U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry RACEMIC
Molecular Formula C24H26N2O4.H2O.H3O4P
Molecular Weight 522.4847
Optical Activity ( + / - )
Defined Stereocenters 0 / 1
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of CARVEDILOL PHOSPHATE MONOHYDRATE

SMILES

O.OP(O)(O)=O.COC1=C(OCCNCC(O)COC2=CC=CC3=C2C4=C(N3)C=CC=C4)C=CC=C1

InChI

InChIKey=JAYBFQXVKDGMFT-UHFFFAOYSA-N
InChI=1S/C24H26N2O4.H3O4P.H2O/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;1-5(2,3)4;/h2-12,17,25-27H,13-16H2,1H3;(H3,1,2,3,4);1H2

HIDE SMILES / InChI
Carvedilol competitively blocks β1, β2 and α1 receptors. The drug lacks sympathomimetic activity and has vasodilating properties that are exerted primarily through α1-blockade. Animal models indicate that carvedilol confers protection against myocardial necrosis, arrhythmia and cell damage caused by oxidising free radicals, and the drug has no adverse effects on plasma lipid profiles. COREG® (carvedilol) is a racemic mixture in which nonselective β-adrenoreceptor blocking activity is present in the S(-) enantiomer and α1-adrenergic blocking activity is present in both R(+) and S(-) enantiomers at equal potency. Carvedilol is the first drug of its kind to be approved for the treatment of congestive heart failure, and is now the standard of care for this devastating disease. Carvedilol is also confirmed as effective in the management of mild to moderate hypertension and ischaemic heart disease.

Originator

Curator's Comment: reference retrieved from http://www.drugfuture.com/chemdata/carvedilol.html

Approval Year

Targets

Targets

Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
COREG

Approved Use

COREG® (carvedilol) is indicated for the treatment of mild-to-severe chronic heart failure of ischemic or cardiomyopathic origin, usually in addition to diuretics, ACE inhibitors, and digitalis, to increase survival and, also, to reduce the risk of hospitalization. COREG is indicated to reduce cardiovascular mortality in clinically stable patients who have survived the acute phase of a myocardial infarction and have a left ventricular ejection fraction of ≤40% (with or without symptomatic heart failure). COREG is indicated for the management of essential hypertension. It can be used alone or in combination with other antihypertensive agents, especially thiazide-type diuretics.

Launch Date

1995
Primary
COREG

Approved Use

COREG® (carvedilol) is indicated for the treatment of mild-to-severe chronic heart failure of ischemic or cardiomyopathic origin, usually in addition to diuretics, ACE inhibitors, and digitalis, to increase survival and, also, to reduce the risk of hospitalization. COREG is indicated to reduce cardiovascular mortality in clinically stable patients who have survived the acute phase of a myocardial infarction and have a left ventricular ejection fraction of ≤40% (with or without symptomatic heart failure). COREG is indicated for the management of essential hypertension. It can be used alone or in combination with other antihypertensive agents, especially thiazide-type diuretics.

Launch Date

1995
Primary
COREG

Approved Use

COREG® (carvedilol) is indicated for the treatment of mild-to-severe chronic heart failure of ischemic or cardiomyopathic origin, usually in addition to diuretics, ACE inhibitors, and digitalis, to increase survival and, also, to reduce the risk of hospitalization. COREG is indicated to reduce cardiovascular mortality in clinically stable patients who have survived the acute phase of a myocardial infarction and have a left ventricular ejection fraction of ≤40% (with or without symptomatic heart failure). COREG is indicated for the management of essential hypertension. It can be used alone or in combination with other antihypertensive agents, especially thiazide-type diuretics.

