Carvedilol vs. metoprolol: Liphapang, ho tšoana, 'me ke hofe ho uena
Lithethefatsi Vs. MotsoalleKakaretso ea lithethefatsi le liphapang tse kholo | Maemo a phekotsoe | Tshebetso | Ho koahela inshorense le papiso ea litšenyehelo | Litla-morao | Likamano tsa lithethefatsi | Litemoso | LBH
Carvedilol le metoprolol ke meriana ea ngaka e sebelisetsoang ho phekola khatello e phahameng ea mali (khatello ea kelello) le mathata a pelo, joalo ka ho hloleha ha pelo. Meriana ena e ka sebelisoa ho fokotsa kotsi ea lefu kamora lefu la pelo (infarction ea myocardial infarction).
Ka bobeli carvedilol le metoprolol li khetholloa e le beta-blockers , E tsejoang hape e le li-block-adrenergic block agents. Li sebetsa ka ho thibela li-beta receptors, tse thibelang litlamorao tsa norepinephrine le epinephrine pelong le methapong ea mali. Beta-blockers ba thusa ho fokotsa khatello ea mali le ho otla ha pelo ho fokotsa khatello ea maikutlo pelong.
Carvedilol le metoprolol ka bobeli ke meriana e tloaelehileng. Le ha ba arolelana lintho tse tšoanang, ba boetse ba na le phapang ea litekanyetso, tlhahiso le litlamorao.
Phapang e kholo ke efe lipakeng tsa carvedilol le metoprolol?
Carvedilol e nkoa e le 'beta-blocker' e sa khethang. Sena se bolela hore carvedilol e ka thibela li-receptor tsa beta-1 le li-receptor tsa beta-2. Li-receptor tsa Beta-1 li fumaneha ka pelong ha li-beta-2 receptors li fumanoa haholo mesifa e boreleli. Carvedilol e boetse e thibela li-alpha receptors methapong, e thusang ho fokotsa khatello ea mali.
Carvedilol ke lebitso le tloaelehileng la Coreg. Hangata e nkuoa e le 3.125 mg, 6.25 mg, 12.5 mg, kapa 25 mg pilisi ea molomo habeli ka letsatsi. Carvedilol e boetse e fumaneha ka foromo ea tokollo e atolositsoeng (Coreg CR) e ka nkuoang hang ka letsatsi.
Metoprolol ke beta-1 blocker e khethang e thibelang li-beta-1 receptors ka pelong. Leha ho le joalo, e boetse e thibela li-receptor tsa beta-2, leha e le hanyane. Li-beta-blockers tse khethiloeng li ka ba le litlamorao tse fapaneng hanyane ha li bapisoa le li-beta-blockers tse sa khethang.
Metoprolol e tla ka mefuta e 'meli e fapaneng ea letsoai: metoprolol tartrate le metoprolol succinate . Metoprolol tartrate, eo hape e tsejoang ka lebitso la Lopressor, ke letlapa la molomo le lokolloang hanghang le tlang ka matla a 25 mg, 37.5 mg, 50 mg, 75 mg, le 100 mg. Metoprolol succinate, eo hape e tsejoang ka lebitso la Toprol XL, ke letlapa la molomo le lokolloang ka bongata le tlisoang ke matla a 25 mg, 50 mg, 100 mg le 200 mg.
