卡維地洛

用途

• Heart failure (adjunctive therapy)
• Early/mild heart failure or later stages of CHF
• Heart failure (target plasma concentration)
• Dilated cardiomyopathy
• Chronic heart failure / Dilated Cardiomyopathy (DCM)
• ACVIM stage B2 degenerative mitral valve disease

給藥方式

可能的副作用

• Inappetence
• Lassitude (lethargy/fatigue)
• Hypotension
• Decompensation of heart failure (if titrated too rapidly)
• Bronchospasm (reported in humans)
• Mild hepatocellular injury (rare)

注意事項與禁忌

• Class IV decompensated heart failure
• Bronchial asthma
• 2nd or 3rd degree AV block
• Sick sinus syndrome (unless artificially paced)
• Severe bradycardia
• Cardiogenic shock
• Hypersensitivity to the drug
• > **Black Box Warning Equivalent:** Too rapid beta blockade can cause decompensation in patients with heart failure; cautious dosage titration is mandatory. * **Hepatic Insufficiency:** Because the drug is extensively metabolized in the liver, patients with hepatic insufficiency should receive the drug with caution. * **Pregnancy/Nursing:** FDA Category C. Increased post-implantation loss seen in animal studies. Unknown if it enters canine milk, but does enter rat milk. Use with caution in nursing patients.

藥物相互作用

• Beta-Blockers (other): Use with carvedilol may cause additive effects
• Calcium Channel Blockers (e.g., diltiazem, verapamil): May rarely cause hemodynamic compromise
• Cimetidine: May decrease metabolism and increase AUC of carvedilol
• Clonidine: Carvedilol may potentiate the cardiovascular effects of clonidine
• Cyclosporine: Carvedilol may increase cyclosporine levels
• Digoxin: Can increase digoxin plasma concentrations by approximately 15%
• Fluoxetine, Paroxetine, Quinidine: May increase R(+)carvedilol concentrations and increase alpha-1 blocking effects (vasodilation)
• Insulin / Oral Antidiabetic Agents: Carvedilol may enhance the blood glucose lowering effects of insulin or other antidiabetic agents
• Rifampin: Can decrease carvedilol plasma concentrations by as much as 70%
• Reserpine: Can cause increased bradycardia and hypotension in patients taking carvedilol
• Anaesthetic agents: Enhanced hypotensive effect and myocardial depression

常見問題