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Kredex - instructions for use, analogs, reviews and release forms (tablets 6.25 mg, 12.5 mg and 25 mg) of the drug for the treatment of hypertension, coronary artery disease, angina pectoris and chronic heart failure in adults, children and in pregnancy

Kredex - instructions for use, analogs, reviews and release forms (tablets 6.25 mg, 12.5 mg and 25 mg) of the drug for the treatment of hypertension, coronary artery disease, angina pectoris and chronic heart failure in adults, children and in pregnancy

In this article, you can read the instructions for using the drug Creadex. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Credex 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 Credex in the presence of existing structural analogues.Use for the treatment of chronic heart failure, arterial hypertension, ischemic heart disease (CHD), prevention of angina attacks in adults, children, as well as in pregnancy and lactation.

 

Creadex - antihypertensive agent from the group of alpha and beta adrenoblockers without internal sympathomimetic activity. It blocks alpha1, beta1 and beta2-adrenergic receptors. As a result of blockade of beta1-adrenergic receptors moderately reduces conduction, force and heart rate, without causing a sharp bradycardia. As a result of the blockade of alpha 1-adrenergic receptors, the peripheral vessels expand. As a result of blockade of beta2-adrenergic receptors, it can slightly increase the tone of the bronchi, some vessels of the microcirculatory bed, and also the tone and peristalsis of the intestine.

 

Composition

 

Carvedilol + excipients.

 

Pharmacokinetics

 

After oral administration, Kredeks is rapidly and almost completely absorbed from the gastrointestinal tract (GIT). The maximum concentration in the blood plasma is reached within 1 hour. Bioavailability is 25%. In patients with impaired liver function, bioavailability can increase to 80%.Binding to plasma proteins is 98-99%. Penetrates through the placental barrier, excreted in breast milk. Exposed to the effect of "first passage" through the liver. Metabolites have a pronounced antioxidant and adrenoblocking effect. It is excreted mainly with bile.

 

Indications

  • Essential (primary) arterial hypertension;
  • ischemic heart disease (IHD): prevention of attacks of stable angina pectoris;
  • chronic (congestive) heart failure (as part of combination therapy).

 

Forms of release

 

Tablets 6.25 mg, 12.5 mg and 25 mg.

 

Instructions for use and dosing regimen

 

Tablets Kredeks take inside, washed down with a sufficient amount of water.

 

With essential hypertension, the first two days are 12.5 mg once a day, then 25 mg once a day. If necessary, the dose can be increased at intervals of at least 2 weeks to a maximum of 50 mg per day.

 

With congestive heart failure, 3.125 mg twice a day for 2 weeks, followed by a 2-fold increase in the dose (if necessary) every 2 weeks (up to 50 mg per day).

 

Maximum doses: 25 mg twice a day for patients weighing less than 85 kg and 50 mg twice a day for patients with a body weight of more than 85 kg.

 

Side effect

  • episodes of excessive lowering of blood pressure;
  • bradycardia (decrease in heart rate);
  • violations of peripheral blood flow;
  • attacks of angina pectoris;
  • atrioventricular blockade (AV blockade);
  • episodes of intermittent claudication;
  • increased manifestations of heart failure;
  • weakness, fatigue;
  • headache;
  • sleep disorders;
  • mental depression;
  • paresthesia (a sensitivity disorder characterized by sensations of numbness, tingling sensation, crawling crawling);
  • increased tonus and intestinal motility;
  • change in the activity of transaminases in blood plasma;
  • allergic exanthema, itching;
  • hives;
  • reactions resembling flat lichen;
  • the appearance of psoriatic plaques or exacerbation of an earlier psoriatic process;
  • nasal congestion;
  • thrombocytopenia, and leukopenia.

 

Contraindications

  • atrioventricular blockades of 2 and 3 degrees;
  • pronounced bradycardia (rare pulse);
  • heart failure in the stage of decompensation;
  • shock;
  • bronchial asthma;
  • chronic lung diseases with bronchoobstructive syndrome in history;
  • liver failure;
  • pregnancy;
  • lactation (breastfeeding);
  • hypersensitivity to carvedilol.

 

Application in pregnancy and lactation

 

Credex is contraindicated for use in pregnancy and lactation (breastfeeding).

