Carvedilol Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Do not stop taking this medication without consulting your doctor. Some conditions may become worse when you suddenly stop this drug. Some people who have suddenly stopped taking similar drugs have had chest pain, heart attack, and irregular heartbeat. If your doctor decides you should no longer use this drug, your doctor may direct you to gradually decrease your dose over 1 to 2 weeks.

When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Get medical help right away if you develop chest pain/tightness/pressure, chest pain spreading to the jaw/neck/arm, unusual sweating, trouble breathing, or fast/irregular heartbeat.

Warnings:

Do not stop taking this medication without consulting your doctor. Some conditions may become worse when you suddenly stop this drug. Some people who have suddenly stopped taking similar drugs have had chest pain, heart attack, and irregular heartbeat. If your doctor decides you should no longer use this drug, your doctor may direct you to gradually decrease your dose over 1 to 2 weeks.

When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Get medical help right away if you develop chest pain/tightness/pressure, chest pain spreading to the jaw/neck/arm, unusual sweating, trouble breathing, or fast/irregular heartbeat.

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Uses

Carvedilol is used to treat high blood pressure and heart failure. It is also used after a heart attack to improve the chance of survival if your heart is not pumping well. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.This drug works by blocking the action of certain natural substances in your body, such as epinephrine, on the heart and blood vessels. This effect lowers your heart rate, blood pressure, and strain on your heart. Carvedilol belongs to a class of drugs known as alpha and beta blockers.

How to use Carvedilol

See also Warning section.

Read the Patient Information Leaflet if available from your pharmacist before you start taking carvedilol and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with food as directed by your doctor, usually twice daily.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully.

Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

For the treatment of high blood pressure, it may take 1 to 2 weeks before you get the full benefit of this drug. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings remain high or increase, or you have worsening symptoms of heart failure like increased shortness of breath).

Side Effects

See also Warning and Precautions sections.

Dizziness, lightheadedness, drowsiness, diarrhea, impotence, or tiredness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. The risk of dizziness is highest within 1 hour after you take your dose. Taking this medication with food and starting treatment with a low dose and slowly increasing your dose as directed by your doctor help to reduce the risk of dizziness.

This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: very slow heartbeat, severe dizziness, fainting, unusual weakness, signs of kidney problems (such as change in the amount of urine), numbness/tingling of the hands/feet, blue fingers/toes, easy bruising/bleeding, mental/mood changes (such as confusion, depression), seizures.

Although this medication may be used to treat heart failure, some people may rarely develop new or worsening symptoms of heart failure, especially at the start of carvedilol treatment. Tell your doctor right away if you develop any of these serious side effects: shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking carvedilol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain types of heartbeat/heart rhythm problems (such as slow/irregular heartbeat, sick sinus syndrome, second- or third-degree atrioventricular block), breathing problems (such as asthma, chronic bronchitis, emphysema), severe heart failure requiring hospitalization, liver disease, kidney disease, blood circulation problems (such as Raynaud’s disease, peripheral vascular disease), serious allergic reactions including those needing treatment with epinephrine, overactive thyroid disease (hyperthyroidism), a certain type of tumor (pheochromocytoma), other heart problems (such as Prinzmetal’s variant angina), a certain muscle disease (myasthenia gravis), certain eye problems (cataracts, glaucoma).

This drug may make you dizzy or drowsy or cause you to faint. This is most likely to occur within 1 hour after taking your dose, especially when you start carvedilol treatment or any time your doctor increases your dose. During these periods, avoid driving and doing hazardous tasks. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

People who wear contact lenses may have dry eyes while taking this medication.

Before having surgery (including cataract/glaucoma eye surgery), tell your doctor or dentist if you are taking or have ever taken this medication, and about all the other products you use (including prescription drugs, nonprescription drugs, and herbal products).

This product may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). The risk is higher if you have diabetes, or are vomiting, fasting, or not eating regularly. Other symptoms of low blood sugar level, such as dizziness and sweating, are not affected by this drug.

If you have diabetes, this product may make it harder to control your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

Children may be at greater risk for low blood sugar (hypoglycemia) while using this drug, especially if they are vomiting or not eating regularly. To help prevent low blood sugar, make sure children eat regularly. If your child cannot eat regularly, is vomiting, or has symptoms of low blood sugar (such as sweating, shaking), tell the doctor right away.

Older adults may be more sensitive to the side effects of this drug, especially dizziness and lightheadedness.

Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using carvedilol. Carvedilol may harm an unborn baby. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.

It is unknown if carvedilol passes into breast milk. However, it is unlikely to pass into breast milk in large amounts. There is a low risk that it may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

One product that may interact with this drug is: fingolimod.

Some products have ingredients that could raise your heart rate or blood pressure or worsen your heart failure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

Does Carvedilol interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: very slow heartbeat, severe dizziness, fainting, slow/shallow breathing, seizures.

Do not share this medication with others.

Lifestyle changes that may help this medication work better include exercising, stopping smoking, and eating a low-cholesterol/low-fat diet. Consult your doctor for more details.

Have your blood pressure and pulse (heart rate) checked regularly while taking this medication. Learn how to monitor your own blood pressure and pulse at home, and share the results with your doctor.

