Carvedilol vs. metoprolol: Kusiyana, kufanana, ndi zomwe zili zabwino kwa inu
Mankhwala osokoneza bongo Vs. MnzanuKuwunika kwa mankhwala osokoneza bongo & kusiyana kwakukulu | Zinthu zothandizira | Mphamvu | Kuphunzira inshuwaransi ndikufanizira mtengo | Zotsatira zoyipa | Kuyanjana kwa mankhwala | Machenjezo | FAQ
Carvedilol ndi metoprolol ndi mankhwala akuchipatala omwe amagwiritsidwa ntchito kuthana ndi kuthamanga kwa magazi (matenda oopsa) komanso mavuto amtima, monga mtima kulephera. Mankhwalawa amathanso kugwiritsidwa ntchito pochepetsa chiopsezo chakufa pambuyo povulala kwamtima (myocardial infarction).
Onse carvedilol ndi metoprolol amadziwika kuti otchinga beta , yotchedwanso beta-adrenergic blocking agents. Amagwira ntchito poletsa zolandilira za beta, zomwe zimalepheretsa zotsatira za norepinephrine ndi epinephrine pamtima ndi mitsempha yamagazi. Beta-blockers amathandiza kuchepetsa kuthamanga kwa magazi komanso kuthamanga kwa mtima kuti athetse nkhawa pamtima.
Carvedilol ndi metoprolol onse ndi mankhwala achibadwa. Ngakhale amagawana zofananira, amakhalanso ndi kusiyana kwa mlingo, kapangidwe kake, ndi zovuta zake.
Kodi pali kusiyana kotani pakati pa carvedilol ndi metoprolol?
Carvedilol amadziwika kuti ndi beta-blocker osasankha. Izi zikutanthauza kuti carvedilol imatha kulepheretsa onse beta-1 receptors ndi beta-2 receptors. Beta-1 receptors amapezeka mumtima pomwe beta-2 receptors amapezeka makamaka minofu yosalala. Carvedilol imatsekanso ma alpha receptors mumitsempha, yomwe imathandizira kutsitsa magazi.
Carvedilol ndi dzina loti Coreg. Nthawi zambiri amatengedwa ngati 3.125 mg, 6.25 mg, 12.5 mg, kapena 25 mg piritsi yamlomo kawiri patsiku. Carvedilol imapezekanso mufomu yotulutsa (Coreg CR) yomwe imatha kumwedwa kamodzi tsiku lililonse.
Metoprolol ndi beta-1 blocker yosankha yomwe imatseka kwambiri zolandilira za beta-1 mumtima. Komabe, imatchotsanso beta-2 receptors, ngakhale pang'ono. Kusankha beta-blockers kumatha kukhala ndi zotsatirapo zosiyana poyerekeza ndi osasankha-beta-blockers.
Metoprolol imabwera mumitundu iwiri yamchere: metoprolol tartrate ndi metoprolol succinate . Metoprolol tartrate, yomwe imadziwikanso kuti Lopressor, ndi piritsi yamlomo yotulutsidwa mwachangu yomwe imabwera mu 25 mg, 37.5 mg, 50 mg, 75 mg, ndi 100 mg. Metoprolol succinate, yomwe imadziwikanso ndi dzina loti Toprol XL, ndi piritsi lotulutsa pakamwa lomwe limadza ndi mphamvu ya 25 mg, 50 mg, 100 mg, ndi 200 mg.
ZOKHUDZA: Metoprolol vs. Atenolol
| Kusiyana kwakukulu pakati pa carvedilol ndi metoprolol | ||
|---|---|---|
| Chosema | Zamgululi | |
| Gulu la mankhwala osokoneza bongo | Beta-blocker | Beta-blocker |
| Chizindikiro cha Brand / generic | Ma brand ndi generic amapezeka | Ma brand ndi generic amapezeka |
| Kodi dzina lake ndi ndani? | Coreg (kutulutsidwa mwachangu) Coreg CR (yomasulidwa) | Lopressor (kumasulidwa mwachangu) Toprol XL (kutulutsidwa kwina) |
| Kodi mankhwalawa amabwera mwa mawonekedwe ati? | Piritsi lapakamwa | Piritsi lapakamwa |
| Kodi mulingo woyenera ndi uti? | Carvedilol (kutulutsidwa mwachangu): 25 mg kawiri tsiku lililonse Carvedilol (kutulutsa kwina): 10 mpaka 80 mg kamodzi tsiku lililonse Mlingo umadalira momwe akuchiritsira | Metoprolol tartrate (kutulutsidwa mwachangu): 50 mpaka 100 mg kawiri tsiku lililonse Metoprolol succinate (kutulutsa kwina): 25 mpaka 100 mg kamodzi tsiku lililonse Mlingo umadalira momwe akuchiritsira |
| Kodi mankhwalawa amatenga nthawi yayitali bwanji? | Nthawi yayitali | Nthawi yayitali |
| Ndani amagwiritsa ntchito mankhwalawa? | Akuluakulu | Akuluakulu |
Zomwe zimathandizidwa ndi carvedilol ndi metoprolol
Onse carvedilol ndi metoprolol succinate ndi omwe FDA amavomereza kuti athetse vuto la mtima lomwe limayambitsidwa ndi ischemia, matenda oopsa, kapena mtima. Onse beta-blockers amavomerezedwanso kuti athetse matenda oopsa.