Launch Date

1995
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
18.4 ng/mL
6.25 mg 2 times / day steady-state, oral
dose: 6.25 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
CARVEDILOL, (+)- plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: FASTED
8.46 ng/mL
6.25 mg 2 times / day steady-state, oral
dose: 6.25 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
CARVEDILOL, (-)- plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: FASTED
26.5 ng/mL
6.25 mg 2 times / day steady-state, oral
dose: 6.25 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
CARVEDILOL plasma
Homo sapiens
population: UNHEALTHY
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
94.3 ng × h/mL
6.25 mg 2 times / day steady-state, oral
dose: 6.25 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
CARVEDILOL, (+)- plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: FASTED
42.2 ng × h/mL
6.25 mg 2 times / day steady-state, oral
dose: 6.25 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
CARVEDILOL, (-)- plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: FASTED
139 ng × h/mL
6.25 mg 2 times / day steady-state, oral
dose: 6.25 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
CARVEDILOL plasma
Homo sapiens
population: UNHEALTHY
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
300 mg single, oral
Overdose
Dose: 300 mg
Route: oral
Route: single
Dose: 300 mg
Co-administed with::
lorazepam(7 mg)
Sources:
unknown, 41 years
n = 1
Health Status: unknown
Age Group: 41 years
Sex: M
Population Size: 1
Sources:
Other AEs: Wheezing...
Other AEs:
Wheezing (1 patient)
Sources:
80 mg 1 times / day multiple, oral
Highest studied dose
Dose: 80 mg, 1 times / day
Route: oral
Route: multiple
Dose: 80 mg, 1 times / day
Sources:
unhealthy, 66.7±12.0 years
n = 7
Health Status: unhealthy
Condition: chronic heart failure
Age Group: 66.7±12.0 years
Sex: M+F
Population Size: 7
Sources:
375 mg single, oral
Overdose
Dose: 375 mg
Route: oral
Route: single
Dose: 375 mg
Co-administed with::
simvastatin(fifteen 20-mg tablets)
Sources:
unhealthy, 84 years
n = 1
Health Status: unhealthy
Age Group: 84 years
Sex: M
Population Size: 1
Sources:
Other AEs: Hypotension...
Other AEs:
Hypotension (1 patient)
Sources:
50 mg 1 times / day steady, oral
Recommended
Dose: 50 mg, 1 times / day
Route: oral
Route: steady
Dose: 50 mg, 1 times / day
Sources:
unhealthy, adult
n = 765
Health Status: unhealthy
Condition: heart failure
Age Group: adult
Population Size: 765
Sources:
Disc. AE: Hypotension...
AEs leading to
discontinuation/dose reduction:
Hypotension (0.7%)
Sources:
20 mg 2 times / day multiple, oral
Dose: 20 mg, 2 times / day
Route: oral
Route: multiple
Dose: 20 mg, 2 times / day
Sources: Page: p. 61
unhealthy, adult
n = 54
Health Status: unhealthy
Age Group: adult
Population Size: 54
Sources: Page: p. 61
Disc. AE: Congestive cardiac failure...
AEs leading to
discontinuation/dose reduction:
Congestive cardiac failure (moderate, 1 patient)
Sources: Page: p. 61
25 mg 2 times / day steady, oral
Dose: 25 mg, 2 times / day
Route: oral
Route: steady
Dose: 25 mg, 2 times / day
Sources:
unhealthy, adult
n = 1156
Health Status: unhealthy
Condition: severe heart failure
Age Group: adult
Population Size: 1156
Sources:
Disc. AE: Dizziness...
AEs leading to
discontinuation/dose reduction:
Dizziness (1.3%)
Sources:
6.25 mg 2 times / day multiple, oral
Dose: 6.25 mg, 2 times / day
Route: oral
Route: multiple
Dose: 6.25 mg, 2 times / day
Sources: Page: p. 61
unhealthy, adult
n = 54
Health Status: unhealthy
Age Group: adult
Population Size: 54
Sources: Page: p. 61
Disc. AE: Abdominal distension...
AEs leading to
discontinuation/dose reduction:
Abdominal distension (1 patient)
Sources: Page: p. 61
6.25 mg 2 times / day multiple, oral
Dose: 6.25 mg, 2 times / day
Route: oral
Route: multiple
Dose: 6.25 mg, 2 times / day
Sources: Page: p. 61
unhealthy, adult
n = 54
Health Status: unhealthy
Age Group: adult
Population Size: 54
Sources: Page: p. 61
Disc. AE: Rash...
AEs leading to
discontinuation/dose reduction:
Rash (moderate, 1 patient)
Sources: Page: p. 61
AEs

