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V-BLOC

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    Komposisi:

    Carvedilol

    Bentuk sediaan:

    Tablet 6,25 mg dan 25 mg

    Farmakologi:

    Menghambat aktivasi reseptor beta-1, inotropik (-) sehingga menurunkan kontraksi jantung, kronotropik (-) : menurunkan frekuensi denyut jantung. Menghambat aktivasi reseptor alfa-1: vasodilatasi pembuluh darah dan menurunkan resistensi perifer. Absorpsi cepat, T.maks 1-2 jam dan ekskresi dalam feses dan  tidak perlu penyesuaian dosis pada pasien dengan gangguan ginjal

    Indikasi:

    Hipertensi esensial dan gagal jantung kronik

    Kontraindikasi:

    - Gagal jantung kelas IV dan terapi inotropik secara i.v
    - Asma bronkial dan PPOK
    - Disfungsi hati
    - AV block derajat 2 dan 3 Sick Sinus Syndrome
    - Bradikardi, syok, hipotensi ( tekanan darah sistolik < 85 mmHg)
    - Hipersensitif, alergi- 
    - Kehamilan dan anak-anak

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    Dosis:

    - Hipertensi esensial dewasa dan orang tua diawali dosis 12,5 mg sekali sehari dalam dua hari pertama dilanjutkan 25 mg sekali sehari. Dosis dapat ditingkatkan dalam interval 2 minggu hingga dosis maks. 50 mg perhari. - Pasien gagal jantung kongestif  3,125 mg dua kali sehari selama 2 minggu dapat ditingkatkan menjadi 6,25 mg dua kali sehari.  - Dosis maks. pada pasien diatas berat badan 85 kg dosis diberikan 25 mg dua kali sehari, pada pasien dengan berat < 85 kg diberikan 25 mg dua kali sehari

    Peringatan dan Perhatian:

    Hipertensi sekunder atau tidak stabil, angina pektoris tidak stabil, gangguan persarafan jantung, serangan jantung baru, diabetes, usia lanjut

    Efek Samping:

    Edema, pusing, bradikardia, mual, diare, gangguan penglihatan

     

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    V-BLOC

     

    Composition:

    Carvedilol 6.25 or 25 mg.

    Presentation:

    Box of 3 strips x 10 tablets.

    Pharmacology:

    Carvedilol is an b-adrenoceptor antagonist which also causes peripheral vasodilatation primarily via a1-adrenergic blockade. Carvedilol produces its antihypertensive effect partly by reducing total peripheral resistance by blocking a1-adrenoceptor and by preventing b-adrenoceptor-mediated compensatory mechanisms.

    Indications:

    - Congestive heart failure : V-BLOC® is indicated for the treatment of mild or moderate (NYHA class II or III) heart failure of ischemic or cardiomyopathic origin. - Management of essential hypertension.

    Contraindications:

    V-BLOC® must not be used in patients with : - New York Heart Association (NYHA) Class-IV decompensated heart failure requiring intravenous inotropic support. - Asthma bronchial. - Chronic obstructive pulmonary disease (COPD) with a bronchospastic component. - Clinically manifest liver dysfunction. - 2nd and 3rd degree AV-block. - Severe bradycardia (< 50 bpm). - Shock, including cardiogenic shock and hypovolaemic shock. - Sick sinus syndrome (including sino-artrial block). - Severe hypotension (systolic blood pressure < 85 mmHg). - Hypersensitivity to the drug. Alergic disorders (including asthma and allergic rhinitis) which may suggest a predisposition to bronchospasm. - V-BLOC® should not be used during pregnancy or lactation, or in children younger than 18 years.

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    Dosage:

    - Congestive heart failure : The recommended starting dose of carvedilol is 3.125 mg twice daily for two weeks. If this dose is tolerated, it can then be increased to 6.25 mg twice daily. Dosing should then be doubled every 2 weeks to the highest level tolerated by the patient. - Essential hypertension : -- Adult : the recommended dose for initiation of therapy is 12.5 mg once a day (or 6.25 mg twice daily) for the first 2 days. Thereafter, the recommended dosage is 25 mg once a day. If necessary, the dosage may subsequently be increased at intervals of at least two weeks up to the highest level tolerated by the patient. -- Elderly: The recommended dose for initiation of therapy is 12.5 mg once daily, which has provided satisfactory control in some patients. If response is inadequate, the dose may be titrated at intervals of at least two weeks up to the recommended maximum daily dose. The maximum recommended dose is 50 mg daily in patients weighing less than 85 kg and 100 mg daily in patients weighing more than 85 kg. Carvedilol should be taken with food to slow the rate of absorption and reduce the incidence of orthostatic effects.

    Warning and Precautions:

    Markedly reduce performance of the heart, labile or secondary (organically induced) high blood pressure, unstable angina pectoris, impulse conductions disturbances in the heart (complete bundle branch blocks), final stages of peripheral artery disease, impaired renal function (serum creatinine concentration > 1.8 mg/dl or creatinine clearance < 30 mL/min), recent heart attack (less than 6 months old), tendency to drop in blood-pressure lowering drugs (alpha-1 receptor antagonists), uncontrolld diabetes mellitus, older patients especially who already taking diuretics, psoriasis, patients with a tendency towards bronchial constriction (bronchospastic reactions)..

    Adverse events:

    The most common adverse reaction in this and other studies were oedema, dizziness, bradycardia, hypotension, nausea, diarrhea, and blurred vision. There may occasionally be dizziness, headaches and tiredness. These symptoms usually mild and occur particularly at the beginning of treatment.

    Drugs Interaction:

    Other blood pressure lowering drugs, reserpine, guanethidine, methyldopa, clonidine or guanfacine, rifampicin, digoxin, insulin or other blood sugar lowering drugs,certain sedative (barbiturates phenothiazines) and drugs for treating depression (acyclic anti depressants).

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