Karvedil 12.5 mg Tablet

Beta-blocker with alpha-blocking (vasodilating) action for:

• Chronic heart failure (with other standard treatment)
• High blood pressure
• Stable angina
• Left ventricular dysfunction after a heart attack

Heart failure: start 3.125 mg twice daily for 2 weeks, then double every 2 weeks as tolerated to 6.25 mg, 12.5 mg, up to 25 mg twice daily (50 mg twice daily if over 85 kg).

Hypertension: 12.5 mg once daily for 2 days, then 25 mg once daily; maximum 50 mg daily (single or divided).

Angina: 12.5 mg twice daily for 2 days, then 25 mg twice daily.

• Take with food to reduce dizziness.
• Do not stop suddenly; taper over 1–2 weeks.

• Decompensated heart failure needing IV treatment
• Severe slow heart rate, heart block (2nd/3rd degree), sick sinus syndrome (without pacemaker)
• Cardiogenic shock, severe low blood pressure
• Asthma or bronchospasm history
• Severe liver impairment
• Allergy to carvedilol

Very common: dizziness, headache, tiredness, low blood pressure (especially when starting or increasing).

Common: slow heartbeat, weight gain/fluid retention, worsening heart failure at the start, nausea, diarrhoea, raised blood sugar, visual problems, cold extremities.

Rare but serious: heart block, bronchospasm, severe skin reactions, kidney function worsening.

• Weigh daily in heart failure; report rapid weight gain or breathlessness.
• Diabetes: may mask hypoglycaemia.
• COPD: caution.
• Contact lens users: reduced tear production.
• Tell the surgeon before an operation, or before cataract surgery (floppy iris).

Use in pregnancy only if benefit outweighs risk (risk of slow heart rate and low sugar in the baby). Not recommended while breastfeeding.

• Verapamil, diltiazem, amiodarone, digoxin (slow pulse, heart block)
• Clonidine (rebound when stopping)
• Insulin and diabetes tablets (hidden hypoglycaemia)
• Rifampicin (reduces levels); fluoxetine, paroxetine (raise levels)
• Ciclosporin (raises ciclosporin levels)
• NSAIDs (reduced effect)

Severe low blood pressure, slow heartbeat, heart failure, bronchospasm, shock. Emergency treatment.

Store below 30°C, protected from moisture.