United Kingdom. Carvedilol (Eucardic: SmithKline Beecham) has been licensed for use in chronic heart failure. It is the first-adrenoreceptor antagonist to be granted such a licence.

Carvedilol is indicated for patients with mild to moderate symptomatic heart failure as an adjunct to standard therapies. Treatment should be initiated at low doses (3.125 mg twice a day for two weeks) with dose titration to stabilise the patient, under the supervision of a hospital doctor. The most commonly reported adverse reaction is dizziness.

For many years, -adrenoreceptor antagonists were thought to be dangerous in heart failure, but recent studies have shown benefit with certain drugs. Carvedilol is a non-selective -adrenoreceptor antagonist with vasodilating properties. The vasodilatation is predominantly mediated through -1 antagonism.

Reference: The Pharmaceutical Journal Vol. 261, p. 150, 1 August 1998.