Eyona >> Iziyobisi Vs. Umhlobo >> ICarvedilol vs.Metoprolol: Umahluko, ukufana, kwaye kukuphi okungcono kuwe

ICarvedilol vs.Metoprolol: Umahluko, ukufana, kwaye kukuphi okungcono kuwe

Iziyobisi Vs. Umhlobo

ICarvedilol kunye ne-metoprolol ngamayeza amiselweyo asetyenziselwa ukunyanga uxinzelelo lwegazi (uxinzelelo lwegazi) kunye neengxaki zentliziyo, ezinje ngokusilela kwentliziyo. La mayeza angasetyenziselwa ukunciphisa umngcipheko wokufa emva kokuhlaselwa kwentliziyo (i-myocardial infarction).

Zombini i-carvedilol kunye ne-metoprolol zihlelwa njenge beta-iibhlokhi , eyaziwa ngokuba yi-beta-adrenergic blocking agents. Basebenza ngokuthintela ii-beta receptors, ezithintela iziphumo ze-norepinephrine kunye ne-epinephrine entliziyweni nasemithanjeni yegazi. I-Beta-blockers zinceda ukunciphisa uxinzelelo lwegazi kunye nokuhamba kancinci kwentliziyo ukunciphisa uxinzelelo entliziyweni.

ICarvedilol kunye ne-metoprolol zombini ziyeza. Nangona babelana ngokufana, banokwahluka kwidosi, ukwenziwa, kunye neziphumo ebezingalindelekanga.

Yintoni umahluko ophambili phakathi kwe-carvedilol kunye ne-metoprolol?

ICarvedilol ithathwa njenge-beta-blocker engakhethiyo. Oku kuthetha ukuba i-carvedilol inokuthintela zombini ii-beta-1 receptors kunye ne-beta-2 receptors. Ii-beta-1 receptors zifumaneka entliziyweni ngelixa ii-beta-2 receptors zifumaneka ikakhulu kwimisipha egudileyo. ICarvedilol ikwathintela ii-alpha receptors kwimithambo, enceda uxinzelelo lwegazi.

ICarvedilol ligama eliqhelekileyo likaCoreg. Ihlala ithathwa njenge-3.125 mg, 6.25 mg, 12.5 mg, okanye 25 mg ithebhulethi yomlomo kabini imihla ngemihla. ICarvedilol ikwafumaneka kwifom ekhutshiweyo eyandisiweyo (Coreg CR) enokuthi ithathwe kube kanye yonke imihla.

I-Metoprolol yi-beta-1 blocker ekhethiweyo ethintela ikakhulu ii-beta-1 receptors entliziyweni. Nangona kunjalo, ikwathintela i-beta-2 receptors, nangona inqanaba elincinci. I-beta-blockers ekhethiweyo inokuba neziphumo ezahlukeneyo xa kuthelekiswa ne-beta-blockers engakhethiyo.

IMetoprolol iza ngeendlela ezimbini ezahlukeneyo zetyuwa: I-metoprolol tartrate kunye ne-metoprolol succinate . I-Metoprolol tartrate, ekwabizwa ngegama le-brand Lopressor, yithebhulethi yomlomo ekhutshwa kwangoko eza ngamandla e-25 mg, 37.5 mg, 50 mg, 75 mg, kunye ne-100 mg. I-Metoprolol succinate, ekwabizwa ngegama lophawu iToprol XL, yithebhulethi yomlomo ekhulisiweyo eyandisiweyo eza ngamandla e-25 mg, 50 mg, 100 mg, kunye ne-200 mg.