Lab and/or medical tests (such as kidney/liver function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

carvedilol 12.5 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 25 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 3.125 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 25 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 3.125 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 3.125 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 12.5 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 6.25 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 3.125 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 12.5 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 6.25 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 3.125 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 3.125 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 6.25 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 12.5 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 25 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 6.25 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 6.25 mg tablet

Color: whiteShape: roundImprint: G 41

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 25 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 6.25 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 6.25 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 3.125 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 3.125 mg tablet

Color: whiteShape: ellipticalImprint: TV 51

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 25 mg tablet

Color: whiteShape: ovalImprint: SZ 117

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 12.5 mg tablet

Color: whiteShape: ovalImprint: SZ 116

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 6.25 mg tablet

Color: whiteShape: ovalImprint: SZ 62

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 3.125 mg tablet

Color: whiteShape: ovalImprint: SZ 61

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 12.5 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 25 mg tablet

Color: whiteShape: ovalImprint: 247

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 12.5 mg tablet

Color: whiteShape: ovalImprint: 245

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 6.25 mg tablet

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This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 12.5 mg tablet

Color: whiteShape: ellipticalImprint: TV 7295

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 12.5 mg tablet

Color: whiteShape: ellipticalImprint: 93 7295

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 25 mg tablet

Color: whiteShape: roundImprint: M C34

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 6.25 mg tablet

Color: whiteShape: roundImprint: M C32

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

carvedilol 3.125 mg tablet

Color: blueShape: roundImprint: M C31

This medicine is a white, round, film-coated, tablet imprinted with “ZC41”.

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Drug Survey

Are you currently using Carvedilol?

This survey is being conducted by the WebMD marketing sciences department.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Carvedilol: a medicine used to treat high blood pressure and prevent angina, heart disease and stroke.

1. About carvedilol

Carvedilol is a beta blocker.

It’s used to treat high blood pressure (hypertension) and helps prevent:

• heart disease
• heart attacks
• strokes

It can also be given with other medicines to treat heart failure and to prevent chest pain caused by angina.

Carvedilol is only available on prescription. It comes as tablets.

2. Key facts

• Carvedilol slows down your heart rate and makes it easier for your heart to pump blood around your body.
• You’ll usually take carvedilol once or twice a day.
• It usually starts to work after about 1 hour. But it will take days or weeks for it to reach its full effect.
• Common side effects of carvedilol include headaches and feeling tired or dizzy.
• Do not stop taking carvedilol suddenly. This can make your condition worse, especially if you have heart disease.

3. Who can and cannot take carvedilol

Carvedilol can be taken by most adults. It can sometimes be prescribed by a specialist for children aged 2 years and over.

Carvedilol is not suitable for some people. Tell your doctor before starting the medicine if you have:

• ever had an allergic reaction to carvedilol or any other medicines
• lung disease or asthma
• heart failure that is getting worse
• have low blood pressure (hypotension) or a slow heart rate
• a liver problem
• serious circulation problems in your arms and legs, such as Raynaud’s

4.

How and when to take carvedilol

When you start taking carvedilol, your doctor may advise you to take your first dose just before you go to bed. This is because it can make you feel dizzy.

After the first dose, if you do not feel dizzy, you can take your medicine in the morning. If you do feel dizzy, it’s best to keep taking your medicine at bedtime.

It’s best to take carvedilol at the same time each day.

If you take it twice a day, you’ll usually have 1 dose in the morning and 1 dose in the evening. Leave 10 to 12 hours between doses if you can.

Swallow the tablets whole with a drink of water. Do not chew or crush them.

Carvedilol does not usually upset your stomach, so you can take it with or without food. However, if you are taking carvedilol for heart failure, it’s best to take the tablets with food. This will help reduce the risk of you feeling dizzy or faint when you stand up.

If you find tablets difficult to swallow, some strengths have a score line to help you break the tablet in half. Check the information leaflet that comes with your medicine to see if you can do this.

Dosage

Carvedilol tablets come in 4 different strengths – 3.125mg, 6.25mg, 12.5mg and 25mg.

How much you take depends on why you need carvedilol.

The usual starting dose to treat:

• high blood pressure is 12.5mg once a day for 2 days – this is increased to 25mg, taken once a day. If your blood pressure does not go down enough your doctor may increase your dose to up to 50mg a day. This can be taken as a single dose or split into 2 doses.
• heart failure is 3.125mg, taken twice a day for 2 weeks. Your doctor will then slowly increase the dose every 2 weeks up to a maximum of 25mg to 50mg (depending on your weight).
• angina is 12.5mg, taken twice a day for 2 days – this is increased to 25mg, taken twice a day.

If your child is prescribed carvedilol, the doctor will use their weight to work out the right dose.

What if I forget to take it?

If you miss a dose of carvedilol, take it as soon as you remember, unless it’s nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

The amount of carvedilol that can lead to an overdose varies from person to person.

Taking too much carvedilol can lower your blood pressure, slow your heart rate, and make it difficult to breathe.

Urgent advice: Contact 111 for advice now if:

• you take too much carvedilol

Call 111 or go to 111.nhs.uk

If you need advice for a child under the age of 5 years, call 111.