Beta-blockers amagwiritsidwa ntchito kuphatikiza pa mankhwala ena monga angiotensin-converting enzyme (ACE) zoletsa ndi okodzetsa. Kutsika kwa systolic kapena diastolic magazi kumatha kuchepetsa chiopsezo cha zochitika zamtima ngati matenda amtima kapena sitiroko.
Carvedilol ndi metoprolol zitha kugwiritsidwa ntchito pochepetsa chiopsezo cha kufa ndi kufa kutsatira matenda amtima . Mankhwalawa amathanso kuthana ndi vuto lakumapeto kwamitsempha yam'mimba pambuyo podwala mtima.
Mankhwala onsewa amatha kugwiritsidwa ntchito pochiza angina pectoris, kapena kupweteka pachifuwa, chifukwa cha matenda amtima. Carvedilol kapena metoprolol atha kulembedwa kuti achepetse ziwopsezo za angina ndikuwonjezera mphamvu zolimbitsa thupi kwa iwo omwe ali ndi matenda amtima kapena kulephera kwamtima.
Kugwiritsa ntchito kwa carvedilol ndi metoprolol kumaphatikizapo chithandizo cha arrhythmias, kapena mitima yachilendo ya mtima, monga atrial fibrillation.
| Mkhalidwe | Chosema | Zamgululi |
| Mtima kulephera | Inde | Inde |
| Matenda oopsa | Inde | Inde |
| Mnyewa wamtima infarction | Inde | Inde |
| Angina pectoris | Kutumiza | Inde |
| Mpweya | Kutumiza | Kutumiza |
Kodi carvedilol kapena metoprolol ndiyothandiza kwambiri?
Pulogalamu ya Carvedilol kapena Metoprolol Mayeso aku Europe (COMET) anali mayesero olamuliridwa mosasintha omwe amayerekezera carvedilol ndi metoprolol mwa odwala omwe ali ndi vuto la mtima losatha. Mlanduwu udachitika pafupifupi zaka zisanu mwa odwala opitilira 1,500. Zotsatira, zomwe zidasindikizidwa mu Lancet , adawonetsa zakufa zonse 34% ya carvedilol motsutsana ndi 40% ya metoprolol. Mwanjira ina, carvedilol idapezeka kuti ikuwonjezera kupulumuka kwa odwala olephera mtima kuposa metoprolol.
Kafukufuku woyerekeza wa 2021 kuchokera ku American Journal of Cardiology adapeza kuti panalibe kusiyana kwakukulu pamitengo yopulumuka pambuyo povulala kwamtima ndi carvedilol motsutsana ndi metoprolol mwa odwala omwe ali ndi kachigawo kakang'ono kotulutsira madzi kopitilira 40%. Komabe, mwa iwo omwe ali ndi kachigawo kakang'ono kotulutsira ma ventricular kotsika 40%, carvedilol itha kukhala beta-blocker yothandiza kwambiri.
Malinga ndi a kusanthula meta , carvedilol ndi metoprolol zimagwiranso ntchito chimodzimodzi akagwiritsa ntchito matenda amtima. Poyerekeza ndi placebo, onse beta-blockers adapezeka kuti amachepetsa kwambiri zochitika zamtima ndi ziwopsezo zamtsogolo za mtima. Komabe, palibe phindu lililonse pazomwe zimayambitsa kufa, kusintha kwa magazi, ndi kuchipatala zomwe zidapezeka pa carvedilol kapena metoprolol.
Onse carvedilol ndi metoprolol atha kukhala njira zabwino zothandizira . Chithandizochi chitha kukhala chamunthu payekha malinga ndi momwe amathandizidwira, zotsatirapo zake, komanso mtengo wake. Funsani wothandizira zaumoyo kuti akuthandizeni.
