Koriol

Koriol – _alfa1-, _beta1-and _{beta2-adrenoblocker} with vasodilating, anti-anginal and antiarrhytmic action.

Form of release and structure

Dosage form – tablets:

• 3,125 mg – round, slightly convex from two parties, white color, with slanted edges;
• 6,25 mg – oval, slightly convex from two parties, white color, with a notch on one party and marking of "S2" – on another;
• 12,5 mg – oval, slightly convex from two parties, white color, with a notch on one party and marking of "S3" – on another;
• 25 mg – round, slightly convex from two parties, with slanted edges, white color, with a notch on one of the parties.

Tablets in blisters on 10 pieces are packed up, 3 blisters are packed into a pack cardboard.

Active ingredient: карведилол, in 1 tablet – 3,125 mg, 6,25 mg, 12,5 mg or 25 mg.

Inactive substances: povidone, sucrose, кросповидон, silicon dioxide colloid, lactoses monohydrate, magnesium stearate.

Indications to use

• Stable stenocardia;
• Arterial hypertension (as monodrug or in a combination with other antihypertensives);
• Chronic cardiac stenocardia (as a part of complex therapy).

Contraindications

Strict (Koriol's use is categorically contraindicated):

• The expressed bradycardia;
• Atrioventricular block of II and III degrees;
• Arterial hypotension (systolic arterial pressure is less than 85 mm hg);
• Dekompensirovanny heart failure;
• Sick sinus syndrome;
• Bronkhospastichesky syndrome;
• Bronchial asthma;
• Liver failure;
• Age up to 18 years;
• Period of pregnancy of a lactation;
• Hypersensitivity to a karvedilol or auxiliary components of drug.

Relative (Koriol's use has to be carried out with extra care, after assessment of potential advantage and possible risks, in connection with probability of development of complications):

• Emphysema of lungs;
• Chronic bronchitis;
• Printsmetal's stenocardia;
• Thyrotoxicosis;
• Hypoglycemia;
• Diabetes mellitus;
• Occlusal diseases of peripheral vessels;
• Depression;
• Pheochromocytoma;
• The expressed metabolic acidosis;
• Renal failure;
• Psoriasis;
• Myasthenia.

Route of administration and dosage

Koriol it is necessary to accept inside after food, washing down with enough water.

The recommended dosing modes:

• Stable stenocardia: an initial dose – on 12,5 mg 2 times a day. If necessary 7-14 days later under control of the doctor the dose is increased, up to 50 mg in 2 receptions. At insufficient efficiency, but on condition of good tolerance of drug, in 14 days the dose can be increased still. The most admissible daily dose makes 100 mg in 2 receptions, for elderly people 70 years – 50 mg in 2 receptions are aged more senior;
• Arterial hypertension: an initial dose (in the first 7-14 days) – on 12,5 mg in 1 reception in the morning after a breakfast or on 6,25 mg 2 times a day. A maintenance dose – 25 mg of 1 times a day in morning reception or on 12,5 mg 2 times a day. 14 days later if there is a need, the daily dose is increased to 50 mg;
• Chronic heart failure: an initial dose – on 3,125 mg 2 times a day with gradual increase to the moment of achievement of necessary therapeutic effect. The most admissible doses: for patients with body weight less than 85 kg – on 25 mg 2 times a day, for patients weighing more than 85 kg – on 50 mg 2 times a day.

At the beginning of therapy and at each increase in a dose it is necessary to control a condition of the patient.

If Koriol's reception for any reason is interrupted more than for 2 weeks, it is necessary to resume treatment from the minimum dose on 3,125 mg 2 times a day, gradually raising it.