AEs

AESignificanceDosePopulation
Wheezing 1 patient
300 mg single, oral
Overdose
Dose: 300 mg
Route: oral
Route: single
Dose: 300 mg
Co-administed with::
lorazepam(7 mg)
Sources:
unknown, 41 years
n = 1
Health Status: unknown
Age Group: 41 years
Sex: M
Population Size: 1
Sources:
Hypotension 1 patient
375 mg single, oral
Overdose
Dose: 375 mg
Route: oral
Route: single
Dose: 375 mg
Co-administed with::
simvastatin(fifteen 20-mg tablets)
Sources:
unhealthy, 84 years
n = 1
Health Status: unhealthy
Age Group: 84 years
Sex: M
Population Size: 1
Sources:
Hypotension 0.7%
Disc. AE
50 mg 1 times / day steady, oral
Recommended
Dose: 50 mg, 1 times / day
Route: oral
Route: steady
Dose: 50 mg, 1 times / day
Sources:
unhealthy, adult
n = 765
Health Status: unhealthy
Condition: heart failure
Age Group: adult
Population Size: 765
Sources:
Congestive cardiac failure moderate, 1 patient
Disc. AE
20 mg 2 times / day multiple, oral
Dose: 20 mg, 2 times / day
Route: oral
Route: multiple
Dose: 20 mg, 2 times / day
Sources: Page: p. 61
unhealthy, adult
n = 54
Health Status: unhealthy
Age Group: adult
Population Size: 54
Sources: Page: p. 61
Dizziness 1.3%
Disc. AE
25 mg 2 times / day steady, oral
Dose: 25 mg, 2 times / day
Route: oral
Route: steady
Dose: 25 mg, 2 times / day
Sources:
unhealthy, adult
n = 1156
Health Status: unhealthy
Condition: severe heart failure
Age Group: adult
Population Size: 1156
Sources:
Abdominal distension 1 patient
Disc. AE
6.25 mg 2 times / day multiple, oral
Dose: 6.25 mg, 2 times / day
Route: oral
Route: multiple
Dose: 6.25 mg, 2 times / day
Sources: Page: p. 61
unhealthy, adult
n = 54
Health Status: unhealthy
Age Group: adult
Population Size: 54
Sources: Page: p. 61
Rash moderate, 1 patient
Disc. AE
6.25 mg 2 times / day multiple, oral
Dose: 6.25 mg, 2 times / day
Route: oral
Route: multiple
Dose: 6.25 mg, 2 times / day
Sources: Page: p. 61
unhealthy, adult
n = 54
Health Status: unhealthy
Age Group: adult
Population Size: 54
Sources: Page: p. 61
PubMed