Kuphunzira ndi kuyerekezera mtengo wa carvedilol vs. metoprolol
Carvedilol ili ndi Medicare komanso mapulani a inshuwaransi ambiri. Copay idzadalira dongosolo la mapulani ndi kufotokozera. Mtengo wapakati wa carvedilol ndi pafupifupi $ 160. Ngakhale ndi inshuwaransi, carvedilol imatha kukhala yokwera mtengo. Kugwiritsa ntchito khadi yotsitsa ya SingleCare ya carvedilol kumatha kutsitsa mtengo wamthumba mpaka $ 5.
Metoprolol imaphatikizidwanso ndi ambiri Medicare ndi mapulani a inshuwaransi. Funsani wamankhwala kapena inshuwaransi yanu kuti mudziwe kuti copay ya metoprolol ingakhale yotani. Mtengo wapakatikati wa metoprolol ndi pafupifupi $ 168. Khadi lochotsera la SingleCare la metoprolol tartrate kapena metoprolol succinate lingakuthandizeni kupulumutsa kwambiri pamtengo wamankhwala.
| Chosema | Zamgululi | |
| Nthawi zambiri amakhala ndi inshuwaransi? | Inde | Inde |
| Nthawi zambiri amakhala ndi Medicare Part D? | Inde | Inde |
| Kuchuluka | Mapiritsi 60 (6.25 mg) | Mapiritsi 60 (25 mg) |
| Wopanga Medicare wamba | $ 0 mpaka $ 15 | $ 0 mpaka $ 65 |
| Mtengo wosakwatiwa | $ 4 + | $ 4 + |
Zotsatira zoyipa za carvedilol vs. metoprolol
Carvedilol ndi metoprolol amagawana zofananira. Zotsatira zoyipa kwambiri za carvedilol ndi chizungulire, kutopa, kufooka, kuthamanga kwa magazi (hypotension), kutsegula m'mimba, shuga wambiri wamagazi (hyperglycemia), kugunda kwamtima pang'ono (bradycardia), ndi kunenepa. Zotsatira zoyipa kwambiri za metoprolol kutopa, chizungulire, kutsegula m'mimba, kuyabwa, ndi kukhumudwa.
Zotsatira zoyipa za carvedilol ndi metoprolol zitha kuchitika, monga kusokonezeka, kuthamanga kwa magazi koopsa, ndi ma bronchospasms kapena kupuma movutikira. Funsani chithandizo chamankhwala mwachangu mukakumana ndi zotupa zazikulu, kutupa, kapena kupuma movutikira mutatenga carvedilol kapena metoprolol.
| Chosema | Zamgululi | |||
| Zotsatira zoyipa | Zoyenera? | Pafupipafupi | Zoyenera? | Pafupipafupi |
| Chizungulire | Inde | 32% | Inde | 10% |
| Kutopa | Inde | 24% | Inde | 10% |
| Kutengeka | Inde | 9% | Inde | 1% |
| Kutsekula m'mimba | Inde | 12% | Inde | 5% |
| Matenda a hyperglycemia | Inde | 12% | Inde | * |
| Kufooka | Inde | 7% | Inde | 10% |
| Kugunda kwa mtima pang'ono | Inde | 9% | Inde | 3% |
| Kulemera | Inde | 10% | Inde | * |
| Kupuma pang'ono | Inde | * | Inde | 3% |
| Kuzizira kozizira | Ayi | - | Inde | 1% |
| Matenda okhumudwa | Inde | <1% | Inde | 5% |
| Kuyabwa | Inde | <1% | Inde | 5% |
* sananene
Pafupipafupi sizidalira zomwe zimayesedwa pamutu. Izi sizingakhale mndandanda wathunthu wazovuta zomwe zingachitike. Chonde onani dokotala wanu kapena wothandizira zaumoyo kuti mudziwe zambiri.
Gwero: DailyMed ( Chosema ), Tsiku Lililonse ( Zamgululi )
Kuyanjana kwa mankhwala a carvedilol vs. metoprolol
Onse carvedilol ndi metoprolol amachepetsa kuthamanga kwa magazi ndikuchepetsa kugunda kwa mtima. Chifukwa chake, amatha kulumikizana ndi mankhwala ena omwe ali ndi zovuta zofananira. Onse carvedilol ndi metoprolol, monga beta-blockers ambiri, amatha kulumikizana ndi othandizira kutsitsa magazi, monoamine oxidase inhibitors (MAOIs), ndi calcium channel blockers. Kutenga mankhwalawa palimodzi kumatha kuonjezera chiopsezo chotsika kwambiri magazi kapena kuchepa kwa mtima.
