- Dosages
- Side effects in children
- Warnings & precautions in children
- Contra-indications in children
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Interactions - PK
- Renal impairment
- References
Pharmacokinetics in children
The elimination half-life is shorter in children than in adults, at 2.9 hours and 5.7 hours respectively. This increases with the age (Laer et al.).
The clearance of carvedilol is greater in young children, namely 2.7 l/h/kg at the age of 1 year and 0.7 l/h/kg at age 19 years [Albers et al.].
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dose recommendation of formulary compared to licensed use (on-label versus off-label)
No information is present at this moment.
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Available formulations
No information is present at this moment.
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Dosages
| Adjuvant treatment to the standard therapy for moderate to severe stable chronic cardiac failure, and heart failure in Duchenne muscular dystrophy |
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Renal impaiment in children > 3 months
GFR ≥10 ml/min/1.73m2: Dose adjustment not required.
GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.
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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here
Side effects in children
Dyspnoea, cold extremities, provocation of congestive heart failure or hypoglycaemia (without symptoms: take care with diabetes patients) and nightmares.
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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here
Contra-indications in children
Sinus bradycardia, AV block, hypotension, asthma and congestive heart failure.
The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here
Warnings & precautions in children
Great caution is needed in concomitant use of verapamil (Isoptin) because of the risk of severe arrhythmia. The clearance of orally administered digoxin halves when carvedilol is used (Ratnapalan et al.). Be careful: digoxin intoxication.
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Interactions
The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here
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| Beta blocking agents, non-selective | ||
|---|---|---|
| C07AA05 | ||
| C07AA07 | ||
| Beta blocking agents, selective | ||
|---|---|---|
| C07AB03 | ||
| C07AB07 | ||
| C07AB09 | ||
| C07AB02 | ||
| Alpha and beta blocking agents | ||
|---|---|---|
| C07AG01 | ||
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References
- Rademaker C.M.A. et al, Geneesmiddelen-Formularium voor Kinderen, 2007
- Erdoğan I, et al, Treatment of dilated cardiomyopathy with carvedilol in children, Turk J Pediatr, 2009, Jul-Aug;51(4), 354-60
- Askari H, et al, Carvedilol therapy in pediatric patients with dilated cardiomyopathy, Turk J Pediatr, 2009, Jan-Feb;51(1), 22-7
- Albers S, et al, Population pharmacokinetics and dose simulation of carvedilol in paediatric patients with congestive heart failure, Br J Clin Pharmacol, 2008, Apr;65(4), 511-22
- Bajcetic M, et al, Effects of carvedilol on left ventricular function and oxidative stress in infants and children with idiopathic dilated cardiomyopathy: a 12-month, two-center, open-label study, Clin Ther., 2008, Apr;30(4), 702-14
- Shaddy RE, et al, : Carvedilol for children and adolescents with heart failure: a randomized controlled trial, JAMA, 2007, Sep 12;298(10), 1171-9
- Blume ED, et al, Prospective single-arm protocol of carvedilol in children with ventricular dysfunction, Pediatr Cardiol, 2006, May-Jun;27(3), 336-42
- Giardini A, et al, Modulation of neurohormonal activity after treatment of children in heart failure with carvedilol, Cardiol Young, 2003, Aug;13(4), 333-6
- Ratnapalan S, et al, Digoxin-carvedilol interactions in children, J Pediatr, 2003, May;142(5), 572-4
- Azeka E, et al, Delisting of infants and children from the heart transplantation waiting list after carvedilol treatment., J Am Coll Cardiol, 2002, Dec 4;40(11), 2034-8
- Williams RV, et al, Intermediate effects of treatment with metoprolol or carvedilol in children with left ventricular systolic dysfunction, J Heart Lung Transplant, 2002, Aug;21(8):, 906-9
- Läer S, et al, Carvedilol therapy in pediatric patients with congestive heart failure: a study investigating clinical and pharmacokinetic parameters., Am Heart J., 2002, May;143(5), 916-22
- Matsumura T, et al, Carvedilol can prevent cardiac events in Duchenne muscular dystrophy, Intern Med, 2010, 49(14), 1357-63. Epub 2010 Jul 15.
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Changes
Changes