E amanang: Metoprolol khahlanong le Atenolol
| Phapang e kholo lipakeng tsa carvedilol le metoprolol | ||
|---|---|---|
| Carvedilol | Metoprolol | |
| Sehlopha sa lithethefatsi | Beta-blocker | Beta-blocker |
| Boemo ba cha / cha | Mofuta oa brand le generic oa fumaneha | Mofuta oa brand le generic oa fumaneha |
| Lebitso la lebitso ke mang? | Coreg (ho lokolloa hanghang) Coreg CR (tokollo e atolositsoeng) | Lopressor (lokolloa hanghang) Toprol XL (tokollo e atolositsoeng) |
| Sethethefatsi se kena ka mefuta e fe? | Letlapa la molomo | Letlapa la molomo |
| Tekanyo e tloaelehileng ke efe? | Carvedilol (ho lokolloa hanghang): 25 mg habeli ka letsatsi Carvedilol (tokollo e atolositsoeng): 10 ho 80 mg hang ka letsatsi Tekanyo e latela boemo ba kalafo | Metoprolol tartrate (ho lokolloa hanghang): 50 ho 100 mg habeli ka letsatsi Metoprolol succinate (ext-release): 25 ho 100 mg hang ka letsatsi Tekanyo e latela boemo ba kalafo |
| Kalafo e tloaelehileng e nka nako e kae? | Nako e telele | Nako e telele |
| Ke mang ea sebelisang meriana eo? | Batho ba baholo | Batho ba baholo |
Maemo a tšoaroang ke carvedilol le metoprolol
Carvedilol le metoprolol succinate ka bobeli ke FDA e lumelletsoeng ho phekola ho hloleha ha pelo ho bakoang ke ischemia, khatello ea kelello kapa lefu la pelo. Bobeli beta-blockers le bona ba lumelloa ho phekola khatello ea mali.
Beta-blockers ba tloaetse ho sebelisoa ho kenyelletsa litlhare tse ling joalo ka li-inhibitors tsa angiotensin-converting enzyme (ACE) le diuretics. Ho theola khatello ea mali ea 'systolic' kapa 'diastolic' ho ka thusa ho theola kotsi ea ketsahalo ea pelo le methapo joaloka lefu la pelo kapa leqeba.
Carvedilol le metoprolol li ka sebelisoa ho fokotsa kotsi ea mafu le lefu ho latela lefu la pelo . Meriana ena e ka boela ea sebetsana le ho se sebetse ha ventricular ka ho le letšehali kamora ho hlaseloa ke pelo.
Meriana ena ka bobeli e ka sebelisoa ho phekola angina pectoris, kapa bohloko ba sefuba, bo bakoang ke lefu la pelo. Carvedilol kapa metoprolol e ka laeloa ho fokotsa litlhaselo tsa angina le ho ntlafatsa bokhoni ba boikoetliso ho ba nang le lefu la pelo kapa ho hloleha ha pelo.
Ts'ebeliso ea li-off-label tsa carvedilol le metoprolol li kenyelletsa kalafo ea arrhythmias, kapa lipina tse sa tloaelehang tsa pelo, joalo ka fibrillation ea atrial.
| Boemo | Carvedilol | Metoprolol |
| Ho hloleha ha pelo | Ho joalo | Ho joalo |
| Hypertension | Ho joalo | Ho joalo |
| Infarction ea myocardial | Ho joalo | Ho joalo |
| Angina pectoris | Off-label | Ho joalo |
| Arrhythmia | Off-label | Off-label |
Na carvedilol kapa metoprolol e sebetsa hantle ho feta?
The Teko ea European Carvedilol kapa Metoprolol (COMET) e ne e le teko e laoloang ka linako tsohle e neng e bapisa carvedilol le metoprolol ho bakuli ba nang le bofokoli ba pelo bo sa foleng. Nyeoe e entsoe ka lilemo tse ka bang hlano ho bakuli ba fetang 1,500. Liphetho, tse phatlalalitsoeng ho Lancet , e bontšitse lefu la lisosa tsohle la 34% bakeng sa carvedilol khahlanong le 40% bakeng sa metoprolol. Ka mantsoe a mang, carvedilol e fumanoe e eketsa pholoho ho bakuli ba hlolehang pelo ho feta metoprolol.