5. Side effects

Like all medicines, carvedilol can cause side effects in some people, but many people have no side effects or only minor ones.

Side effects usually improve as your body gets used to the medicine.

Common side effects

These common side effects may happen in more than 1 in 100 people. They’re usually mild and last a few days after starting the medicine or increasing your dose.

Talk to your doctor or pharmacist if these side effects bother you or do not go away:

• feeling dizzy
• headaches
• feeling tired
• feeling or being sick (nausea or vomiting)
• cold fingers or toes

Serious side effects

It happens rarely, but some people have serious side effects when taking carvedilol.

Tell a doctor straight away if you have:

• nose bleeds that last for more than 10 minutes, unexplained bruising, or you bruise more easily than usual – these can be signs of low numbers of platelets in your blood (thrombocytopenia)
• high temperature, sore throat, mouth sores, toothache, flu-like symptoms – these can be signs of a low number of white blood cells (leukopenia)
• shortness of breath with a cough that gets worse when you exercise (like walking up the stairs), swollen ankles or legs, chest pain, or an irregular heartbeat – these may be signs of other heart problems
• shortness of breath, wheezing and tightening of your chest – these can be signs of lung problems
• yellow skin or the whites of your eyes turn yellow – these can be signs of liver problems

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to carvedilol.

Immediate action required: Call 999 or go to A&E now if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you’re wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of carvedilol. For a full list see the leaflet inside your medicines packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

6. How to cope with side effects of carvedilol

What to do about:

• feeling dizzy – as your body gets used to carvedilol this side effect should wear off. If carvedilol makes you feel dizzy, stop what you’re doing and sit or lie down until you feel better. Do not drive or operate machinery until you feel OK again. Try to avoid alcohol as it’ll make you feel worse.
• headaches – make sure you rest and drink plenty of fluids. Ask your pharmacist to recommend a painkiller. Do not drink too much alcohol. Headaches usually go away after the first week of taking carvedilol. Talk to your doctor if the headaches last more than a week or are severe.
• feeling tired – do not drive, ride a bike, or use tools or machinery if you’re feeling tired. Do not drink any alcohol as this will make you feel more tired.
• feeling sick or being sick – stick to simple meals and do not eat rich or spicy food. It might help to take your carvedilol after a meal or snack. If you’re being sick, try drinking small, frequent sips of water to avoid dehydration.
• cold fingers or toes – put your hands or feet under warm running water, massage them, and wiggle your fingers and toes. Do not smoke or have drinks with caffeine, as this can make your blood vessels narrower and restrict your blood flow. It’s best not to wear tight watches or bracelets as well. Try wearing mittens (they’re warmer than gloves) and warm socks. Speak to your doctor if this side effect bothers you.

7. Pregnancy and breastfeeding

Carvedilol and pregnancy

Carvedilol is not usually recommended if you’re pregnant.

If you’re trying to get pregnant or you’re already pregnant, talk to your doctor about taking carvedilol. It may be possible to change to other medicines that are more suitable when you’re pregnant, such as labetalol or nifedipine.

Carvedilol and breastfeeding

If your doctor or health visitor says that your baby is healthy, it’s OK to take carvedilol while breastfeeding.

There is no information about whether carvedilol passes into breast milk, but it would only be expected to pass through in small amounts. It’s unlikely to cause any side effects in your baby.

If you notice that your baby isn’t feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, then talk to your health visitor, midwife or doctor as soon as possible.

Non-urgent advice: Tell your doctor if you’re:

• trying to get pregnant
• pregnant
• breastfeeding

Find out more about high blood pressure and pregnancy.

8. Cautions with other medicines

There are some medicines that can affect the way carvedilol works.

Tell your doctor if you’re taking:

• other medicines for high blood pressure – when taken together with carvedilol, they can sometimes lower your blood pressure too much
• other medicines that can lower your blood pressure – these include some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), medicines for an enlarged prostate gland like tamsulosin, or levodopa (for Parkinson’s disease)
• medicines for an irregular heartbeat such as amiodarone or flecainide
• medicines for asthma or chronic obstructive pulmonary disease (COPD)
• medicines for diabetes, particularly insulin – carvedilol may make it more difficult to recognise the warning signs of low blood sugar. Speak to your doctor if you have low blood sugar levels without getting any warning signs. You should check your blood sugar after exercise, and follow usual advice about checking it before driving, or operating machinery.
• medicines that treat nose or sinus congestion, or other cold remedies (including those you can buy in the pharmacy)
• medicines for allergies, such as ephedrine, noradrenaline or adrenaline
• non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, diclofenac and naproxen – these medicines may increase your blood pressure

Mixing carvedilol with herbal remedies and supplements

There’s very little information about taking herbal remedies and supplements with carvedilol. However, some herbal products, such as cod liver oil, hawthorn and garlic tablets may cause low blood pressure (hypotension).

Important:
Medicine safety

Tell your doctor or pharmacist if you’re taking any other medicines, including herbal medicines, vitamins or supplements.

9. Common questions about carvedilol

How does carvedilol work?

Carvedilol is a type of medicine called a beta blocker.

Like other beta blockers, carvedilol works by slowing down your heart rate and making it easier for your heart to pump blood around your body.

