Sanofi Carvedilol, tablets 6,25mg 30 pcs.

It has a combined non-selective beta-blocking, alpha1-blocking and antioxidant effect. Vasodilator effect is mainly due to blockade of alpha1-receptors.
Due to vasodilatation it reduces total peripheral vascular resistance. It has no intrinsic sympathomimetic activity and, like propranololol, has membrane stabilizing effect.
A powerful antioxidant, eliminates free oxygen radicals. The combination of vasodilators and beta-adrenoblockers has the following effect: the combination of vasodilator action and beta-adrenoblocking properties of carvedilol leads to the fact that in patients with arterial hypertension, the decrease in blood pressure (BP) is not accompanied by a simultaneous increase in total peripheral resistance, which is observed when taking beta-adrenoblockers. There is a slight decrease in heart rate; renal blood flow and renal function are preserved. Since peripheral blood flow is preserved, limb cooling is very rarely noted, unlike in patients treated with beta-adrenoblockers. Antihypertensive effect develops quickly – 2-3 hours after a single dose – and lasts for 24 hours. With long-term treatment the maximal effect is noted after 3-4 weeks.
In patients with coronary heart disease, carvedilol has anti-ischemic and antianginal effects. It reduces pre- and afterload on heart. It has no significant effect on lipid metabolism and content of potassium, sodium and magnesium ions in blood plasma.
In patients with left ventricular dysfunction and/or circulatory insufficiency, carvedilol has a favorable effect on hemodynamic parameters: increases left ventricular ejection function and reduces its size.
Carvedilol has a favorable effect on cardiac hemodynamics and left ventricular ejection fraction both in dilated cardiomyopathy and in ischemic heart failure. In heart failure, end-systolic and end-diastolic volume as well as peripheral and pulmonary vascular resistance decreases.
Ejection fraction and cardiac index do not change in normal heart function.
In cases of impaired left ventricular function, the alpha1-adrenoblocking effect of carvedilol leads to dilation of arterial and, to a lesser extent, venous vessels.
It is established that when additionally prescribed against the background of taking cardiac glycosides, angiotensin-converting enzyme inhibitors and diuretics, carvedilol reduces mortality rate, slows disease progression and improves general condition of the patient regardless of the disease severity. The effect of carvedilol is more pronounced in patients with tachycardia (heart rate over 82 bpm) and low ejection fraction (less than 23%). During treatment with carvedilol, HDL/LDL cholesterol ratio (high-density lipoproteins/low-density lipoproteins) does not change.

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Patients with diabetes mellitus, hypoglycemia, thyrotoxicosis, chronic obstructive pulmonary disease (COPD), Prinzmetal angina, pheochromocytoma (if alpha-adrenoblockers are used concomitantly, see “Cautionary Note. section “Special Indications”), peripheral vascular occlusive disease, 1st degree atrioventricular block, chronic heart failure with reduced myocardial contractility, left ventricular dysfunction after acute myocardial infarction, psoriasis, renal dysfunction, depression, myasthenia, during general anesthesia, with a history of allergy (see “Allergy history”).

In case of treatment with alpha-adrenoblockers and alpha-adrenomimetics, concomitant use with cardiac glycosides, diuretics and/or monoamine oxidase inhibitors (MAOIs), “slow” calcium channel blockers (verapamil, diltiazem).

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