Phuputso ea papiso ea 2021 e tsoang ho American Journal of Cardiology o fumane hore ho ne ho se na phapang e kholo maemong a ho pholoha kamora lefu la pelo le carvedilol khahlanong le metoprolol ho bakuli ba nang le karoloana e tlohelang ea ventricular ho feta 40%. Leha ho le joalo, ho ba nang le karoloana ejection ea ventricular ejection e ka tlase ho 40%, carvedilol e ka ba beta-blocker e sebetsang hantle.
Ho latela tlhahlobo ea meta , carvedilol le metoprolol li ts'oana ka katleho ha li sebelisoa kamora lefu la pelo. Ha li bapisoa le placebo, bobeli ba beta-blockers ba fumanoe ba fokotsa haholo liketsahalo tsa pelo le methapo le litlhaselo tsa pelo tse latelang. Leha ho le joalo, ha ho na melemo ea bohlokoa ho tsohle tse bakang lefu, revascularization, le ho kena sepetlele tse fumanoeng bakeng sa carvedilol kapa metoprolol.
Ka bobeli carvedilol le metoprolol li ka ba joalo mekhoa e sebetsang ea kalafo . Kalafo e ka ba ea motho ka mong ho ipapisitsoe le boemo ba kalafo, litla-morao tse ka bang teng le litšenyehelo Ikopanye le mofani oa tlhokomelo ea bophelo ka kalafo e nepahetseng bakeng sa hau.
Ho bapisa le ho bapisa litšenyehelo tsa carvedilol vs metoprolol
Carvedilol e koahetsoe ke merero e mengata ea Medicare le inshorense. Copay e tla itšetleha ka moralo oa moralo le tšireletso. Theko ea karolelano ea chelete ea carvedilol e ka ba $ 160. Esita le ka inshorense, carvedilol e ka ba theko e boima. Ho sebelisa karete ea theolelo ea SingleCare bakeng sa carvedilol ho ka khona ho theola litšenyehelo tsa kantle ho pokello ho isa ho $ 5.
Metoprolol e boetse e koahetsoe ke boholo ba Medicare le merero ea inshorense. Ikopanye le rakhemisi kapa leano la inshorense ho fumana hore na copay ea metoprolol e tla ba eng. Theko ea karolelano ea chelete ea metoprolol e ka ba $ 168. Karete ea theolelo ea SingleCare bakeng sa metoprolol tartrate kapa metoprolol succinate e ka u thusa ho boloka haholo ka theko ea lengolo la ngaka.
| Carvedilol | Metoprolol | |
| E koahetsoe ka inshorense? | Ho joalo | Ho joalo |
| E koahetsoe ka tloaelo ke Medicare Part D? | Ho joalo | Ho joalo |
| Bongata | Matlapa a 60 (6.25 mg) | Matlapa a 60 (25 mg) |
| E tloaelehileng ea Medicare copay | $ 0- $ 15 | $ 0- $ 65 |
| Litsenyehelo tsa SingleCare | $ 4 + | $ 4 + |
Litla-morao tse tloaelehileng tsa carvedilol vs metoprolol
Carvedilol le metoprolol li arolelana litla-morao tse tšoanang. Litla-morao tse tloaelehileng tsa carvedilol ke ho tsekela, mokhathala, bofokoli, khatello e tlase ea mali (hypotension), lets'ollo, tsoekere e phahameng maling (hyperglycemia), lebelo la pelo (bradycardia) le ho nona. Litla-morao tse tloaelehileng haholo tsa mokhathala oa metoprolol, ho tsekela, letšollo, ho hlohlona le khatello ea maikutlo.
