course of desensitization as beta-blockers may increase the sensitivity to allergens and the severity of anaphylactic reactions.
Psoriasis. Patients with a history indications of the appearance or worsening of psoriasis when applying beta-blockers, Dilatrend be administered only after careful analysis of the possible risks and benefits.
Simultaneous treatment with blockers of the "slow" calcium channels . Patients taking concomitant blockers "slow" calcium channels such as verapamil or diltiazem, as well as other antiarrhythmics, should regularly monitor the ECG and blood pressure.
Pheochromocytoma.Pheochromocytoma patients before the start of the use of any beta-blocker, you must assign an alpha-blocker. Although Dilatrend has both beta and alpha-adrenoceptor blocking properties and experience of their use in such patients is not, so it should be used with caution in patients with suspected pheochromocytoma.
Prinzmetal angina. Non-selective beta-blockers may provoke the appearance of pain in patients with angina Prinzmetal. Experience destination Dilatrend in these patients is not. Although its alpha-adrenoceptor blocking properties may prevent such symptoms, prescribe carvedilol in such cases should be cautious.
Contact lenses. Persons who use contact lenses should bear in mind the possibility of reducing the amount of tear fluid.
Withdrawal. Dilatrend treatment is carried out for a long time. It should not be stopped abruptly, you must gradually reduce the dose at weekly intervals. This is particularly important in patients with coronary heart disease.
When storing the light can change the color of the tablets.
In the case of the need for surgery using general anesthesia is necessary to warn the anesthesiologist prior therapy Dilatrend.
During treatment excludes the use of ethanol.
Effects on ability to drive vehicles and working with machinery.Dilatrend studies on the effect on the ability to drive vehicles or work with machines and mechanisms have not been conducted. Because individual drug reactions (for example, dizziness, weakness), it may be violated (especially at the beginning of treatment, when changing the dosage, and in the case of simultaneous reception of alcohol). It should be used with caution in patients who require rapid psychomotor reactions.

Symptoms: marked reduction of blood pressure, bradycardia, heart failure, cardiogenic shock, cardiac arrest; possible respiratory failure, bronchospasm, vomiting, confusion, and generalized convulsions.
Treatment: in addition to the general measures necessary to carry out monitoring and correction of vital parameters, if necessary - in the intensive care unit. The following measures can be used:
a) put the patient on the back (with raised feet)
b) with bradycardia - atropine at 0.5-2 mg / in;
c) to maintain cardiovascular activity - glucagon to 1-10 mg / bolus, followed by 2-5 mg per hour as a continuous infusion;
g) sympathomimetics (dobutamine, isoprenaline, orciprenaline or epinephrine (adrenaline) at different doses, depending on the body weight and therapeutic efficacy. If necessary, the administration of drugs with a positive inotropic action, administered phosphodiesterase inhibitors. If dominates hypotension, administered in clinical overdosage norepinephrine (noradrenaline), it is administered in continuous circulatory monitoring indicators.
at resistant to treatment bradycardia shows an application of Art . nnogo pacemaker
When bronchospasm beta-adrenergic agonist is administered as an aerosol (at inefficiency - in / in) or aminophylline / in.
When convulsions in / slow administered diazepam or clonazepam.
Because of severe overdose with symptoms of shock, possibly lengthening the half-life of carvedilol and excretion of the drug from the depot, it is necessary to continue maintenance therapy for quite a long time. The duration of maintenance / detoxification therapy depends on the severity of overdose, it must continue to stabilize the patient's condition.

Digoxin. When simultaneous administration of carvedilol and digoxin digoxin concentrations increased by approximately 15%. As digoxin and carvedilol slow down the atrioventricular conduction. At the start of carvedilol treatment, the selection of the dose or withdrawal of the drug is recommended to regularly monitor the concentration of digoxin in the blood plasma.
Insulin or oral hypoglycemic agents . Drugs with a beta-adrenoceptor blocking properties may enhance glucose-lowering effect of insulin or oral hypoglycemic agents. Symptoms of hypoglycemia, particularly tachycardia, may be masked or weaken. Patients receiving insulin or oral hypoglycemic agents, it is recommended regular monitoring of blood glucose.
Inducers or inhibitors of hepatic metabolism. Rifampicin reduces plasma concentrations of carvedilol by about 70%. Cimetidine increases the area under the curve "concentration-time" by approximately 30% but does not alter C max . Caution is required in patients receiving inducers of multifunctional oxidases, such as rifampicin (reduced concentrations of carvedilol in the plasma), as well as inhibitors of multifunctional oxidases, such as cimetidine (increased plasma concentrations of carvedilol). However, given the relatively small effect of cimetidine on carvedilol concentration, the likelihood of any clinically important interaction is minimal.
Drugs cnizhayuschie content catecholamines. Patients receiving both drugs with beta-adrenoceptor blocking properties, and drugs that reduce levels of catecholamines (e.g., reserpine and monoamine oxidase inhibitors) must be monitored closely because of the risk of hypotension and / or severe bradycardia.
cyclosporine. In the appointment of carvedilol in patients who have had a kidney transplant who developed a chronic vascular graft rejection, noted a moderate increase in average minimum concentration of cyclosporine. To maintain the concentration of cyclosporine in the therapeutic range, approximately 30% of patients had to reduce the dose of cyclosporin (on average 20%), the rest of the patients the dose correction is not needed. Due to the pronounced individual variations required daily dose of cyclosporin recommended careful monitoring of the concentration of cyclosporine after initiation of therapy of carvedilol and, if required, corresponding correction daily dose cyclosporine.
Verapamil, diltiazem and other antiarrhythmic agents (propranolol, amiodarone). Simultaneous treatment with carvedilol can increase the risk of disturbance of atrioventricular conduction.
Clonidine . Simultaneous with the appointment of clonidine with agents with beta-blocking properties may potentiate antihypertensive and slows the heart rate effects. If you plan to stop drug combination therapy with a beta-adrenoceptor blocking properties and clonidine, must first cancel the beta-blocker, and in a few days you can cancel clonidine, gradually reducing the dose.
Blockers "slow" calcium channels. When concomitant administration of carvedilol and diltiazem observed isolated cases of conduction disturbance (rarely - violations of hemodynamic parameters). As is the case with other drugs with beta-adrenoceptor blocking properties, the appointment of carvedilol with blockers "slow" calcium channels such as verapamil or diltiazem is recommended that ECG and blood pressure under control.
Like other drugs with beta-adrenoblokiruyuschey activity, carvedilol may potentiate other concomitant antihypertensive agents (e.g.,? 1 adrenoblokatorov) or drugs which have an antihypertensive effect as a side effect.
It prevents the increase in blood pressure caused by the introduction of the agonist? 1adrenoceptor - phenylephrine, but it does not affect the increase in blood pressure caused by angiotensin II.
Particular attention should be paid during general anesthesia, the possibility of synergistic negative inotropic effects of carvedilol and some anesthetics.

The drug is released by prescription.


List B. The temperature is not above 25 on C, protected from light.
Keep out of the reach of children.
Since the tablets when exposed to light color can be changed, it is recommended to keep them in closed containers.
Shelf life Tablets 6.25 mg - 3 years, 12.5 mg tablets - 4 years, 25 mg tablets - 5 years.
The drug should not be used beyond the expiration date printed on the package.
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