It also works like an alpha blocker to widen some of your blood vessels. This helps lower your blood pressure.

For angina, carvedilol works by improving the blood supply to your heart. Angina is chest pain that comes on when not enough blood gets to the muscles of the heart. It usually happens because the arteries to the heart become hardened and narrowed.

Carvedilol widens the arteries so more oxygen gets to the heart and chest pain is prevented. It also slows your heart down and makes it beat more effectively. This reduces the amount of oxygen needed by your heart muscle and prevents angina.

How long does it take to work?

Carvedilol usually starts to work after about 1 hour. But it will take days or weeks to reach its full effect.

You may not feel any different when you take carvedilol for high blood pressure, but this does not mean it’s not working. It’s important to keep taking your medicine.

How long will I take it for?

Usually, treatment with carvedilol is long term. It may be for the rest of your life.

Can I take carvedilol for a long time?

Most people take carvedilol for a long time with no problems. In fact, it works best when you take it long term.

What will happen if I stop taking it?

Talk to your doctor if you want to stop taking carvedilol. If you’re bothered by side effects, your doctor may be able to prescribe a different medicine instead.

How does it compare with other medicines for high blood pressure?

Carvedilol works as well as other beta blockers to reduce blood pressure, but it’s mainly used to prevent angina or heart failure because it also widens the blood vessels.

The main difference with carvedilol is that it can affect other parts of your body too, such as your lungs.

Other medicines used to lower blood pressure work in different ways to beta blockers. These include:

• ACE inhibitors such as ramipril and lisinopril
• angiotensin receptor blockers like losartan
• calcium channel blockers like amlodipine
• medicines that make you pee more (diuretics) like indapamide

The medicine your doctor prescribes first depends on your age and ethnicity. If you’re under 55 years old, you’ll usually be offered an ACE inhibitor or an angiotensin receptor blocker. If you’re 55 years old or over, or of African Caribbean or black African origin, you’ll usually be offered a calcium channel blocker.

If you are bothered by side effects, you may have to try a different blood pressure medicine. Many people need to take a combination.

How does it compare with other medicines for chest pain and angina?

There are lots of other medicines to prevent angina attacks.

They include:

• calcium channel blockers such as diltiazem and amlodipine
• nitrates like isosorbide mononitrate
• medicines such as ranolazine, nicorandil or ivabradine

If carvedilol does not work for you, or you cannot take carvedilol or other beta blockers because of side effects, you may be able to switch to another medicine.

Your doctor will be able to decide which medicine is best for you. Some people may need to take a combination of medicines to control their angina symptoms.

How does it compare with other medicines that treat heart failure?

Carvedilol is used with other medicines to treat heart failure and prevent complications, These can include ACE inhibitors (like ramipril and lisinopril) or angiotensin receptor blockers (like losartan).

Other beta blockers like bisoprolol and nebivolol can be used instead of carvedilol in a similar way.

Will I need to stop carvedilol before surgery?

Tell your doctor you’re taking carvedilol if you’re going to be put to sleep (using general anaesthetic) or have any kind of major operation.

Your doctor may advise you to stop taking carvedilol before surgery.

This is because carvedilol can lower your blood pressure too much when it’s combined with some general anaesthetics.

Can I drink alcohol?

Drinking alcohol can increase the blood pressure-lowering effect of carvedilol. This can make you feel dizzy or lightheaded.

During the first few days of taking carvedilol, or after an increase in your dose, it is best to stop drinking alcohol until you see how the medicine affects you.

If you find carvedilol makes you feel dizzy it’s best to stop drinking alcohol.

Is there any food or drink I need to avoid?

You can eat and drink normally while taking carvedilol.

Eating a healthy, balanced diet can help your heart condition.

Will it affect my contraception?

Carvedilol will not stop your contraception working.

But some types of combined hormonal methods of contraception, such as the combined pill and contraceptive patch, are not usually recommended for women with high blood pressure.

Talk to your doctor if you’re taking a combined hormonal contraceptive.

If carvedilol makes you vomit, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Read more about what to do if you’re on the pill and you’re being sick.

Will it affect my fertility?

There’s no clear evidence to suggest that taking carvedilol will reduce fertility in either men or women.

If you’re trying for a baby or having problems getting pregnant while on carvedilol, speak to your doctor.

Will it affect my sex life?

Some people on carvedilol say their sex drive goes down and some men say they cannot get an erection.

There’s not enough evidence to say that carvedilol causes this.

If you’re having problems with your sex life, talk to your doctor.

Do I need to avoid playing sports?

You do not need to stop playing sports if you take carvedilol. But it’s a good idea not to push yourself too much.

Regular exercise is good for you because it lowers blood pressure by keeping your heart and blood vessels in good condition.

However, in some sports carvedilol may not be allowed if you’re competing at a very high level.

Can I drive or ride a bike?

Carvedilol can make you feel tired or dizzy, especially when you first start taking it or after increasing your dose.

If this happens to you, do not drive a car, ride a bike, or use tools or machinery until you feel OK again.

Can lifestyle changes help heart problems?

If you have heart problems, you can boost the health of your heart by making some lifestyle changes.