Litla-morao tse tebileng tsa carvedilol le metoprolol li ka hlaha, joalo ka khatello ea mali, khatello e tlase ea mali, le bronchospasms kapa phefumoloho e khuts'oane. Batla tlhokomelo ea meriana hang-hang haeba u e-ba le lekhopho le matla, ho ruruha kapa ho hema ka thata kamora ho nka carvedilol kapa metoprolol.
| Carvedilol | Metoprolol | |||
| Phello e lehlakoreng | E sebetsa? | Maqhubu | E sebetsa? | Maqhubu |
| Botsoa | Ho joalo | 32% | Ho joalo | 10% |
| Mokhathala | Ho joalo | 24% | Ho joalo | 10% |
| Hypotension | Ho joalo | 9% | Ho joalo | 1% |
| Letšollo | Ho joalo | 12% | Ho joalo | 5% |
| Hyperglycemia | Ho joalo | 12% | Ho joalo | * |
| Bofokoli | Ho joalo | 7% | Ho joalo | 10% |
| Ho otla ha pelo butle | Ho joalo | 9% | Ho joalo | 3% |
| Boima ba 'mele | Ho joalo | 10% | Ho joalo | * |
| Phefumoloho e khutšoanyane | Ho joalo | * | Ho joalo | 3% |
| Lipheletsong tse batang | Che | - | Ho joalo | 1% |
| Ho tepella maikutlo | Ho joalo | <1% | Ho joalo | 5% |
| Ho hlohlona | Ho joalo | <1% | Ho joalo | 5% |
* ha e tlalehe
Maqhubu ha a ipapise le tlhaiso-leseling e tsoang hloohong ho ea hloohong. Sena e kanna ea se be lenane le felletseng la litlamorao tse ka bang teng. Ka kopo sheba ngaka ea hau kapa mofani oa tlhokomelo ea bophelo ho ithuta haholoanyane.
Mohloli: DailyMed ( Carvedilol ), Letsatsi le Letsatsi ( Metoprolol )
Likamano tsa lithethefatsi tsa carvedilol vs metoprolol
Carvedilol le metoprolol li ka fokotsa khatello ea mali le ho otla ha pelo butle. Ka hona, ba ka sebelisana le meriana e meng e nang le litlamorao tse tšoanang. Carvedilol le metoprolol, joalo ka boholo ba beta-blockers, li ka sebelisana le khatello ea mali e fokotsang mahlaseli, monoamine oxidase inhibitors (MAOIs), le calcium channel blockers. Ho noa meriana ena ho ka eketsa kotsi ea khatello e tlase ea mali kapa ho fokotsa lebelo la pelo.
Carvedilol le metoprolol li sebetsoa haholo sebeteng ke enzyme ea CYP2D6. Lithethefatsi tse thibelang enzyme ena li ka sebelisana le carvedilol le metoprolol, tse ka lebisang maemong a eketsehileng a carvedilol kapa metoprolol. Ho eketsa mali a carvedilol kapa metoprolol ho ka lebisa kotsing e kholo ea litla-morao.
Beta-blockers ba ka eketsa litla-morao tsa tsoekere maling tsa meriana ea molomo ea hypoglycemic e kang glipizide, metformin kapa insulin. Tlhokomelo e lokela ho eletsoa ha meriana ena e nooa hammoho.
Sheba tafole e ka tlase bakeng sa litšebelisano tse ling tsa lithethefatsi.