Ezinxulumene: I-Metoprolol kunye neAtenolol

Umahluko ophambili phakathi kwe-carvedilol kunye ne-metoprolol
	ICarvedilol	Imitha
Iklasi yeziyobisi	IBeta-blocker	IBeta-blocker
Uhlobo lweBrith / generic	Ibhranti kunye nohlobo oluqhelekileyo olukhoyo	Ibhranti kunye nohlobo oluqhelekileyo olukhoyo
Ngubani igama lophawu?	Coreg (ukukhutshwa kwangoko) I-Coreg CR (ukukhutshwa okwandisiweyo)	I-Lopressor (ukukhutshwa kwangoko) I-Toprol XL (ukukhutshwa kwexesha elide)
Zeziphi iifom eza nalo iziyobisi?	Ithebhulethi yomlomo	Ithebhulethi yomlomo
Ithini idosi esemgangathweni?	ICarvedilol (ukukhutshwa kwangoko): 25 mg kabini yonke imihla I-Carvedilol (ukukhutshwa okwandisiweyo): 10 ukuya kwi-80 mg kanye yonke imihla Isisombululo sixhomekeke kwimeko yokunyangwa	I-Metoprolol tartrate (ukukhutshwa kwangoko): 50 ukuya kwi-100 mg kabini yonke imihla I-Metoprolol succinate (ukukhutshwa okwandisiweyo): 25 ukuya kwi-100 mg kanye yonke imihla Isisombululo sixhomekeke kwimeko yokunyangwa
Lude kangakanani unyango oluqhelekileyo?	Ixesha elide	Ixesha elide
Ngubani oqhelekileyo usebenzisa amayeza?	Abantu abadala	Abantu abadala

Iimeko eziphathwe nge-carvedilol kunye ne-metoprolol

Zombini i-carvedilol kunye ne-metoprolol succinate zivunyiwe yi-FDA ukunyanga ukusilela kwentliziyo okubangelwa yi-ischemia, uxinzelelo lwegazi, okanye i-cardiomyopathy. Zombini ii-beta-blocker ziyavunywa ukuba zinyange uxinzelelo lwegazi.

I-Beta-blockers zihlala zisetyenziselwa ukongeza kwamanye amayeza anje i-angiotensin-eguqula i-enzyme (ACE) inhibitors kunye nomchamo. Ukunciphisa i-systolic okanye i-diastolic yegazi kunokunceda ukunciphisa umngcipheko wesiganeko senhliziyo kunye nokuhlaselwa yintliziyo okanye ukubetha.

ICarvedilol kunye ne-metoprolol zinokusetyenziselwa ukunciphisa umngcipheko wokugula kunye nokufa ukulandela isifo sentliziyo . La mayeza anokunyanga ukungasebenzi kakuhle kwekhohlo emva kwentliziyo emva kokuhlaselwa sisifo sentliziyo.

Omabini la mayeza anokusetyenziselwa ukunyanga i-angina pectoris, okanye iintlungu zesifuba, ezibangelwa sisifo sentliziyo. I-Carvedilol okanye i-metoprolol inokumiselwa ukunciphisa uhlaselo lwe-angina kunye nokuphucula amandla okwenza umthambo kwabo banesifo sentliziyo okanye ukusilela kwentliziyo.

Ukusetyenziswa kwelebula ngaphandle kwe-carvedilol kunye ne-metoprolol kubandakanya unyango lwe-arrhythmias, okanye izingqisho zentliziyo ezingaqhelekanga, ezinje nge-atrial fibrillation.

Imeko	ICarvedilol	Imitha
Ukumelwa yintliziyo	Ewe	Ewe
Uxinzelelo lwegazi	Ewe	Ewe
Imyocardial infarction	Ewe	Ewe
UAngina pectoris	Ngaphandle kwelebheli	Ewe
Arrhythmia	Ngaphandle kwelebheli	Ngaphandle kwelebheli

Ngaba i-carvedilol okanye i-metoprolol iyasebenza ngakumbi?

Inkqubo ye- ICarvedilol okanye iMetoprolol Uvavanyo lwaseYurophu (I-COMET) yayilingo olulawulwa ngokungacwangciswanga ngokuthelekisa i-carvedilol kunye ne-metoprolol kwizigulana ezinokusilela kwentliziyo okungapheliyo. Ityala laqhutywa ngaphezulu kweminyaka emihlanu kwizigulana ezingaphezu kwe-1,500. Iziphumo, ezazipapashwe kwi ILancet , ibonise ukusweleka konke okubangela i-34% ye-carvedilol xa ithelekiswa ne-40% ye-metoprolol. Ngamanye amagama, i-carvedilol yafunyanwa inyusa ukusinda kwizigulana ezingaphumeleli kwintliziyo ngaphezulu kwe-metoprolol.

Isifundo esingama-2021 sokuthelekisa esivela kwi- Ijenali yaseMelika yeCardiology kwafumanisa ukuba kwakungekho mahluko ubonakalayo kumanqanaba okusinda emva kokuhlaselwa kwentliziyo kunye ne-carvedilol xa ithelekiswa ne-metoprolol kwizigulana ezinenxalenye ye-ejection ye-ventricular ekhohlo ngaphezulu kwe-40%. Nangona kunjalo, kulawo aneqhekeza lasekhohlo le-ventricular ejection elingaphantsi kwama-40%, icarvedilol inokuba yeyona ibet-blocker esebenzayo.