It’s a good idea to:

• quit smoking – not smoking will bring down your blood pressure and relieve heart failure symptoms.
• cut down on alcohol – drinking too much alcohol raises blood pressure over time and makes heart failure worse. Drinking alcohol while you’re taking carvedilol can make you feel dizzy or lightheaded.
• exercise – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. Even walking every day will help.
• eat well and lower the salt in your diet – aim to eat plenty of fruit and veg, wholegrains, fat-free or low-fat dairy products and lean proteins. Eating too much salt is the biggest cause of high blood pressure – the more salt you eat, the higher your blood pressure will be.
• deal with stress – when you’re anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse too. Finding ways to cope with stress will help to keep your blood pressure down.

Carvedilol – instructions for use, doses, side effects, reviews of the drug: tablets, 25 mg

Description of the drug Carvedilol (tablets, 12.5 mg) is based on official instructions, approved by the manufacturer in 2005

Approval date: 07/01/2005

Contents

• Active substance
• ATX
• Pharmacological group
• Nosological classification (ICD-10)
• Composition and form of release
• pharmachologic effect
• pharmachologic effect
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Contraindications
• Use during pregnancy and lactation
• Dosage and administration
• Side effects
• Interaction
• Overdose
• Precautionary measures
• special instructions
• Manufacturer
• Storage conditions
• Best before date
• Order in Moscow pharmacies
• Reviews

Active ingredient

Carvedilol* (Carvedilol*)

ATX

C07AG02 Carvedilol

Pharmacological group

Alpha and beta blockers

Nosological classification (ICD-10)

ICD-10 code list

Composition and formulation

Tablets	1 tab.
carvedilol	12.5 mg
	25 mg
excipients: milk sugar; sucrose; polyvidone K25; crospovidone; methylcellulose; croscarmellose sodium

in a blister pack of 10 pcs., in a carton box of 3 packs.

Pharmacological action

Pharmacological action –

vasodilator , antianginal , antiarrhythmic .

Blocks alpha ₁ -, beta ₁ – and beta ₂ -adrenergic receptors. It does not have its own sympathomimetic activity, it has membrane-stabilizing properties. It has an antioxidant effect, eliminating free oxygen radicals.

Blocks alpha ₁ -, beta ₁ – and beta ₂ -adrenergic receptors. It does not have its own sympathomimetic activity, it has membrane-stabilizing properties. It has an antioxidant effect, eliminating free oxygen radicals.

Pharmacodynamics

Reduces peripheral vascular resistance, reduces pre- and afterload on the heart. It does not have a pronounced effect on lipid metabolism and the content of potassium, sodium and magnesium in blood plasma.

Pharmacokinetics

Rapidly and almost completely absorbed from the gastrointestinal tract. Binds to plasma proteins by 98-99%. Bioavailability is about 25% due to the high degree of metabolism in the liver. Metabolites have beta-blocking properties. Food slows absorption but does not affect bioavailability. Plasma concentration is proportional to the dose taken. From _max in plasma is achieved after 1 hour. T _1/2 – 6-10 hours. Excreted mainly with bile.

In elderly patients, plasma concentrations are approximately 50% higher than in younger patients. In case of impaired liver function, bioavailability can increase up to 80%. Passes through the placental barrier, excreted in breast milk.

Indications

Arterial hypertension (monotherapy or in combination with other antihypertensive drugs), stable angina pectoris.

Contraindications

Hypersensitivity, chronic obstructive pulmonary disease, severe liver failure, severe bradycardia, sick sinus syndrome, AV block II and III degree (except in patients with a pacemaker), decompensated heart failure, pulmonary hypertension or cardiogenic shock, arterial hypotension, pregnancy, breast-feeding, age under 18 years (safety and efficacy in persons under 18 years of age have not been established).

Use during pregnancy and lactation

Contraindicated. At the time of treatment should stop breastfeeding.

Dosage and administration

Information for healthcare professionals only.
Are you a healthcare professional?

By mouth, after meals, with a little liquid. The dose is selected individually.

Hypertension: The recommended dose for the first 7-14 days is 12.5 mg/day in the morning after breakfast or divided into 2 doses of 6.25 mg, then 25 mg/day once in the morning or divided into 2 doses of 12. 5 mg. After 14 days, the dose may be increased again.

Stable angina: starting dose is 12.5 mg twice a day, after 7-14 days under the supervision of a physician, the dose can be increased to 25 mg twice a day. After 14 days, with insufficient efficacy and good tolerability of the drug, the dose can be further increased. The total daily dose should not exceed 100 mg (50 mg 2 times a day), over the age of 70 – 50 mg / day (25 mg 2 times a day).

If the next dose is missed, the drug should be taken as soon as possible, however, if the time for the next dose is approaching, then take only it, without doubling it. If it is necessary to cancel the drug, the dose should be reduced gradually over 1-2 weeks.

Side effects

From the side of the nervous system and sensory organs: headache, dizziness, syncope, muscle weakness (more often at the beginning of treatment), sleep disturbances, depression, paresthesia, decreased secretion of lacrimal fluid.

From the side of the cardiovascular system and blood (hematopoiesis, hemostasis): bradycardia, AV blockade, orthostatic hypotension, rarely – “intermittent” claudication, impaired peripheral circulation, progression of heart failure, thrombocytopenia, leukopenia.