 

Although there is no direct indication of the embryo or fetotoxic effect of carvedilol, it is known that it penetrates the placental barrier and is excreted in breast milk. Blockade of alpha and beta-adrenergic receptors in a fetus or newborn can induce a perinatal or neonatal distress syndrome manifested by bradycardia, respiratory depression, hypothermia and hypoglycemia.

 

Use in children

 

Clinical experience with Carvedilol in pediatrics is lacking.

 

Application in elderly patients

 

In elderly patients, an effective dose of 12.5 mg per day can be effective.

 

special instructions

 

With caution apply in patients with ischemic heart disease and heart failure. Before starting treatment with carvedilol in heart failure, adequate therapy should be used to correct the symptoms of decompensation.

 

With the use of Credex in patients with IHD, the need for myocardium in oxygen may be reduced (due to the blockade of beta1-adrenergic receptors).In this regard, the abolition of carvedilol should be carried out gradually to avoid the development of angina attacks.

 

In patients with endocrine disorders, carvedilol can mask symptoms of hyperthyroidism and early signs of acute hyperglycemia, which should be prevented in patients with insulin-dependent diabetes mellitus.

 

During the treatment is not recommended the use of alcohol.

 

Impact on the ability to drive vehicles and manage mechanisms

 

At the beginning of treatment, as well as increasing the dose of Credex during the treatment should refrain from driving and other activities associated with the need for high concentration of attention and rapid psychomotor reactions.

 

Drug Interactions

 

With the simultaneous use of antiarrhythmics with carvedilol, anesthetics, antihypertensive drugs, antianginal drugs, other beta-blockers (including eye drops), there is a risk of unwanted drug interactions.

 

With the simultaneous use of inhibitors of the isoenzyme CYP2D6, the potentiation of carvedilol is theoretically possible.

 

With the simultaneous use of inducers of the isoenzyme CYP2D6 of the cytochrome P450 enzyme system, a decrease in the Credex effect is possible.

 

With simultaneous use with verapamil, diltiazem for intravenous administration, it is possible to develop severe arterial hypotension.

 

With simultaneous use with digoxin, an increase in Digoxin concentration in the blood plasma and an increased risk of development of severe bradycardia and violations of atrioventricular conduction are possible.

 

With the simultaneous use of insulin, oral hypoglycemic drugs may increase the risk of developing hypoglycemia.

 

With simultaneous application with clonidine possible bradycardia, arterial hypotension, conduction disorders. In the case of a sudden withdrawal of clonidine in patients receiving carvedilol, a sharp increase in blood pressure is possible.

 

With simultaneous application with reserpine, monoamine oxidase (MAO) inhibitors, there is a risk of developing severe arterial hypotension and bradycardia.

 

With simultaneous use with rifampicin, the area under the pharmacokinetic curve (AUC) and the maximum concentration of carvedilol in the blood plasma decrease.

 

Fluoxetine inhibits the isoenzyme CYP2D6, which leads to inhibition of the metabolism of Credex and its cumulation. This can exacerbate cardio-depressive action (including bradycardia). Fluoxetine and, mainly, its metabolites are characterized by a long half-life, so the likelihood of drug interaction persists even a few days after the abolition of fluoxetine.

 

With simultaneous application with cimetidine, AUC of carvedilol increases without changing its maximum concentration in blood plasma.

 

With simultaneous application with cyclosporine, an increase (from a small to a moderate one) of the concentration of cyclosporine in the blood plasma is possible.

 

When used simultaneously with ergotamine derivatives, peripheral circulation may worsen.

 

Analogues of the drug Kredex

 

Structural analogs for the active substance:

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

 

Analogues of the drug Kredeks on the pharmacological group (alpha and beta adrenoblockers):

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

 

Response of a therapist

 

Currently, I do not have patients on the site who receive the drug Kredeks, as its supplies to pharmacies have long ceased. When we used it in the treatment of chronic heart failure, arterial hypertension and coronary heart disease, the patients came to the reception from the hospital with the already selected dose of the drug. I remember how they talked about the fact that the main problems occurred during the first stages of Credex treatment: blood pressure was sharply reduced, bradycardia (low heart rate) developed. But after a while everything came back to normal without any special treatment. And then they transferred the drug well, without undesirable reactions to it.

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