General Toxicity Notes
Blood pressure is the best guide to dose and interval. Hyperkalemia in ESRD.
Half-Life (Normalesrd) Hours
5-10/5-10
Plasma Protein Binding %
95
Volume Of Distribution L/Kg
1.2-1.8
Dose For Normal Renal Function
3.125-6.25 mg q12-24h
Second Dose
Second Dose: 6.25-25 mg q12-24h
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
100% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None, [A]
Supplement For Dialysis [Recommendation Level]: Pd
PD: None, [D]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50,titrate, [D]
References
Gehr TW, Tenero DM, Boyle DA, Qian Y, Sica DA, Shusterman NH. The pharmacokinetics of carvedilol and its metabolites after single and multiple dose oral administration in patients with hypertension and renal insufficiency. Eur J Clin Pharmacol. 1999; 55: 269-77. [PMID: 10424319] / Masumura H, Miki S, Kaifu Y, Kitajima W, Abe Y. Pharmacokinetics and efficacy of carvedilol in hypertensive patients with chronic renal failure and hemodialysis patients. J Cardiovasc Pharmacol. 1992; 19 Suppl 1: S102-7. [PMID: 1378134] / McTavish D, Campoli-Richards D, Sorkin EM. Carvedilol. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. Drugs. 1993; 45: 232-58. [PMID: 7681374] / Morgan T. Clinical pharmacokinetics and pharmacodynamics of carvedilol. Clin Pharmacokinet. 1994; 26: 335-46. [PMID: 7914479]
Toxicity Notes
Kinetics are dose dependent. Plasma concentrations of carvedilol have been reported to be increased in patients with renal impairment.