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Cardex Tablet contains Carvedilol
Cardex Tablet side effects
Postural hypotension, dizziness, headache, fatigue, gastro-intestinal disturbances, bradycardia; occasionally diminished peripheral circulation, peripheral oedema and painful extremities, dry mouth, dry eyes, eye irritation or disturbed vision, impotence, disturbances of micturition, influenza-like symptoms, rarely angina, AV block, exacerbation of intermittent claudication or Raynaud's phenomenon, allergic skin reactions, exacerbation of psoriasis, nasal stuffiness, wheezing, depressed mood, sleep disturbances, paresthesia, heart failure, changes in liver enzymes, thrombocytopenia, leukopenia are also reported.
Take caution in hepatic impairment and in heart failure monitor clinical status for 2 hours after initiation and after increasing each dose. Before increasing dose ensure that the renal function and heart failure are not deteriorating.
Drug interactions have been seen with co-administration of carvedilol and digoxin, resulting in an increased bioavailability of digoxin. This increase is not clinically significant and does not correlate with pharmacologic response. Pharmacokinetics studies demonstrated a lack of drug interaction between carvedilol and hydrochlorothiazide, cimetidine, torsemide and warfarin
Carvedilol should not be used during breast-feeding, since no studies have been performed in lactating women and animal studies have shown that carvedilol is excreted in breast milk. Safety and efficacy in children have not been established with carvedilol. Carvedilol should not be used during pregnancy as no studies have been performed in this group. Animal studies have shown that carvedilol crosses the placental barrier. No information is available on safety and efficacy of Carvedilol use in neonates.
Carvedilol is contraindicated in patients with severe chronic cardiac failure requiring intravenous inotropic therapy, bronchial asthma or related bronchospastic conditions, second or third-degree AV block, sick sinus syndrome (unless a permanent pacemaker is in place), cardiogenic shock, or severe bradycardia. Use of carvedilol in patients with clinically manifested hepatic impairment is not recommended. Carvedilol is contraindicated in patients with hypersensitivity to the drug.
The safety and efficacy of carvedilol in paediatric patients have not been established.
Digoxin : In normal healthy volunteers a single dose of carvedilol taken together with a single dose of digoxin resulted in significantly increased levels of digoxin 24 hour later. Patients with congestive heart failure stabilized on digoxin have been given carvedilol concomitantly without any adverse effects. Increased monitoring of digoxin is recommended when initiating, adjusting, or discontinuing the dose of carvedilol.
Rifampin : Pretreatment with rifampin resulted in a 60% decrease in Cmax and AUC.
Warfarin : Carvedilol did not alter the in vitro plasma protein binding of warfarin.
Clonidine : b-receptor antagonists potentiate the pressor reaction which may follow sudden withdrawal of treatment with clonidine although, in theory, the a-blocking action of carvedilol should modify the pressure rise.
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