| Lithethefatsi | Sehlopha sa lithethefatsi | Carvedilol | Metoprolol |
| Clonidine Guanethidine Tsosa maikutlo | Mefuta ea alpha-adrenergic | Ho joalo | Ho joalo |
| Selegiline Isocarboxazid Phenelzine | Monoamine oxidase inhibitors (MAOIs) | Ho joalo | Ho joalo |
| Amlodipine Nifedipine | Lisebelisoa tsa calcium channel | Ho joalo | Ho joalo |
| Fluvoxamine Fluoxetine Chlorpromazine Quinidine Ritonavir Terbinafine | CYP2D6 inhibitors | Ho joalo | Ho joalo |
| Glipizide Metformin Rosiglitazone Sitagliptin | Li-hypoglycemics tsa molomo | Ho joalo | Ho joalo |
| Dihydroergotamine Ergotamine | Li-alkaloids tse fosahetseng | Ho joalo | Ho joalo |
| Hydralazine | Li-Vasodilator | Ho joalo | Ho joalo |
| Digoxin | Li-glycosides tsa pelo | Ho joalo | Ho joalo |
| Cyclosporine | Li-immunosuppressants | Ho joalo | Ho joalo |
| Dipyridamole | Platelet inhibitors | Ho joalo | Ho joalo |
Ikopanye le setsebi sa tlhokomelo ea bophelo bakeng sa litšebelisano tse ling tsa lithethefatsi
Litemoso tsa carvedilol le metoprolol
Beta-blockers ha baa lokela ho emisoa ka tšohanyetso. Sebakeng seo, li lokela ho fokotsoa butle butle ho theola litekanyetso tse tlase. Ho ka 'na ha e-ba le kotsi e eketsehileng ea lefu la methapo ea pelo e mpefalang, angina, infarction ea myocardial, le ventricular arrhythmias kamora ho khaotsa ka tšohanyetso beta-blocker.
Beta-blockers ba ka pata matšoao a hypoglycemia kapa hyperthyroidism , tse kang ho otla ha pelo kapele. Bakuli ba nang le lefu la tsoekere le ba nang le mathata a qoqotho ba ka hloka ho ba hlokolosi ka beta-blockers.
Carvedilol le metoprolol li na le litemoso tsa bronchospasm, haholo-holo ho ba nang le lefu le sa foleng la pulmonary (COPD) kapa mathata a mang a phefumolohang. Leha ho le joalo, lithuto li bontšitse hore beta-blockers e kanna ea fokotsa ho mpefala le ho eketsa ho pholoha ho ba nang le COPD.
Bolella mofani oa hao oa tlhokomelo ea bophelo haeba u na le nalane ea ho hloleha ha pelo, asma, ho otla ha pelo butle, mathata a sebete, kapa khatello ea mmele ho metsoako ea carvedilol kapa metoprolol. Ikopanye le mofani oa tlhokomelo ea bophelo bakeng sa litemoso tse ling le litemoso tse amanang le ts'ebeliso ea carvedilol kapa metoprolol.
Lipotso tse botsoang khafetsa mabapi le carvedilol vs metoprolol
Carvedilol ke eng?
Carvedilol ke moriana oa beta-blocker o sebelisetsoang ho alafa ho hloleha ha pelo le khatello ea mali. E ka sebelisoa ho eketsa ho pholoha kamora tlhaselo ea pelo. Carvedilol e hlaha ka mefuta ea ho lokolla hanghang le e atolositsoeng. E ile ea amoheloa ke FDA ka 1995.
Metoprolol ke eng?
Metoprolol ke beta-blocker meriana e ka alafang ho hloleha ha pelo, khatello ea mali le bohloko bo sa foleng ba sefuba. Metoprolol succinate, mofuta o atolositsoeng oa ho lokolla metoprolol le eona e lumelloa ke FDA ho phekola ho hloleha ha pelo. Metoprolol e lokolloang hang-hang e na le metoprolol tartrate. Metoprolol qalong e ile ea amoheloa ke FDA ka 1978.
Na carvedilol le metoprolol li tšoana?
Carvedilol le metoprolol ka bobeli ke beta-adrenergic receptor blockers, kapa beta-blockers. Ka bobeli li sebelisoa ho phekola ho hloleha ha pelo ho sa foleng le khatello ea mali. Leha ho le joalo, li na le metsoako e fapaneng e sebetsang 'me li sebetsa ka litsela tse fapaneng hanyane. Carvedilol ke beta-blocker e sa khethang mme metoprolol ke beta-1 e khethang beta-blocker.
Na carvedilol kapa metoprolol li betere?