From the respiratory system: sneezing, nasal congestion, bronchospasm, shortness of breath (in predisposed patients).

From the digestive tract: dry mouth, nausea, vomiting, abdominal pain, diarrhea or constipation, increased liver transaminases.

From the urinary system: severe renal dysfunction, edema.

On the part of the skin: exacerbation of psoriatic rashes.

Allergic reactions: exanthema, urticaria, itching, rash.

Other: influenza-like syndrome, pain in the extremities, weight gain.

Interactions

Information for healthcare professionals only.
Are you a healthcare professional?

Enhances the effect of hypoglycemic agents, increases the concentration of digoxin in the blood. Some antiarrhythmic drugs, anesthetics, antihypertensives, antianginal drugs, other beta-blockers (including in the form of eye drops), MAO inhibitors, sympatholytics (reserpine), cardiac glycosides may enhance the effect. Cimetidine increases the concentration of carvedilol in the blood; rifampicin, phenobarbital – reduce. Simultaneous use with ergot alkaloids impairs peripheral circulation. Incompatible with the / in the introduction of verapamil and diltiazem (possibly pronounced slowing of the heart rate and a pronounced decrease in blood pressure).

Overdose

Symptoms: pronounced decrease in blood pressure, bradycardia, impaired respiratory function (including bronchospasm), heart failure, cardiogenic shock, cardiac arrest.

Treatment: gastric lavage, administration of adrenergic agonists; symptomatic therapy.

Precautions

Use with caution in bronchospastic syndrome, chronic bronchitis, pulmonary emphysema, Prinzmetal’s angina (possibly worsening), diabetes mellitus or hypoglycemia (regular monitoring of blood glucose levels is necessary), hyperthyroidism, peripheral vascular disease (possibly worsening course), pheochromocytoma (the appointment of beta-blockers is possible only after prior therapy with alpha-blockers), depression, myasthenia gravis, psoriasis, renal failure, severe metabolic acidosis, in patients using contact lenses.

At the beginning of treatment and with increasing doses, orthostatic hypotension, dizziness, syncope may occur (especially in elderly patients with heart failure or while using other antihypertensive drugs or diuretics). It is recommended to monitor renal function in patients with renal insufficiency, ischemic heart disease, diffuse peripheral vascular disease, heart failure (with a deterioration in renal function, drug withdrawal is necessary). It is possible to reduce the sensitivity of allergic tests. Before extensive surgical interventions, a gradual withdrawal of the drug is recommended. If concomitant therapy with carvedilol and clonidine is discontinued, treatment with carvedilol should be discontinued initially, and clonidine should be discontinued only a few days later.

It is not recommended to drink alcoholic beverages during the treatment period.

Special instructions

Do not stop taking the drug or change its dosage without first consulting a doctor. If treatment is interrupted for 2 weeks or more, treatment should be resumed with the lowest doses. If there is no therapeutic effect or if the condition worsens, you should consult your doctor.

Should not be used during work by drivers of vehicles and people whose profession is associated with increased concentration of attention.

Producer

Makiz-Pharma, Russia.

Storage conditions

In a dry, dark place, at a temperature not exceeding 25 °C.

Keep out of reach of children.

Expiry date

3 years.

Do not use after the expiry date which is stated on the package.

Update date: 06/07/2023

The information provided about the prices of drugs is not an offer to sell or buy goods.

The information is intended solely for comparing prices in stationary pharmacies operating in
in accordance with Article 55 of the Federal Law “On the Circulation of Medicines” dated April 12, 2010 No. 61-FZ.

Carvedilol-KV tablets 12.5 mg blister №30

Pharmacological authorities

Pharmacodynamics. antihypertensive, sudinorogenesis, antianginal zasib. carvedilol is a non-selective blocker of α1-, β1- and β2-adrenergic receptors, without internal sympathomimetic activity. sudinorozshiryuvalny diyu is stalked by the head rank blockade of α1-adrenergic receptors. blocking β-adrenergic receptors, reducing the activity of the renin-angiotensin-aldosterone system, the activity of renin in the blood plasma, while decreasing without hindering the vision of the renin. lower heat, peripheral vascular resistance, pre- and post-natalization on the heart, moderately change the heart rate, without affecting the blood flow and the function of the blood vessels. poddnannya sudinorozshiryuvalnoy di and β-adrenergic blocking power due to the fact that in ailments ag scorching heat is not accompanied by one-hour movement of the peripheral support of the vessels, as in the case of taking other blockers of β-adrenergic receptors. volodia membrane-stabilizing power.

As an anti-oxidant that absorbs free radicals. Chi does not add to lipid metabolism, zocrema to the increase in HDL/LPNS, and to blood potassium ions, sodium and magnesium.

Antihypertensive effect develops in 2-3 years after a single dose and lasts for 24 years. With a trivalent lust, the maximum effect develops after 3-4 strokes. In patients with IXC, it shows protischemic and antianginal disease. In patients with impaired function of the left duct and/or insufficiency of blood circulation, it favorably adds to the hemodynamic indications, increasing the fraction of the left duct and changing the volume, reducing the end systolic blood pressure endemic diastolic obsyag, as well as peripheral and legenevic opir, increasing tolerance to physical challenge. The fraction of the wiki and the heart index do not change during normal heart function. Diagnosis of carvedilol was more pronounced in patients with tachycardia (HR 82 bpm) and a low fraction of vikid (23%).

