Carvedilol to improve heart function

Name of medicine

Carvedilol

Brand name: Eucardic

Why is it important for my child to take Carvedilol?

In heart failure, the heart does not pump as well as it might. Carvedilol relaxes the blood vessels, which makes it easier for the heart to pump blood around the body.

What is Carvedilol available as?

Tablets: 3.125 mg, 6.25 mg, 12.5 mg, 25 mg; these contain a small amount of lactose

When should I give Carvedilol

The Carvedilol is usually given twice each day. Give one dose in the morning and one in the evening. Ideally these times are 10–12 hours apart. For example, this could be between 7am and 8am and between 7pm and 8pm.

Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of Carvedilol (the dose) that is right for your child. The dose will be shown on the medicine label.

Your doctor may suggest that your child starts with a low dose. They may then increase the dose as your child gets used to the medicine and depending on how they respond to it. Your doctor will explain what to do. If you are not sure how much to give, check with your doctor, nurse or pharmacist.

How should I give Carvedilol?

Tablets

• Tablets should be swallowed with a glass of water, squash or juice. Your child should not chew the tablets.
• You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey, or mashed potato. Make sure your child swallows it straight away, without chewing.

• Occasionally, the only way to provide the correct dose of Carvedilol for your child will be to give part of a tablet or to disperse a tablet in a small amount of water and give some of the mixture. Your doctor or pharmacist will let you know if this is necessary and explain what to do. This method should only be used when you have been told to do it. Any unused mixture should be poured into a paper towel and put in the bin. Do not pour it down the sink.

When should the medicine start working?

Your child’s symptoms of heart failure should start to get better once your doctor has worked out the best dose. You may notice that your child is less short of breath, has a better appetite and their skin is less puffy.

What if my child is sick (vomits)?

• If your child is sick less than 30 minutes after having a dose of Carvedilol, give them the same dose again.
• If your child is sick more than 30 minutes after having a dose of Carvedilol, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

What if I forget to give it?

If you usually give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7am, you can give the missed dose at any time up to 11am. If you remember after that time, do not give the missed dose. Give the next dose as usual.

What if I give too much?

If you think you may have given your child too much Carvedilol, contact your doctor or local NHS services (details at end of leaflet) or take your child to hospital. Have the medicine container or packaging with you, even if it is empty. This will be useful to the doctor.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side effects).

Side effects you must do something about

Other side-effects you need to know about

• Your child may feel dizzy or light-headed when they stand up, or may faint. Encourage them to stand up slowly, and to sit or lie down if they feel dizzy or light-headed. If this happens often, contact your doctor to check your child’s blood pressure and blood sugar level, as it may be too low.

• Your child may get flu-like symptoms (high temperature, aches and pains, headache), blocked nose, headache or wheeziness.

• They may get nausea, vomiting or diarrhoea.

• Your child may have a dry mouth. Eating citrus fruits (e.g. oranges) and sipping water may help.

• Your child’s eyesight may be blurred (fuzzy).

• They may have difficulty sleeping or have nightmares, or they may feel more sleepy and tired than normal.

• Your child’s eyes may feel dry or irritated (red and itchy).

• Children sometimes feel depressed when taking this medicine.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at mhra.gov.uk/yellowcard

Can other medicines be given at the same time as Carvedilol?

• You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

• Carvedilol should not be taken with some medicines. Tell your doctor or pharmacist about any other medicines your child is taking before giving Carvedilol.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Is there anything else I need to know about this medicine?

• Treatment with Carvedilol is usually started in hospital, so that its effects on your child can be monitored carefully and the right dose worked out.

• Your doctor will test your child’s blood regularly to check that Carvedilol has not affected their kidneys.

• Your doctor will check your child’s blood pressure and pulse rate regularly while taking Carvedilol.

General advice about medicines

• Try to give medicines at about the same times each day, to help you remember.

• If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.

• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

• Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.

• Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight.

• It does not need to be kept in the fridge.

• Make sure that children cannot see or reach the medicine.

• Keep the medicine in the container it came in.

Who to contact for more information?

Your child’s doctor, pharmacist or nurse will be able to give you more information about Carvedilol and about other medicines used to treat heart failure.

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, all rights reserved. Review by June 2022.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.