RAVILDO 6.25 MG 30 TAB

Indications

Approved Uses

Hypertension; chronic stable angina pectoris; chronic heart failure with reduced ejection fraction (as adjunct to standard therapy); left ventricular dysfunction following myocardial infarction.

Dosage & Administration

Dosing by Condition

Hypertension: start 6.25 mg twice daily, increase after 7-14 days to 12.5 mg twice daily, then 25 mg twice daily as needed/tolerated (max commonly 50 mg/day in divided doses). Chronic stable angina: start 12.5 mg twice daily for ~2 days then 25 mg twice daily; may increase to 50 mg twice daily if needed/tolerated. Heart failure (HFrEF): start 3.125 mg twice daily for 2 weeks, then 6.25 mg, 12.5 mg, 25 mg twice daily at ≥2‑week intervals; target 25 mg twice daily (<85 kg) or 50 mg twice daily (≥85 kg) as tolerated. Post‑MI LV dysfunction: start 6.25 mg twice daily, increase after 3-10 days to 12.5 mg twice daily, then to 25 mg twice daily as tolerated.

Initial Dose

6.25 mg twice daily (hypertension/LV dysfunction post-MI); 3.125 mg twice daily (heart failure)

Maintenance Dose

Heart failure: 6.25-25 mg twice daily (up to 50 mg twice daily if >85 kg); Hypertension: 12.5-25 mg twice daily; LV dysfunction post-MI: 12.5-25 mg twice daily

Maximum Dose

Heart failure: up to 25 mg twice daily if ≤85 kg; up to 50 mg twice daily if >85 kg. Hypertension: up to 50 mg/day. (Angina commonly up to 25 mg twice daily = 50 mg/day).

Dose Adjustment Notes

Titrate gradually; in heart failure increase no more frequently than every 2 weeks (and generally 1-2 weeks for hypertension/angina) as tolerated; do not up‑titrate and consider dose reduction/temporary interruption if symptomatic bradycardia, hypotension, fluid retention/worsening HF, or worsening renal function occurs; contraindicated in severe hepatic impairment.

How to Take

Oral: swallow the film‑coated tablet whole with water; take with food (especially at initiation and dose increases) and take doses at the same times each day.

Side Effects

Common Side Effects

Dizziness, fatigue, hypotension/orthostatic hypotension, bradycardia, headache, nausea/diarrhea, weight gain and peripheral edema (especially in heart failure), and hyperglycemia/worsened glycemic control in diabetics.

Safety & Warnings

Contraindications

Bronchial asthma/bronchospastic disease; 2nd- or 3rd-degree AV block; sick sinus syndrome (unless pacemaker); severe bradycardia; cardiogenic shock; decompensated heart failure requiring IV inotropes; severe hepatic impairment; hypersensitivity to carvedilol.

Warnings & Precautions

Do not stop abruptly (taper 1-2 weeks); take with food to reduce orthostatic hypotension; caution in diabetes (masks hypoglycemia), peripheral vascular disease/Raynaud’s, non-asthmatic bronchospastic disease (COPD), thyroid disease (masks thyrotoxicosis), pheochromocytoma (use alpha-blockade first), and monitor renal function in HF during initiation/titration.

Age Restriction

Not established/Not routinely recommended under 18 years (safety and efficacy not established).

Drug Interactions

Interaction Severity

MAJOR/clinically significant: verapamil or diltiazem (additive AV block/bradycardia/hypotension), amiodarone/other antiarrhythmics with AV‑node effects (bradycardia/heart block), clonidine (risk of rebound hypertension if clonidine withdrawn-taper beta‑blocker first), and other strong negative chronotropes. MODERATE: digoxin (↑ digoxin levels and additive bradycardia), insulin/oral antidiabetics (masked hypoglycemia and possible altered glycemic control), CYP2D6 inhibitors such as fluoxetine/paroxetine (↑ carvedilol exposure), and rifampin (↓ carvedilol exposure).

Food Interaction

Take with food; food slows absorption and reduces the risk of orthostatic hypotension (especially during initiation/titration).

Special Populations

Breastfeeding

Caution

Elderly

Start at lower doses (3.125-6.25 mg twice daily), titrate slowly with careful monitoring of blood pressure, heart rate, and renal function

Liver Impairment

Severe hepatic impairment: contraindicated; mild-to-moderate impairment: use with caution and consider lower doses/slow titration.

Storage & Patient Advice

Stopping the Medicine

Do not stop abruptly; taper gradually over ~1-2 weeks under medical supervision.

Patient Counseling

Take with food; rise slowly to reduce dizziness/orthostatic hypotension; do not stop abruptly-taper under medical supervision; monitor BP and pulse and report very slow pulse, fainting, or worsening HF symptoms (rapid weight gain, swelling, increasing shortness of breath); if diabetic, monitor glucose more closely because hypoglycemia symptoms may be masked; use caution with driving/alcohol until effects are known and inform clinicians before surgery/new medicines.

Monitoring Requirements

Monitor blood pressure and heart rate (especially with titration), signs of worsening heart failure (weight, edema, dyspnea), renal function in heart failure during initiation/up‑titration, and blood glucose in patients with diabetes; consider ECG if conduction abnormalities/bradyarrhythmia suspected and liver function tests if hepatic injury suspected.

Pharmacology

Mechanism of Action

Blocks β1 and β2 receptors (reducing heart rate and contractility) and blocks α1 receptors (causing peripheral vasodilation), lowering blood pressure and myocardial oxygen demand and improving outcomes in HFrEF/post‑MI LV dysfunction.

Duration of Effect

Approximately 12 hours for the immediate‑release tablet (supporting twice‑daily dosing).

Protein Binding

>98% protein bound (mainly to albumin).

Product Information

Available Dosage Forms

Film‑coated tablet (immediate‑release) for this product (Ravildo 6.25 mg).

Composition per Dose

Each film-coated tablet: Carvedilol 6.25 mg

Generic Availability

Yes

OTC Alternatives

No OTC alternative

Cv Drug Class

Beta-blocker

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