Coriol - instructions for use, reviews, analogs and forms of release (tablets 3,125 mg, 6.25 mg, 12.5 mg and 25 mg) of the drug for the treatment of hypertension, angina in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Coriol. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Coriol in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Coriol in the presence of existing structural analogs. Use for the treatment of arterial hypertension, stable angina and chronic heart failure in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Coriol - alpha1, beta1 and beta2-adrenoblocker without internal sympathomimetic activity. Has vasodilator, antianginal and antiarrhythmic action.

Due to the blockade of beta 1-adrenergic receptors, the myocardium moderately reduces atrioventricular (AV) conduction, reduces the heart rate (heart rate) and cardiac output without causing a sharp bradycardia. Blocking alpha 1-adrenergic receptors, the drug causes an expansion of peripheral vessels, reducing the overall peripheral vascular resistance (OPSS). With blockade of beta2-adrenergic receptors, it is possible to increase the tone of the bronchi, some vessels, and also the tone and peristalsis of the intestine. In patients with heart failure, the drug increases the fraction of the ejection of the left ventricle. The effect on blood pressure (BP) and heart rate is most pronounced 1-2 hours after taking the drug.

Composition

Carvedilol + excipients.

Pharmacokinetics

After ingestion, Carvedilol is rapidly and almost completely absorbed from the gastrointestinal tract (GIT). Bioavailability is 25%. Simultaneous food intake slows the absorption of the drug, but does not affect its bioavailability.Binding to plasma proteins is 98-99%. Passes through the placental barrier, excreted in breast milk. Carvedilol is actively biotransformed in the liver with the formation of metabolites, which have a pronounced antioxidant effect. It is excreted with bile and feces. In the elderly, the carvedilol concentration in plasma is 50% higher than in young patients. In patients with impaired liver function, bioavailability can increase to 80%.

Indications

• arterial hypertension (in the form of monotherapy or in combination with other antihypertensive drugs);
• stable angina;
• chronic heart failure (as part of combination therapy).

Forms of release

Tablets for oral administration 3,125 mg, 6.25 mg, 12.5 mg and 25 mg.

Instructions for use and dosing regimen

With arterial hypertension, the dose is set individually. In the first 7-14 days, the recommended dose is 12.5 mg in the morning after breakfast. The dose can be divided into 2 divided doses of 6.25 mg. For further treatment, the drug is prescribed in a dose of 25 mg in the morning or divided into two doses of 12.5 mg. If necessary, after 14 days, the dose may be increased to a maximum daily dose of 50 mg.

With stable angina, the initial dose is 12.5 mg 2 times a day. After 7-14 days under the supervision of a doctor, the dose of the drug can be increased to 50 mg, divided into 2 divided doses. After 14 days with insufficient efficiency and good tolerability, the dose can be further increased. The total daily dose for angina pectoris should not exceed 100 mg divided into 2 doses.

For patients over the age of 70, the daily dose should not exceed 50 mg divided into 2 divided doses.

In chronic heart failure, the recommended initial dose is 3.125 mg 2 times a day. The dose is carefully increased until an optimal therapeutic effect is achieved. The maximum dose is 25 mg twice a day for patients with a body weight of up to 85 kg and 50 mg twice a day for patients with a body weight of more than 85 kg.

The condition of patients should be monitored at the beginning of treatment and with a subsequent dose increase. If the treatment is interrupted for more than 2 weeks, then it is resumed with a minimum dose of 3.125 mg 2 times a day, followed by a dose increase.

The drug is taken after a meal, squeezed with a small amount of liquid.

Side effect

• headache and dizziness;
• depression;
• paresthesia (sensations of numbness, tingling, crawling);
• Orthostatic hypotension (lowering blood pressure in the vertical position of the body);
• bradycardia (decrease in heart rate);
• intermittent claudication;
• attacks of angina pectoris;
• violation of peripheral circulation (cold extremities);
• progression of heart failure;
• syncope (loss of consciousness);
• nasal congestion and sneezing;
• dyspnea;
• nausea, vomiting;
• diarrhea, constipation;
• stomach ache;
• an increase in the activity of hepatic transaminases (hepatic enzymes in the biochemical blood test);
• leukopenia, thrombocytopenia (a decrease in blood levels of leukocytes, platelets);
• edema;
• impaired renal function;
• urticaria, itching, skin rashes;
• pain in the limbs;
• irritation and dry eyes;
• muscle weakness;
• increase in body weight;
• hypo- or hyperglycemia (decrease or increase in blood glucose);
• hypercholesterolemia (increase in cholesterol in the blood).

Contraindications

• heart failure in the stage of decompensation;
• syndrome of weakness of the sinus node (SSSU);
• atrioventricular block 2 and 3 degrees;
• pronounced bradycardia (rare pulse);
• arterial hypotension (systolic pressure less than 85 mm Hg);
• bronchial asthma;
• bronchospastic syndrome (narrowing of the lumen of the bronchi);
• liver failure;
• pregnancy;
• lactation period (breastfeeding);
• age to 18 years;
• hypersensitivity to carvedilol and other components of the drug.

Application in pregnancy and lactation

The use of Coriol in pregnancy is possible only in cases where the intended benefit to the mother exceeds the possible risk for fetal development.

Carvedilol excreted in breast milk, so if you need to prescribe the drug during lactation, breastfeeding should be discontinued.