Carvedilol ndi metoprolol zimakonzedwa makamaka m'chiwindi ndi enzyme ya CYP2D6. Mankhwala omwe amaletsa enzyme iyi amatha kulumikizana ndi carvedilol ndi metoprolol, zomwe zingayambitse kuchuluka kwa carvedilol kapena metoprolol. Kuchuluka kwa magazi a carvedilol kapena metoprolol kumatha kubweretsa chiopsezo chowonjezeka cha zotsatirapo.
Beta-blockers amatha kuwonjezera kutsitsa kwa magazi m'magazi am'magazi ngati glipizide, metformin, kapena insulin. Chenjezo liyenera kulangizidwa pamene mankhwalawa atengedwa palimodzi.
Onani tebulo ili m'munsi pazomwe zingagwiritsidwe ntchito ndi mankhwala.
| Mankhwala osokoneza bongo | Gulu la mankhwala osokoneza bongo | Chosema | Zamgululi |
| Clonidine Guanethidine Onaninso | Alfa-adrenergic wothandizila | Inde | Inde |
| Selegiline Isocarboxazid Phenelzine | Monoamine oxidase inhibitors (MAOIs) | Inde | Inde |
| Amlodipine Nifedipine | Oletsa ma calcium | Inde | Inde |
| Fluvoxamine Fluoxetine Chlorpromazine Quinidine Ritonavir Terbinafine | CYP2D6 zoletsa | Inde | Inde |
| Glipizide Metformin Rosiglitazone Sitagliptin | Matenda apakamwa | Inde | Inde |
| Dihydroergotamine Ergotamine | Ma alkaloid opunduka | Inde | Inde |
| Hydralazine | Vasodilators | Inde | Inde |
| Digoxin | Ma glycosides amtima | Inde | Inde |
| Cyclosporine | Odwala matenda opatsirana pogonana | Inde | Inde |
| Dipyridamole | Ma Platelet inhibitors | Inde | Inde |
Funsani katswiri wa zamankhwala pazinthu zina zomwe zingagwiritsidwe ntchito ndi mankhwala
Machenjezo a carvedilol ndi metoprolol
Beta-blockers sayenera kuthetsedwa mwadzidzidzi. M'malo mwake, amayenera kupendedwa pang'onopang'ono kuti athe kutsitsa. Pakhoza kukhala chiopsezo chowonjezeka cha matenda owopsa amitsempha, angina, infarction ya myocardial, ndi ma ventricular arrhythmias atasiya mwadzidzidzi beta-blocker.
Beta-blockers amatha kubisa zizindikiro za hypoglycemia kapena hyperthyroidism , monga kugunda kwa mtima. Odwala matenda ashuga komanso omwe ali ndi vuto la chithokomiro angafunike kusamala ndi beta-blockers.
Carvedilol ndi metoprolol amakhala ndi machenjezo a bronchospasm, makamaka kwa iwo omwe ali ndi matenda osokoneza bongo (COPD) kapena mavuto ena opuma. Komabe, maphunziro awonetsa kuti beta-blockers atha kuchepetsa kukweza ndikuwonjezera kupulumuka kwa iwo omwe ali ndi COPD.
Uzani wothandizira zaumoyo wanu ngati muli ndi mbiri ya kupsinjika kwa mtima, mphumu, kugunda kwamtima pang'ono, mavuto a chiwindi, kapena kusokonezeka kwa zosakaniza mu carvedilol kapena metoprolol. Funsani wothandizira zaumoyo kuti akuchenjezeni ndi zodzitetezera zina zokhudzana ndi kugwiritsa ntchito carvedilol kapena metoprolol.
Mafunso omwe amafunsidwa kawirikawiri za carvedilol vs. metoprolol
Kodi carvedilol ndi chiyani?
Carvedilol ndi mankhwala a beta-blocker omwe amagwiritsidwa ntchito pochiza kulephera kwa mtima komanso kuthamanga kwa magazi. Itha kugwiritsidwanso ntchito kupititsa patsogolo kupulumuka pambuyo povutika ndi mtima. Carvedilol imabwera mumafomu otulutsira pomwepo komanso otulutsidwa. Anavomerezedwa ndi FDA mu 1995.
Kodi metoprolol ndi chiyani?
Metoprolol ndi beta-blocker mankhwala omwe amatha kuchiza kulephera kwa mtima, kuthamanga kwa magazi, komanso kupweteka pachifuwa. Metoprolol succinate, njira yotulutsira metoprolol imavomerezedwanso ndi FDA kuti ithetse mtima. Kutulutsa msanga metoprolol kumakhala ndi metoprolol tartrate. Metoprolol poyamba idavomerezedwa ndi FDA mu 1978.
