Tìm theo
Carvedilol
Các tên gọi khác (4 ) :
  • (+-)-1-(Carbazol-4-yloxy)-3-((2-(O-methoxyphenoxy)ethyl)amino)-2-propanol
  • Carvedilol
  • Carvedilolum
  • SKF 105517
Thuốc tim mạch
Thuốc Gốc
Small Molecule
CAS: 72956-09-3
ATC: C07AG02
ĐG : Actavis Group , http://www.actavis.com
CTHH: C24H26N2O4
PTK: 406.4742
Carvedilol is a non-selective beta blocker indicated in the treatment of mild to moderate congestive heart failure (CHF). It blocks beta-1 and beta-2 adrenergic receptors as well as the alpha-1 adrenergic receptors.
Nhận Dạng Quốc Tế & Đặc Tính Hóa Học
Công thức hóa học
C24H26N2O4
Phân tử khối
406.4742
Monoisotopic mass
406.18925733
InChI
InChI=1S/C24H26N2O4/c1-28-21-10-4-5-11-22(21)29-14-13-25-15-17(27)16-30-23-12-6-9-20-24(23)18-7-2-3-8-19(18)26-20/h2-12,17,25-27H,13-16H2,1H3
InChI Key
InChIKey=OGHNVEJMJSYVRP-UHFFFAOYSA-N
IUPAC Name
[3-(9H-carbazol-4-yloxy)-2-hydroxypropyl][2-(2-methoxyphenoxy)ethyl]amine
Traditional IUPAC Name
carvedilol
SMILES
COC1=CC=CC=C1OCCNCC(O)COC1=CC=CC2=C1C1=CC=CC=C1N2
Độ tan chảy
114.5 °C
Độ hòa tan
Practically insoluble (0.583 mg/L)
logP
4.19
logS
-5
pKa (strongest acidic)
14.03
pKa (Strongest Basic)
8.74
PSA
75.74 Å2
Refractivity
115.64 m3·mol-1
Polarizability
45.03 Å3
Rotatable Bond Count
10
H Bond Acceptor Count
5
H Bond Donor Count
3
Physiological Charge
1
Number of Rings
4
Bioavailability
1
Rule of Five
true
Ghose Filter
true
MDDR-Like Rule
true
Dược Lực Học : Carvedilol is a nonselective beta-adrenergic blocking agent with alpha1-blocking activity and is indicated for the treatment of hypertension and mild or moderate (NYHA class II or III) heart failure of ischemic or cardiomyopathic origin. Carvedilol is a racemic mixture in which nonselective b-adrenoreceptor blocking activity is present in the S(-) enantiomer and a-adrenergic blocking activity is present in both R(+) and S(-) enantiomers at equal potency. Carvedilol has no intrinsic sympathomimetic activity. The effect of carvedilol's b-adrenoreceptor blocking activity has been demonstrated in animal and human studies showing that carvedilol (1) reduces cardiac output in normal subjects; (2) reduces exercise-and/or isoproterenol-induced tachycardia and (3) reduces reflex orthostatic tachycardia.
Cơ Chế Tác Dụng : Carvedilol is a non-selective beta blocker indicated in the treatment of mild to moderate congestive heart failure (CHF). It blocks beta-1 and beta-2 adrenergic receptors as well as the alpha-1 adrenergic receptors. Carvedilol is a racemic mixture in which nonselective beta-adrenoreceptor blocking activity is present in the S(-) enantiomer and alpha-adrenergic blocking activity is present in both R(+) and S(-) enantiomers at equal potency. Carvedilol's beta-adrenergic receptor blocking ability decreases the heart rate, myocardial contractility, and myocardial oxygen demand. Carvedilol also decreases systemic vascular resistance via its alpha adrenergic receptor blocking properties. Carvedilol and its metabolite BM-910228 (a less potent beta blocker, but more potent antioxidant) have been shown to restore the inotropic responsiveness to Ca2+ in OH- free radical-treated myocardium. Carvedilol and its metabolites also prevent OH- radical-induced decrease in sarcoplasmic reticulum Ca2+-ATPase activity. Therefore, carvedilol and its metabolites may be beneficial in chronic heart failure by preventing free radical damage.
Dược Động Học :
▧ Absorption :
Carvedilol is rapidly and extensively absorbed following oral administration, with an absolute bioavailability of approximately 25% to 35% due to a significant degree of first-pass metabolism.
▧ Volume of Distribution :
* 115 L
▧ Protein binding :
98%
▧ Metabolism :
Hepatic. Carvedilol is metabolized primarily by aromatic ring oxidation and glucuronidation. The oxidative metabolites are further metabolized by conjugation via glucuronidation and sulfation. Demethylation and hydroxylation at the phenol ring produce three active metabolites with b-receptor blocking activity. The 4'-hydroxyphenyl metabolite is approximately 13 times more potent than carvedilol for b-blockade.
▧ Route of Elimination :
Carvedilol is extensively metabolized. Less than 2% of the dose was excreted unchanged in the urine. Carvedilol is metabolized primarily by aromatic ring oxidation and glucuronidation. The oxidative metabolites are further metabolized by conjugation via glucuronidation and sulfation. The metabolites of carvedilol are excreted primarily via the bile into the feces.