Use in children

Contraindicated for children and adolescents under 18 years.

Application in elderly patients

For patients over the age of 70, the daily dose should not exceed 50 mg divided into 2 divided doses.

special instructions

Caioriol should be used with caution in chronic bronchitis, emphysema, Prinzmetal angina, diabetes mellitus, hypoglycemia, thyrotoxicosis, peripheral vascular occlusive diseases, pheochromocytoma, depression, myasthenia gravis, psoriasis, renal insufficiency.

At the beginning of treatment and with an increase in the dose of Coriol in patients, excessive decrease in blood pressure is possible, especially on rising. On the background of therapy, dizziness and fainting are possible, especially in elderly patients, with heart failure, and with the simultaneous use of other antihypertensive drugs and diuretics.

Do not abruptly stop therapy with Coriol, especially in patients with angina (as this can cause deterioration). The dose should be reduced gradually within 1-2 weeks.

In patients with renal insufficiency, ischemic heart disease, diffuse peripheral vascular disease, reduced blood pressure and / or heart failure, it is recommended to monitor renal function. If the kidney function worsens, Coriol should be discarded.

Beta-adrenoblockers can aggravate the clinical picture of peripheral angiopathy, psoriasis and anaphylactic reactions, as well as reduce the sensitivity of allergic samples.

Beta-adrenoblockers can aggravate the course of angina Prinzmetal (provoke the appearance of pain).

Because beta-blockers slow the heart rate, they can mask the symptoms of hypoglycemia in patients with diabetes and thyrotoxicosis in patients with thyroid disease.

Against the background of taking Coriol may reduce tear, which is important for patients wearing contact lenses.

The patient should be warned that prior to surgery it is necessary to inform the doctor about taking Coriola.

Caution is required when performing general anesthesia using drugs that inhibit cardiac muscle activity (eg, ether, cyclopropane, trichlorethylene). Before extensive surgery, gradual abolition of Coriol is recommended.

Caution should be given to the drug with severe metabolic acidosis.

Patients with pheochromocytoma can be assigned beta-adrenoreceptor blockers only after the beginning of adrenoceptor blockade.

With the cancellation of simultaneous therapy with Coriol and clonidine, it is first necessary to stop treatment with Coriol and only after a few days to abolish clonidine.

With the progression of heart failure in the background of treatment with Coriol it is recommended to increase the dose of diuretic, in case of renal insufficiency, the dose is regulated depending on the functional state of the kidneys.

During the treatment should be avoided the use of alcohol.

Safety and effectiveness of Coriol in children are not established.

Impact on the ability to drive vehicles and manage mechanisms

Early treatment Corioli and by increasing the dose may excessive decrease in blood pressure accompanied by dizziness. Patients are advised not to drive and therefore should refrain from other activities related to the necessity of high concentration and rapid psychomotor reactions.

Drug Interactions

In patients receiving Verapamil or diltiazem, intravenously, in the appointment of Corioli possible a marked reduction in heart rate and a significant decrease in blood pressure, so this combination of drugs not prescribed.

Enhancing Corioli possible while the use of certain antiarrhythmic drugs, anesthetic drugs, antihypertensive drugs, drugs for treatment of angina pectoris, with other beta-blockers (e.g., in the form of eye drops), MAO inhibitors, sympatholytic (reserpine), with cardiac glycosides . Therefore, with combined therapy, care should be taken to select doses for the products of these groups.

With the simultaneous administration of Coriol, an increase in the concentration of Digoxin in the blood plasma is possible.

Diuretics enhance the effects of Coriol.

The pharmacokinetics of carvedilol may change with simultaneous administration with inducers or inhibitors of the activity of the isoenzyme CYP2D6 (for example, cimetidine increases the concentration of carvedilol in the blood serum and rifampicin reduces it).

With simultaneous application with ergot alkaloids impairment of peripheral circulation is observed.

Carvedilol can enhance the effect of hypoglycemic drugs and mask the manifestations of hypoglycemia. Therefore, regular monitoring of the concentration of glucose in the blood is recommended.

Analogues of the drug Coriol

Structural analogs for the active substance:

• Acridilol;
• Bagolol;
• Vedicardol;
• Dilatrend;
• Carvedigamma;
• Carvedilol;
• Carvenal;
• Carvetrend;
• Carvydil;
• Kardivas;
• Credex;
• Rekardium;
• Talliton.

Analogues for the pharmacological group (alpha and beta-adrenoblockers):

• L-Arginine;
• Acridilol;
• Albert;
• Albert;
• Bagolol;
• Butylamin hydroxypropoxyphenoxymethyl methyloxadiazole;
• Vedicardol;
• Dilatrend;
• Carvedigamma;
• Carvedilol;
• Carvenal;
• Carvetrend;
• Carvydil;
• Kardivas;
• Credex;
• Proxodolol;
• Rekardium;
• Talliton.

Response of a therapist

It so happened that I rarely use the Coriol drug. It is used to reduce blood pressure in arterial hypertension, for the treatment of angina pectoris and chronic heart failure (in complex therapy). I assigned him to several patients with high blood pressure. And practically each of these patients after about a week of treatment started complaining of dizziness and a marked slowing of the pulse. After the abolition of Coriol, these symptoms disappeared. Therefore now I try to select to my patients other drugs that do not give such side effects.

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