Durol 6.25 mg Tablet

Durol 6.25 mg tablet is a medicine from Square Pharmaceuticals PLC, Pabna containing Carvedilol, a third-generation beta-blocker used to treat chronic heart failure, high blood pressure and to protect the heart after a heart attack.

Carvedilol works in two ways. It blocks beta receptors in the heart, slowing the heart rate and reducing the heart's workload, and it also blocks alpha receptors in blood vessels, relaxing and widening them. This double action lowers blood pressure and, over months, helps a weakened heart pump more efficiently — which is why it is a key medicine in heart failure treatment.

• Chronic heart failure — mild to severe, together with other heart failure medicines
• High blood pressure (hypertension) — alone or in combination
• After a heart attack with reduced heart pumping function (left ventricular dysfunction)
• Angina (chest pain) — in selected patients

Your doctor will decide your dose of Durol. In heart failure it is always started very low and doubled slowly every 2 weeks or more, watching your weight, pulse and pressure — this slow build-up is essential and must not be rushed.

• Take Durol with food — this slows absorption and reduces dizziness from a sudden pressure drop.
• Usually taken twice daily at the same times each day.
• If you miss a dose, take it when remembered unless the next dose is near; never double up.
• Weigh yourself regularly in heart failure; report rapid weight gain or swelling.

Never stop Durol suddenly or on your own, even when you feel fine — abrupt stopping can sharply worsen heart failure or trigger chest pain and rebound high pressure. Any change must be made gradually by your doctor.

Possible side effects of carvedilol include:

• Dizziness or light-headedness, especially after dose increases — usually settles in 1–2 weeks
• Tiredness, weakness, slow pulse
• Low blood pressure on standing
• Temporary fluid retention or slight weight gain when starting (in heart failure)
• Cold hands and feet, headache, nausea, diarrhoea
• Blurred vision, dry eyes
• Worsening wheeze in asthma patients
• Seek prompt care for fainting, very slow pulse, marked breathlessness or rapid swelling

• Monitor pulse, blood pressure and (in heart failure) daily weight; report a gain of more than 1.5–2 kg in a few days.
• Rise slowly from sitting or lying; avoid driving until dizziness settles after each dose increase.
• Tell your doctor about asthma, COPD, diabetes, liver disease, kidney disease, thyroid problems or circulation disorders.
• Diabetics: carvedilol can mask low-sugar warning signs — monitor sugar more closely.
• Wearers of contact lenses may notice dry eyes.
• Inform doctors before surgery or anaesthesia; do not stop the medicine before surgery unless instructed.
• Avoid alcohol close to dosing (especially extended-release forms) — it can speed up drug release.

• Verapamil, diltiazem: risk of very slow pulse and heart block — close monitoring needed
• Digoxin: carvedilol can raise digoxin levels and further slow the heart
• Insulin and diabetes medicines: enhanced sugar-lowering and masked hypoglycaemia symptoms
• Rifampicin: markedly reduces carvedilol levels
• Fluoxetine, paroxetine and other CYP2D6 inhibitors: may increase carvedilol effects
• Clonidine: careful sequencing needed when stopping
• Other antihypertensives, nitrates: additive pressure lowering
• NSAIDs: may blunt the blood-pressure effect

• Allergy to carvedilol or any component
• Acute decompensated heart failure needing intravenous medicines
• Severe asthma or history of severe bronchospasm
• Very slow pulse, sick sinus syndrome or second/third-degree heart block without a pacemaker
• Cardiogenic shock or severe symptomatic low blood pressure
• Severe liver impairment

Pregnancy: Carvedilol should be used in pregnancy only if your doctor judges the benefit outweighs the risk. Beta-blockers can slow the baby's growth and heart rate, and may cause low blood sugar in the newborn. Tell your doctor immediately if you are or plan to become pregnant — a safer alternative may be chosen.

Lactation: Small amounts may pass into breast milk. Breastfeeding is generally not recommended during treatment unless your doctor advises otherwise after weighing the benefits.

Store below 30°C in a dry place, protected from light and moisture. Keep in the original packaging and out of the reach of children. Do not use after the expiry date.