Pharmacokinetics. Shvidko and mayzhe povnistyu smoky in the mucosal intestinal tract. C max in the blood is reached after about 1 year. Bioavailability to become 25% for the effect of the first passage through the liver (60-75%). Taking it does not affect bioavailability and the same level of C max, but wait an hour to reach it. Contact with blood plasma proteins by 98-99%. It is intensively metabolized more importantly in the liver for the liver with glucuronic acid. As a result of demethylation and hydroxylation, three metabolites with β-blocking and antioxidant activity are metabolized. Obsyag rozpodіlu to become close to 2 l/kg body weight and increase with damaged liver function. Penetrates through the placental barrier, seen in breast milk. T ½ carvedilol – 6-10 years, plasma clearance – close to 590 ml/min. It is excreted mainly by liver, a small part of the dose is seen in metabolites that look like drugs.

With impaired liver function, the volume of the liver increases by 80%. With liver cirrhosis, bioavailability increases by 4 times, and Cmax in blood plasma – by 5 times. In patients of the frail age, the concentration of carvedilol in blood plasma is 50% higher, lower in young people. Impaired function of nirok is not accompanied by cumulation of carvedilol. Practically not seen in hemodialysis.

Reading

Ag (when used as monotherapy and in combination with other antihypertensive conditions), stable angina pectoris, chronic heart failure (stages I-III according to nyha) in combination with diuretics, digoxin and inhibitors apf.

Zastosuvannya

Assign to grown-ups independently of the adopted person. the dose and duration of treatment are determined individually by the doctor depending on the disease, tolerability and effectiveness of therapy. in case of insufficiency of blood circulation, it is more likely to take a half hour, so that you can help to improve and change the risk of orthostatic reactions. the tablet is forged not rozzhovuchi, washed down with a sufficient amount of water.

AG. Start the dose at 12.5 mg 1 time per day for the first 2 days (the dose can be divided into two doses of 6.25 mg each), which can still ensure the necessary effect. If necessary, the dose can be increased after 2 days to 25 mg 1 time per dose, then at intervals of at least 2 days to 50 mg/day once a day or for 2 doses (25 mg in the evening). The maximum additional dose is 50 mg.

Angina. Start the dose at a dose of 12.5 mg 2 times per doba for the first 2 days, then 25 mg 2 times per doba (later in the evening). If necessary, the dose can be increased at intervals of not less than 2 tizhniv to the highest additional dose of 100 mg divided into 2 doses. For ailments of the summer age, the maximum additional dose is 50 mg, divided into 2 doses.

Chronic heart failure. The dose is selected individually, conducting a monitoring of the patient. The patient is obliged to rebuy under constant observation at the first 2-3 years after the first drug intake and after the increased dose. Doses of digoxin, diuretics, and ACE inhibitors are due to be fixed prior to drug recognition. It is recommended to start the dose at the start of 6.25 mg 1 time per doba. In case of extreme tolerance and the need to increase the dose, increase at intervals of not less than 2 times up to 6.25 mg 2 times per doba, then – up to 12.5 mg 2 times per doba, after which – up to 25 mg 2 times per doba. For patients with a body weight of 85 kg, the maximum additional dose is 50 mg in 2 doses, for patients with a body weight of 85 kg – 100 mg in 2 doses.

Contraindication

Increased individual sensitivity to drug components, arterial hypotension, decompensated heart failure, pronounced bradycardia (50 bpm), av-blockade II and III degree patients with piecemeal rhythm), sinus node weakness syndrome , cardiogenic shock, COPD, BA, impaired liver function, metabolic acidosis, period of pregnancy and breastfeeding, child age (up to 18 years of age).

Side effects

The drug is generally well tolerated.

Rarely may cause: lateral to the cardiovascular system: bradycardia, orthostatic hypotension, angina pectoris, AV block, progression of circulatory failure (cooling of the heart), progression of heart failure, zhnіh kіntsivok.

From the side of the central and peripheral nervous system: headache, confusion, weakness, mild weakness (as a rule, on the cob of glee), depression, sleep disturbance, paresthesia.

On the side of the herbal system: dryness in the mouth, nausea, pain in the abdomen, diarrhea or constipation, increased liver transaminases.

Sideways speech exchange: hyperglycemia, weight loss, hypercholesterolemia.

From the side of the hematopoietic system: thrombocytopenia, leukopenia.

To the side of the dichal system: posterior, bronchospastic reactions in mild ailments.

Allergic reactions: visip, sverbіzh, visip on the skin, the appearance of that / or acute psoriasis, phlegm, nasal congestion; more rarely – anaphylactoid reaction.

Іnші: more rarely – aggravation of the syndrome of intermittent culvicity, Raynaud’s syndrome, bіl in kіntsіvkakh, disruption of the mucosa and / or functions of the nirok, flu-like syndrome, altered sleazovidіlennya, manifestation of uterine diarrhoea. abeta of a latent overrun or an increase in the manifestation of yogo symptoms.

