Carivalan 25/5 Tab

Tablet

Management of chronic stable angina and chronic heart failure in patients where control of heart rate and blood pressure is required, as prescribed by a cardiologist

Carvedilol is a beta-blocker with alpha-1 blocking action that slows heart rate and reduces blood pressure, lowering the heart’s workload. Ivabradine selectively inhibits the If current in the sinoatrial node to reduce heart rate without significantly affecting blood pressure or heart muscle contractility.

Take by mouth exactly as prescribed. Usually taken with food (carvedilol is preferably taken with meals) at the same time each day; swallow whole with water. Do not stop abruptly; dose changes should be made only under medical supervision.

Dizziness, tiredness/fatigue, low blood pressure, slow heart rate (bradycardia), headache, nausea, blurred vision/visual brightness (phosphenes), cold extremities, constipation

Prescription-only medicine. Monitor blood pressure and pulse; may cause dizziness—avoid driving if symptomatic. Do not use in severe bradycardia, sick sinus syndrome, 2nd/3rd degree AV block (unless paced), acute decompensated heart failure/cardiogenic shock, severe hypotension, severe hepatic impairment; ivabradine is contraindicated in atrial fibrillation and when resting heart rate is very low (as per label). Use caution in diabetes (may mask hypoglycemia symptoms), asthma/COPD, peripheral vascular disease, and in elderly. Do not stop beta-blocker suddenly due to risk of worsening angina/arrhythmias.

Strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, erythromycin, ritonavir), CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, St John’s wort), other heart-rate lowering drugs (verapamil, diltiazem, amiodarone, digoxin, other beta-blockers), antihypertensives (additive hypotension), nitrates (additive effects), insulin/oral antidiabetics (masked hypoglycemia), clonidine (rebound hypertension if stopped improperly)

Store below 25°C in a dry place, protected from light and moisture. Keep in original blister pack and out of reach of children.

Ivabrad 5 mg + Carvedilol 25 mg tablets (various brands), Carva-Iva 25/5 tablets (various brands), Carviva 25/5 tablets (various brands), IvaCar 25/5 tablets (various brands)