Carvedilol le metoprolol ka bobeli ke meriana e sebetsang haholo ha e bapisoa le placebo. Carvedilol e ka ba betere bakeng sa bakuli ba bang ba nang le bofokoli ba pelo, ho latela Teko ea COMET . Carvedilol le metoprolol le tsona li sebetsa hantle bakeng sa ho eketsa ho pholoha kamora tlhaselo ea pelo. Litaelo ho tsoa ho American College of Cardiology (ACC) le American Heart Association (AHA) ba khothaletsa ts'ebeliso ea carvedilol, metoprolol succinate, kapa bisoprolol bakeng sa bakuli ba nang le ts'oaetso ea pelo ba nang le karoloana ea ejection e fokotsehileng. Ikopanye le mofani oa tlhokomelo ea bophelo bakeng sa khetho e nepahetseng ea kalafo bakeng sa boemo ba hau bo ikhethang.
Na nka sebelisa carvedilol kapa metoprolol ha ke le moimana?
Beta-blockers ba e sebelisoang hangata ho basali ba nang le maemo a pelo. Leha ho le joalo, ha ho na bopaki bo bontšang hore beta-blockers e bolokehile ka botlalo kapa e kotsi nakong ea bokhachane. Bobeli ba carvedilol le metoprolol li ka ba le kotsi ea ho tsoa kotsi ha lesea. Ikopanye le mofani oa tlhokomelo ea bophelo bo botle bakeng sa likeletso tsa bongaka pele u sebelisa beta-blocker nakong ea bokhachane.
A na nka sebelisa carvedilol kapa metoprolol ka joala?
Ho ka ba le kotsi e eketsehileng ea litla-morao ha u kopanya beta-blocker le joala. Ho nka carvedilol kapa metoprolol ka joala ho ka eketsa menyetla ea ho otsela, ho tsekela le khatello ea mali e tlase. Joala bo ka boela ba fokotsa katleho ea beta-blockers.
Na carvedilol e fokotsa khatello ea mali ho feta metoprolol?
Carvedilol e ka fokotsa khatello ea mali ho feta metoprolol. Lebaka ke hore carvedilol e na le thepa ea vasodilating e thusang ho khatholla methapo ea mali le khatello e tlase ea mali. Ha ho lithuto tse kileng tsa bapisa ka kotloloho khatello ea mali e theolang litlamorao tsa carvedilol le metoprolol. Leha ho le joalo, carvedilol e ka thusa thibela liketsahalo tsa pelo ho feta metoprolol ho bakuli ba nang le khatello e phahameng ea mali.
O ka chencha metoprolol ho ea carvedilol? / Na ho bolokehile ho chencha li-beta blockers?
Ka kakaretso ho bolokehile ho chencha beta-blockers ha ho hlokahala kapa joalo ka ha ho khothalelitsoe ke mofani oa tlhokomelo ea bophelo. Ho ipapisitse le beta-blocker, switch e ka ba hanghang kapa lethal dose la beta-blocker ea pele le ka khoesoa ha lethal dose la beta-blocker le ntse le eketseha hanyane ka hanyane ho ea tekanyong Maeto a ho latela a ka hlokahala ho lekola ho sebetsa ha beta-blocker e ncha.
Ke eng sebaka se setle sa carvedilol?
Phetolo e ntle ka ho fetisisa ea carvedilol e tla itšetleha ka boemo bo alafshoang. Ho na le meriana e 'meli feela e amoheloang ke FDA ea ho alafa ho hloleha ha pelo ntle le carvedilol: bisoprolol le metoprolol succinate. Mehlala e meng ea beta-blockers e kenyelletsa atenolol, nebivolol le propranolol.
Na ho na le beta blocker e betere ho feta metoprolol?
Mekhoa e meng e ka sebelisoang ho phekola ho hloleha ha pelo e kenyelletsa bisoprolol le carvedilol. Beta blocker e betere e tla u thusa haholo. Lintlha tse ling li ka bapala karolo ea ho khetha beta blocker, joalo ka litšenyehelo, litla-morao le meriana e meng eo u ka e sebelisang.
