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    Default Co - dilatrol tablets

    CO-DILATROL® (Carvedilol + Hydrochlorothiazide)



    Carvedilol

    Carvedilol, sold under the brand name Coreg among others, is a beta blocker used for treating mild to severe congestive heart failure (CHF), left ventricular dysfunction (LVD) following heart attack in people who are otherwise stable, and for treating high blood pressure.
    dilatrol tablets attachment.php?attachmentid=3351&d=1509716032

    Beta blockers block the beta receptors on heart muscle and other cells, making them more relaxed and less responsive to stress hormones. Carvedilol also blocks alpha receptors, which are found on blood vessels, and relaxes the blood vessels, dilating them, which lowers blood pressure and vascular resistance.


    It is a nonselective beta blocker/alpha-1 blocker and belongs to the third generation of beta blockers.


    Carvedilol was discovered by Fritz Wiedemann at Boehringer Mannheim and was initially approved in the U.S. in 1995. On October 20, 2006, the FDA approved an extended-release formulation.

    Mechanism of action:

    Carvedilol is both a non-selective beta adrenergic receptor blocker (β1, β2) and an alpha adrenergic receptor blocker (α1). The S(-) enantiomer accounts for the beta blocking activity whereas the S(-) and R(+) enantiomer have alpha blocking activity.Carvedilol reversibly binds to beta adrenergic receptors on cardiac myocytes. Inhibition of these receptors prevents a response to the sympathetic nervous system, leading to decreased heart rate and contractility. This action is beneficial in heart failure patients where the sympathetic nervous system is activated as a compensatory mechanism.Carvedilol blockade of α1 receptors causes vasodilation of blood vessels. This inhibition leads to decreased peripheral vascular resistance and an antihypertensive effect. There is no reflex tachycardia response due to carvedilol blockade of β1 receptors on the heart.

    Indications:
    Carvedilol is indicated in the management of congestive heart failure (CHF), commonly as an adjunct to angiotensin-converting-enzyme inhibitor (ACE inhibitors) and diuretics. It has been clinically shown to reduce mortality and hospitalizations in people with CHF. The mechanism behind its positive effect when used long-term in clinically stable CHF patients is not fully understood, but is thought to contribute to remodeling of the heart, improving upon its structure and function.In addition, carvedilol is indicated in the treatment of hypertension and to reduce risk of mortality and hospitalizations in a subset of people following a heart attack. It can be used alone or with other anti-hypertensive agents.

    Contraindications:
    According to the FDA, carvedilol should not be used in people with bronchial asthma or bronchospastic conditions. It should not be used in people with second- or third-degree AV block, sick sinus syndrome, severe bradycardia (unless a permanent pacemaker is in place), or a decompensated heart condition. People with severe hepatic impairment are also not advised to take carvedilol.

    Hydrochlorothiazide
    (abbreviated HCTZ, HCT, or HZT) is a diuretic medication often used to treat high blood pressure and swelling due to fluid build up. Other uses include diabetes insipidus, renal tubular acidosis, and to decrease the risk of kidney stones in those with high calcium level in the urine. For high blood pressure it is often recommended as a first line treatment. HCTZ is taken by mouth and may be combined with other blood pressure medications as a single pill to increase the effectiveness.


    Potential side effects include poor kidney function, electrolyte imbalances especially low blood potassium and less commonly low blood sodium, gout, high blood sugar, and feeling faint initially upon standing up. While allergies to HCTZ are reported to occur more often in those with allergies to sulfa drugs this association is not well supported. It may be used during pregnancy but is not a first line medication in this group.


    It is in the thiazide medication class and acts by decreasing the kidneys' ability to retain water. This initially reduces blood volume, decreasing blood return to the heart and thus cardiac output. Long term, however, it is believed to lower peripheral vascular resistance.


    Two companies, Merck and Ciba, state they discovered the medication which became commercially available in 1959. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. In 2008 it was the second most commonly used blood pressure medication in the United States. It is available as a generic drug and is relatively affordable.











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