Kodi carvedilol ndi metoprolol ndizofanana?
Onse carvedilol ndi metoprolol ndi beta-adrenergic receptor blockers, kapena beta-blockers. Zonsezi zimagwiritsidwa ntchito pochiza kulephera kwa mtima komanso kuthamanga kwa magazi. Komabe, ali ndi zosakaniza zosiyanasiyana ndipo amagwira ntchito mosiyanasiyana. Carvedilol ndi beta-blocker yosasankha ndipo metoprolol ndi beta-1 yosankha beta-blocker.
Kodi carvedilol kapena metoprolol ndibwino?
Carvedilol ndi metoprolol ndi mankhwala othandiza kwambiri poyerekeza ndi placebo. Carvedilol atha kukhala bwino kwa odwala ena omwe ali ndi vuto la mtima, malinga ndi Kuyesa kwa COMET . Carvedilol ndi metoprolol ndizofanananso zothandiza pakukhalitsa ndi moyo mutadwala matenda amtima. Malangizo ochokera ku American College of Cardiology (ACC) ndi American Heart Association (AHA) amalimbikitsa kugwiritsa ntchito carvedilol, metoprolol succinate, kapena bisoprolol kwa odwala omwe ali ndi vuto la mtima omwe ali ndi gawo locheperako la ejection. Funsani wothandizira zaumoyo kuti akuthandizeni njira yabwino yothandizira matenda anu.
Kodi ndingagwiritse ntchito carvedilol kapena metoprolol ndili ndi pakati?
Beta-blockers ali amagwiritsidwa ntchito kwambiri mwa amayi apakati omwe ali ndi vuto la mtima. Komabe, palibe umboni wosonyeza kuti beta-blockers ali otetezeka kwathunthu kapena owopsa panthawi yapakati. Onse carvedilol ndi metoprolol atha kutenga chiopsezo cha fetus. Funsani othandizira azaumoyo kuti akalandire malangizo asanagwiritse ntchito beta-blocker panthawi yapakati.
Kodi ndingagwiritse ntchito carvedilol kapena metoprolol ndi mowa?
Pakhoza kukhala chiopsezo chowonjezeka cha zotsatirapo pophatikiza beta-blocker ndi mowa. Kutenga carvedilol kapena metoprolol ndi mowa kumachulukitsa chiopsezo chogona, chizungulire, ndi kuthamanga magazi. Mowa amathanso kuchepetsa mphamvu ya beta-blockers.
Kodi carvedilol amachepetsa kuthamanga kwa magazi kuposa metoprolol?
Carvedilol imatha kutsitsa kuthamanga kwa magazi kuposa metoprolol. Izi ndichifukwa choti carvedilol ili ndi ma vasodilating katundu omwe amathandizira kupumula mitsempha yamagazi ndikuchepetsa kuthamanga kwa magazi. Palibe kafukufuku amene anafanizira mwachindunji kuthamanga kwa magazi kutsitsa zotsatira za carvedilol ndi metoprolol. Komabe, carvedilol itha kuthandiza pewani zochitika zamtima kuposa metoprolol odwala oopsa.
Kodi mungasinthe kuchokera ku metoprolol kupita ku carvedilol? / Kodi ndizotetezeka kusinthana ndi ma beta blockers?
Ndizotetezeka kusinthana ndi beta-blockers ngati pakufunika kutero kapena monga akuvomerezera ndi othandizira azaumoyo. Kutengera ndi beta-blocker, kusinthana kumatha kukhala kwachangu kapena kuchuluka kwa beta-blocker kumatha kuyamwa kuyamwa pomwe kuchuluka kwa beta-blocker kumakulirakulira pang'onopang'ono mpaka pamlingo woyenera. Maulendo obwereza angafunike kuti muwone ngati beta-blocker yatsopanoyo ili ndi mphamvu.
Kodi cholowa m'malo mwa carvedilol ndi chiyani?
Carvedilol yabwino m'malo mwake itengera momwe akuchiritsira. Pali mankhwala awiri okha omwe FDA imavomereza kuchiza kulephera kwa mtima kupatula carvedilol: bisoprolol ndi metoprolol succinate. Zitsanzo zina za beta-blockers ndi atenolol, nebivolol, ndi propranolol.
Kodi pali beta blocker yabwinoko kuposa metoprolol?
Njira zina zothetsera metoprolol succinate yolephera mtima ndi bisoprolol ndi carvedilol. Beta blocker yabwinoko ndi yomwe ingakuthandizireni bwino. Zina zingatenge gawo pakusankha beta blocker, monga mtengo, zoyipa, ndi mankhwala ena omwe mungakhale mukumwa.