Side effects

• From respiratory system: nose congestion, sneezing, bronchospasm; predisposed patients have an asthma;
• From cardiovascular system: AV blockade, disturbances of peripheric circulation, syncopal states, stenocardia attacks, bradycardia, orthostatic hypotension, progressing of heart failure, the alternating lameness;
• From the central and peripheral nervous system: depression, dizziness, paresthesias, headache;
• From urinogenital system: hypostases, heavy renal failures; seldom – decrease in a potentiality;
• From the alimentary system: abdominal pains, lock/diarrhea, nausea, vomiting, dryness in a mouth, increase in activity of hepatic transaminases;
• From system of a hemopoiesis: thrombocytopenia, leukopenia;
• Allergic reactions: exacerbation of psoriasis rashes, dieback, itch, skin rash, small tortoiseshell;
• Others: increase in body weight, irritation of eyes, reduction of products of the lacrimal liquid, extremity pain, hyper - and a hypoglycemia, a hypercholesterolemia, muscular weakness (is more often in an initiation of treatment).

Special instructions

At the beginning of Koriol's reception and at each increase in a dose perhaps excessive lowering of arterial pressure, especially in case of change of position of a body (at a rising). During treatment there can be dizzinesses and faints, especially at elderly people, patients with heart failure, and also the patients receiving at the same time diuretics and/or other hypotensive drugs.

Koriol it is not necessary to cancel suddenly, especially to patients with stenocardia (the aggravation of symptoms is possible); it is necessary to reduce gradually a drug dose within 1-2 weeks.

In case of progressing of heart failure during Koriol's use it is recommended to increase a diuretic dose.

At a renal failure the dose of drug is regulated, based on a functional condition of kidneys.

During treatment it is necessary to control function of kidneys at patients with a renal failure, coronary heart disease, reduced arterial pressure and/or heart failure and diffusion diseases of peripheral vessels. At deterioration in function of kidneys drug needs to be cancelled.

Beta adrenoblockers can reduce sensitivity of allergy tests, aggravate the course of stenocardia of Printsmetal and a clinical picture of anaphylactic reactions, psoriasis and a peripheral angiopatiya.

Slowing down a cordial rhythm, Koriol can mask hypoglycemia signs at patients with diseases of a thyroid gland and patients with a diabetes mellitus.

When carrying out the patients receiving карведилол of operation under the general anesthesia using drugs which suppress activity of a cardiac muscle (for example, cyclopropane, ether or trichloroethylene) need to be careful. If extensive surgical intervention is necessary, Koriol is recommended to cancel gradually. Before operation the patient has to warn the doctor about reception of this drug.

Karvedilol can reduce a slezoproduktion, it should be considered to patients who carry contact lenses.

Patients with a pheochromocytoma can appoint blockers of beta adrenoceptors only after the beginning of reception of blockers of alpha adrenoceptors.

At completion of therapy at patients who accept карведилол in a combination with a clonidine at first it is necessary to cancel Koriol and only in several days – a clonidine.

During treatment it is necessary to refrain from alcohol intake.

As at the beginning of administration of drug and at each increase in a dose perhaps excessive lowering of arterial pressure which is followed by dizziness is recommended to refrain from driving and performance of other types of the works demanding the high speed of reactions and concentration of attention.

Medicinal interaction

Koriol's use by the patients receiving diltiazem or verapamil intravenously can lead to the expressed reduction of heart rate and a considerable lowering of arterial pressure. For this reason similar combinations are contraindicated.

Effect of a karvedilol some antiarrhytmic drugs, anesthetics, other beta adrenoblockers (for example, in the form of eye drops) can strengthen, sympatholytics (for example, Reserpinum), monoamine oxidase inhibitors, drugs for treatment of stenocardia, anti-hypertensive means, cardiac glycosides. In need of carrying out a combination therapy it is necessary to select doses of the specified drugs carefully.

Koriol can increase concentration of digoxin in a blood plasma.

Drug can strengthen effect of hypoglycemic means and mask hypoglycemia signs. During treatment regular control of level of glucose in blood is necessary.

In case of simultaneous use of alkaloids of an ergot deterioration in peripheric circulation is noted.

Diuretics strengthen Koriol's action.

The pharmacokinetics of a karvedilol can change at simultaneous use of inductors or inhibitors of activity of an isoenzyme CYP2D6. For example, rifampicin reduces concentration of a karvedilol in blood serum, and Cimetidinum – raises.

Terms and storage conditions

To store at a temperature no more than 30 °C.

Period of validity – 2 years.