The initial dose of carvedilol in the management of CHF is 3.125 mg bid for two weeks, followed by 6.25 mg bid for two more weeks; the dose is then doubled every two weeks up to a maximum of 25 mg bid for patients weighing less than 85 kg or 50 mg bid for patients weighing more than 85 kg. With each dosage increase it is recommended that the patient be observed for dizziness, lightheadedness and symptoms of worsening heart failure (dyspnea, pedal edema) for 1 h following the increased dose.
No dosage reduction is required in patients with renal dysfunction. However, patients with cirrhosis may require a small dosage reduction. These patients demonstrate a reduction in drug clearance, as well as an increase in bioavailability and volume of distribution. Buy Asthma Inhalers Online
AVAILABILITY AND COST
Carvedilol is available as 3.125 mg, 6.25 mg, 12.5 mg and 25 mg tablets at a cost of $127.00 per 100 tablets (all strengths). At a dose of 25 mg orally bid, the monthly drug acquisition cost of carvedilol is $76.20.