▧ Half Life :
7-10 hours
▧ Clearance :
* 500-700 mL/min
Độc Tính : Not expected to be toxic following ingestion.
Chỉ Định : For the treatment of mild or moderate (NYHA class II or III) heart failure of ischemic or cardiomyopathic origin.
Tương Tác Thuốc :
  • Acetohexamide The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Chlorpropamide The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Citalopram The SSRI, citalopram, may increase the bradycardic effect of the beta-blocker, carvedilol.
  • Clonidine Increased hypertension when clonidine stopped
  • Cyclosporine Carvedilol may increase the therapeutic and adverse effects of cyclosporine.
  • Digoxin Carvedilol may increase the serum levels and effect of digoxin.
  • Dihydroergotamine Ischemia with risk of gangrene
  • Disopyramide The beta-blocker, carvedilol, may increase the toxicity of disopyramide.
  • Epinephrine Hypertension, then bradycardia
  • Ergonovine Ischemia with risk of gangrene
  • Ergotamine Ischemia with risk of gangrene
  • Escitalopram The SSRI, escitalopram, may increase the bradycardic effect of the beta-blocker, carvedilol.
  • Etravirine Carvedilol, when used concomitantly with etravirine (a CYP2C9 inhibitor), may experience an increase in serum concentration. It is recommended to monitor for signs and symptoms of an increased response to carvedilol, such as orthostatic hypotension and bradycardia.
  • Fenoterol Antagonism
  • Fluoxetine The SSRI, fluoxetine, may increase the bradycardic effect of the beta-blocker, carvedilol.
  • Formoterol Antagonism
  • Gliclazide The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Glipizide The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Glisoxepide The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Glyburide The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Glycodiazine The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Ibuprofen Risk of inhibition of renal prostaglandins
  • Indomethacin Risk of inhibition of renal prostaglandins
  • Insulin Aspart The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Insulin Detemir The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Insulin Glargine The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Insulin Glulisine The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Insulin Lispro The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Isoprenaline Antagonism
  • Lidocaine The beta-blocker, carvedilol, may increase the effect and toxicity of lidocaine.
  • Methysergide Ischemia with risk of gangrene
  • Orciprenaline Antagonism
  • Paroxetine The SSRI, paroxetine, may increase the bradycardic effect of the beta-blocker, carvedilol.
  • Pipobroman Antagonism
  • Pirbuterol Antagonism
  • Piroxicam Risk of inhibition of renal prostaglandins
  • Prazosin Risk of hypotension at the beginning of therapy
  • Procaterol Antagonism
  • Repaglinide The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Salbutamol Antagonism
  • Salmeterol Antagonism
  • Sertraline The SSRI, sertraline, may increase the bradycardic effect of the beta-blocker, carvedilol.
  • Terazosin Increased risk of hypotension. Initiate concomitant therapy cautiously.
  • Terbinafine Terbinafine may reduce the metabolism and clearance of Carvedilol. Consider alternate therapy or monitor for therapeutic/adverse effects of Carvedilol if Terbinafine is initiated, discontinued or dose changed.
  • Terbutaline Antagonism
  • Tolazamide The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Tolbutamide The beta-blocker, carvedilol, may decrease symptoms of hypoglycemia.
  • Topotecan The p-glycoprotein inhibitor, Carvedilol, may increase the bioavailability of oral Topotecan. A clinically significant effect is also expected with IV Topotecan. Concomitant therapy should be avoided.
  • Treprostinil Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
  • Verapamil Increased effect of both drugs
Liều Lượng & Cách Dùng : Tablet - Oral
Dữ Kiện Thương Mại
Giá thị trường
Nhà Sản Xuất
  • Công ty :
    Sản phẩm biệt dược : Coreg
  • Công ty :
    Sản phẩm biệt dược : Coreg CR
  • Công ty :
    Sản phẩm biệt dược : COREGCR
Đóng gói
Tài Liệu Tham Khảo Thêm
drugbank
http://www.drugbank.ca/drugs/DB01136
PubChem Compound
http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?sid=2585
PubChem Substance
http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?sid=46505146
KEGG Compound
http://www.genome.jp/dbget-bin/www_bget?cpd:C06875
KEGG Drug
http://www.genome.jp/dbget-bin/www_bget?drug:D00255
ChemSpider
http://www.chemspider.com/Chemical-Structure.2487.html
BindingDB
http://www.bindingdb.org/bind/chemsearch/marvin/MolStructure.jsp?monomerid=25759
National Drug Code Directory
http://www.hipaaspace.com/Medical_Billing/Coding/National.Drug.Codes/PDF/0228-2175-11
PharmGKB
http://www.pharmgkb.org/drug/PA448817
Wikipedia
http://en.wikipedia.org/wiki/Carvedilol
RxList
http://www.rxlist.com/cgi/generic3/carvedilol.htm
Drugs.com
http://www.drugs.com/cdi/carvedilol.html
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