Special indications

For protection and under the control of the doctor (especially on the cob of treatment and with cutaneous elevated doses) the drug should be congested in patients with a frail age, with uveal diabetes (mask clinical and show hyperglycemia) and hypoglycemia, thyrotoxicosis, occlusive disease of peripheral vessels, av-blockade of the 1st stage, COPD, vasospastic angina pectoris of Printsmetal (may provoke attacks), psoriasis, impaired function of the tumors, depression, myasthenia gravis, in patients with pheochromocytoma (only in the case of α-adrenergic receptor blockers), with significant surgical interventions and global anesthesia, and also on aphids with α-adrenergic blockers, α-adrenergic agonists, digitalis preparations, diuretics and/or MAO inhibitors. in these cases, treatment should be started with low doses with further gradual progress to effective ones. on the cob likuvannya or when increasing the dose of the drug in patients, especially frail age, may be marked by an overhead decrease in heat, especially when standing up, which will require dose correction.

Patients with heart failure are advised to take the drug every hour to avoid orthostatic hypotension. If these patients develop symptoms of depression and / or worsening symptoms of heart failure, then increase the dose of diuretics and, if necessary, reduce the dose of carvedilol until the patient becomes ill. In times, a decrease in heart rate to 55 beats. / Xv drug slid vіdminiti.

When recognized to patients with a lack of blood circulation, with a low arterial pressure (systolic arterial pressure 100 mm Hg. St.), ischemic heart disease and / or a circulatory deficiency, it is necessary to control the function of the blood vessels , in case of її worsening – change the dose or administer the drug and increase the dose diuretics.

In patients with COPD, the bronchospastic component, which does not contain protiastmatic drugs, carvedilol may only be indicative of this condition, as the measles of the disease outweighs the potential risk. In patients with severe allergies, or undergo a course of desensitization, carvedilol can help with allergic reactions. We are ill, in some cases earlier on aphids treated with β-adrenergic receptor blockers or psoriasis, the drug can be recognized only after a serious assessment of possible coryza and rhysics. Like other β-adrenergic receptor blockers, carvedilol may alter the severity of thyrotoxicosis. At the time of the surgical intervention with general anesthesia, the anesthesiologist should be ahead of the anterior therapy with carvedilol. Patients with pheochromocytoma should have α-blockers before starting therapy. Individuals, yakі koristuyutsya with contact lenses, are guilty of being ahead of the possibility of a change in slezovidіlennya. During the period of jubilation, ethanol was used uniquely.

If one-hour recognition of blockers of major calcium channels – similar to phenylalkylamine (verapamil) and benzothiazepine (diltiazem), as well as class I antiarrhythmic drugs (amiodarone) is required, it is recommended to stay monitoring of ECG and AT.

When contemplating one-hour therapy with clonidine, add carvedilol to the back of the head, then, after a few days, add clonidine. Carvedilol does not affect the concentration of glucose in the blood and does not change the indications in the glucose tolerance test in patients with insulin-dependent diabetes mellitus.

Therapy was carried out slowly, it was not due to but it was sharply pinched, especially in patients with IXC due to the possibility of aggravating the overcoming of the main disease. It is recommended for 1-2 days to lower the dose by half the skin for 3 days. In case of re-treatment for 2 days and more, repeat the treatment with the next minimum doses.

Carvedilol cannot be taken with alcohol.

Congestion during pregnancy and breastfeeding. The drug is contraindicated in the period of pregnancy. If you need to stop during lactation, breastfeeding should be given.

Children. The drug is contraindicated for children under 18 years of age.

The ability to increase the speed of the reaction when caring for vehicles or robots with other mechanisms. During the period of jubilation, it is necessary to take advantage of transport barriers and occupy potentially unsafe types of activity, which will require increased concentration of respect and quick reaction.

Interactions

Carvedilol cannot be ingested, so the patient is taken in / in verapamil, diltiazem, antiarrhythmic drugs (especially class I). potentiation of the effect is indicated by one-hour administration of antihypertensive drugs, nitrates and antiarrhythmic drugs. drugs that reduce catecholamines (reserpine, MAO inhibitors), and clonidine increase the risk of arterial hypotension and bradycardia. microsomal oxidation inhibitors (cimetidine) are effective, and inducers (phenobarbital, rifampicin) are to reduce the effects of carvedilol. overnight zastosuvannya z alkaloids rіzhkіv increased peripheral krovoobіg. when congested with cardiac glycosides (digoxin), verapamil and diltiazem, av-conduction damage can occur, rarely with hemodynamic damage. carvedilol increases with digoxin and cyclosporine in the blood, which means correction of these doses. Hot anesthetics potentiate the negative inotropic and hypotensive effects of carvedilol. Carvedilol may potentiate insulin and oral hypoglycemia by masking symptoms of hypoglycemia (especially tachycardia) while maintaining regular control of blood glucose levels.

Overdose

Symptoms: severe arterial hypotension (systolic pressure ≤80 mm Hg), bradycardia (50 bpm), cardiogenic shock, impaired respiratory function (bronchospasm), circulatory failure , sudomi, zupinka heart.

Jubilation: during the first years – induction of vomiting and washing of the drain, gave – control and correction of the life of important indications in intensive care.