Carvid Dosage/Direction for Use

General Dosing Recommendations: Carvedilol dosage must be individualized and closely monitored by a physician.
Fluid retention should be minimized before starting carvedilol treatment.
Should be taken with food to slow the rate of absorption and reduce the incidence of orthostatic effects.
Carvedilol treatment is a long-term therapy. Do not discontinue treatment abruptly but rather gradually reduce at weekly intervals. This is particularly important in patients with concomitant coronary heart disease.
Recommended Oral Carvedilol Dose: Hypertension: Recommended Starting Dose: 12.5 mg once daily or 6.25 mg twice daily.
Thereafter, the recommended dosage is 25 mg once daily or 12.5 mg twice daily.
Dosage may be increased at intervals of at least two weeks to the maximum recommended dose of 50 mg, given once daily or in divided doses (twice daily).
The full antihypertensive effect of carvedilol is seen within 7 to 14 days.
Co-administration with a diuretic may produce additive effects and exaggerate the orthostatic component of carvedilol.
Angina Pectoris: Adults: Recommended Starting Dose: 12.5 mg twice daily for the first two days.
Thereafter, the recommended dosage is 25 mg twice daily.
Dosage may be increased at intervals of at least two weeks to the maximum recommended dose of 100 mg, given in divided doses (twice daily).
Elderly: Recommended Maximum Dose: 50 mg given in divided doses (twice daily).
Symptomatic, Stable, Chronic Heart Failure: In patients receiving diuretics and/or digoxin and/or ACE inhibitors, dosing of these other drugs should be stabilized before starting carvedilol.
Recommended Starting Dose: 3.125 mg twice daily for two weeks.
If this dose is tolerated, dosage should be increased subsequently to 6.25 mg twice daily, followed by 12.5 mg twice daily and thereafter 25 mg twice daily, at intervals of not less than two weeks. Maintain patients on lower doses if higher doses are not tolerated.
At initiation of each new dose, observe patients for signs of dizziness or light headedness for one hour.
Maximum Recommended Dose: 25 mg twice daily for patients with severe heart failure and for patients with mild to moderate heart failure weighing less than 85 kg (187 lbs) and 50 mg twice daily in patients with mild to moderate heart failure weighing more than 85 kg.
Treat fluid retention (with or without transient worsening heart failure symptoms) with increased doses of diuretics. Occasionally, it may be necessary to lower carvedilol dose and, rarely, temporarily discontinue carvedilol.
If carvedilol treatment is discontinued for more than one week, resume therapy at half the dose the patient is previously taking and up-titrate in line with the previously mentioned dosing recommendation. If carvedilol treatment is discontinued for more than two weeks, resume therapy at 3.125 mg twice daily and up-titrate in line with the previously mentioned dosing recommendation.
Deterioration of renal and/or cardiac functions may occur during up-titration of the dose in patients with systolic blood pressure <100 mmHg. Therefore, before each dose increase, these patients should be evaluated by a physician for renal function and symptoms of worsening heart failure or vasodilation. Transient worsening of heart failure, vasodilation or fluid retention may be treated by adjusting doses of diuretics or ACE inhibitors or by modifying or temporarily discontinuing carvedilol treatment. Under these circumstances, do not increase carvedilol until symptoms of worsening heart failure or vasodilation have been stabilized.
Left Ventricular Dysfunction Following Myocardial Infarction: Before Starting Carvedilol Treatment: Hemodynamically stable patients should have received an ACE inhibitor for at least 48 hours, given at a stable dose during at least the preceding 24 hours. Carvedilol can then be started between day 3 and day 21 after the myocardial infarction.
First Carvedilol Dose: Recommended Starting Dose: 6.25 mg.
Patients should be under close medical supervision for at least 3 hours after the first dose.
Subsequent Carvedilol Dose: Increase dose to 6.25 mg twice daily and maintain for 3 to 10 days based on patient's tolerability (i.e., heart rate >50 beats/min, systolic blood pressure >80 mmHg, absence of clinical signs of intolerance).
Decrease dose to 3.125 mg twice daily if patient develops signs of intolerance (i.e., bradycardia <50 beats/min, systolic blood pressure <80 mmHg or fluid retention). Discontinue carvedilol if this dose is not tolerated.
If it is well tolerated, increase dose again to 6.25 mg twice daily after 3 to 10 days.
Subsequent Up-titration: If 6.25 mg twice daily is well-tolerated, increase dose at intervals of 3 to 10 days to 12.5 mg twice daily and then to 25 mg twice daily.
The maintenance dose is the maximum dose tolerated by the patient.
Maximum Recommended Dose: 25 mg twice daily (irrespective of the patient's weight).
Or, as prescribed by a physician.