PubMed

TitleDatePubMed
Carvedilol and lacidipine prevent cardiac hypertrophy and endothelin-1 gene overexpression after aortic banding.
1999 Dec
Statins and peripheral neuropathy.
1999 Jan
The novel beta-blocker, carvedilol, provides neuroprotection in transient focal stroke.
2000 Aug
Beta-blockers of the third generation inhibit endothelin-1 liberation, mRNA production and proliferation of human coronary smooth muscle and endothelial cells.
2000 Nov
Comitogenic effect of catecholamines on rat cardiac fibroblasts in culture.
2000 Nov
Improvement in cardiac function and free fatty acid metabolism in a case of dilated cardiomyopathy with CD36 deficiency.
2000 Sep
Variceal bleeding and portal hypertension: still a therapeutic challenge?
2001 Feb
Inhibitory effect of carvedilol in the high-conductance state of the mitochondrial permeability transition pore.
2001 Feb 2
Catecholamines stimulate interleukin-6 synthesis in rat cardiac fibroblasts.
2001 Jul
Stereoselective effects of (R)- and (S)-carvedilol in humans.
2001 Jul
Using isoproterenol stress echocardiography to predict the response to carvedilol in patients with dilated cardiomyopathy.
2001 Jun
Beta-blockers to reduce mortality in patients with systolic dysfunction: a meta-analysis.
2001 Jun
Bucindolol, a nonselective beta 1- and beta 2-adrenergic receptor antagonist, decreases beta-adrenergic receptor density in cultured embryonic chick cardiac myocyte membranes.
2001 Jun
Plasma N-terminal pro-brain natriuretic peptide and adrenomedullin: prognostic utility and prediction of benefit from carvedilol in chronic ischemic left ventricular dysfunction. Australia-New Zealand Heart Failure Group.
2001 Jun 1
Beta-blocker trials seem to be in conflict.
2001 Jun 12
Beta-blockade in chronic heart failure.
2001 Jun 12
[Adrenergic beta inhibitors in heart insufficiency: which and when?].
2001 Mar
Are all beta-blockers the same for chronic heart failure?
2001 Mar
[Severe heart failure. Carvedilol lowers mortality].
2001 Mar 1
Benefits of beta-blockers in heart failure: a class specific effect?
2001 May
Carvedilol versus other beta-blockers in heart failure.
2001 May
Current role of beta-adrenergic blockers in the management of chronic heart failure.
2001 May 7
Economic impact of beta blockade in heart failure.
2001 May 7
Patents

Sample Use Guides

Take with food. Individualize dosage and monitor during up-titration.• Heart failure: Start at 3.125 mg twice daily and increase to 6.25, 12.5, and then 25 mg twice daily over intervals of at least 2 weeks. Maintain lower doses if higher doses are not tolerated.• Left ventricular dysfunction following myocardial infarction: Start at 6.25 mg twice daily and increase to 12.5 mg then 25 mg twice daily afterintervals of 3 to 10 days. A lower starting dose or slower titration may be used.• Hypertension: Start at 6.25 mg twice daily and increase if needed for blood pressure control to 12.5 mg then 25 mg twice daily over intervals of 1 to 2 weeks.
Route of Administration: Oral
Compared with the PDGF-stimulated control, DNA synthesis decreased significantly to 60.3% +/- 10.4% and 18.3% +/- 5.9% in the presence of 1 and 10 microM of carvedilol, respectively (P < 0.05, each). Carvedilol significantly inhibited the activity of VSMCs stimulated by ET-1 and ANG-II. The IC50 of carvedilol was 1-10 microM. CsA only inhibited VSMCs significantly in the PDGF-stimulated subgroup. The addition of CsA in the presence of carvedilol did not affect the inhibitory activity of carvedilol. The pattern of inhibition in the combined group was uniform and similar to that of the carvedilol alone group, regardless of the stimulator used.
Name Type Language
CARVEDILOL PHOSPHATE MONOHYDRATE
Common Name English
2-PROPANOL, 1-(9H-CARBAZOL-4-YLOXY)-3-((2-(2-METHOXYPHENOXY)ETHYL)AMINO)-, PHOSPHATE, HYDRATE (1:1:1)
Systematic Name English
Code System Code Type Description
PUBCHEM
23649704
Created by admin on Fri Dec 15 18:57:02 GMT 2023 , Edited by admin on Fri Dec 15 18:57:02 GMT 2023
PRIMARY
FDA UNII
4S19O2F64L
Created by admin on Fri Dec 15 18:57:02 GMT 2023 , Edited by admin on Fri Dec 15 18:57:02 GMT 2023
PRIMARY
CAS
1196658-85-1
Created by admin on Fri Dec 15 18:57:02 GMT 2023 , Edited by admin on Fri Dec 15 18:57:02 GMT 2023
PRIMARY