Ngokwe- Uhlalutyo lweemeta , I-carvedilol kunye ne-metoprolol ziyafana ngokusebenza xa zisetyenziswa emva kokuhlaselwa sisifo sentliziyo. Xa kuthelekiswa ne-placebo, zombini i-beta-blockers zifunyenwe ukunciphisa kakhulu izehlo zentliziyo kunye nohlaselo lwentliziyo olulandelayo. Nangona kunjalo, akukho zibonelelo zibalulekileyo kuzo zonke izizathu zokufa, ukuvuselelwa kwemithambo, kunye nokulaliswa esibhedlele kwafunyanwa nokuba yi-carvedilol okanye i-metoprolol.

Zombini i-carvedilol kunye ne-metoprolol zinokuba njalo unyango olusebenzayo . Unyango lunokuthi lube lolomntu ngokusekwe kwimeko yonyango, iziphumo ebezingalindelekanga ezinokubakho, kunye neendleko. Nxibelelana nomboneleli wezempilo ngonyango olulungileyo.

Umyinge kunye neendleko zokuthelekisa i-carvedilol vs metoprolol

ICarvedilol igutyungelwe luninzi lwezonyango kunye nezicwangciso zeinshurensi. I-copay iya kuxhomekeka kwifomula yesicwangciso kunye nokugubungela. Ixabiso eliphakathi lemali le-carvedilol lijikeleze i- $ 160. Nokuba i-inshurensi, icarvedilol inokubiza. Sebenzisa ikhadi lesaphulelo se-SingleCare kwi-carvedilol unokukwazi ukwehlisa iindleko eziphuma epokothweni ukuya kuthi ga kwi-5 yeedola.

I-Metoprolol ikwagqunywe luninzi lwezonyango kunye nezicwangciso zeinshurensi. Qhagamshelana nesikhemistiki sakho okanye isicwangciso se-inshurensi ukuze ufumane ukuba yiyiphi i-copay ye-metoprolol eya kuba. Ixabiso eliphakathi lemali ye-metoprolol ijikeleze i-168 yeedola. Ikhadi lesaphulelo se-SingleCare le-metoprolol tartrate okanye i-metoprolol succinate inokukunceda ugcine kakhulu kwiindleko zokumiselwa.

	ICarvedilol	Imitha
Ngokuqhelekileyo i-inshurensi?	Ewe	Ewe
Ngokuqhelekileyo ihlanganiswe yiCandelo le-Medicare?	Ewe	Ewe
Ubungakanani	Iipilisi ezingama-60 (6.25 mg)	Iipilisi ezingama-60 (25 mg)
I-Medicare copay eqhelekileyo	$ 0- $ 15	$ 0- $ 65
Ixabiso elilodwa	$ 4 +	$ 4 +

Iziphumo eziqhelekileyo ezichaphazelekayo ze-carvedilol vs.metoprolol

ICarvedilol kunye ne-metoprolol zabelana ngemiphumo efanayo. Iziphumo ebezingalindelekanga ezixhaphakileyo ze-carvedilol sisiyezi, ukudinwa, ubuthathaka, uxinzelelo lwegazi (hypotension), urhudo, iswekile ephezulu yegazi (hyperglycemia), izinga lentliziyo elicothayo (bradycardia), kunye nokuzuza ubunzima. Iziphumo eziqhelekileyo ezichaphazelekayo zokudinwa kwe-metoprolol, isiyezi, urhudo, ukurhawuzelela, kunye noxinzelelo.

Iziphumo ebezingalindelekanga ezimandundu ze-carvedilol kunye ne-metoprolol zinokwenzeka, njengokuguliswa komzimba, ingozi ephantsi yoxinzelelo lwegazi, kunye ne-bronchospasms okanye ukuphefumla kancinci. Funa unyango kwangoko ukuba ufumana irhashalala, ukudumba, okanye ukuphefumla nzima emva kokuthatha i-carvedilol okanye i-metoprolol.

	ICarvedilol	Imitha
Imiphumela	Iyasebenza?	Rhoqo	Iyasebenza?	Rhoqo
Ukuba nesiyezi	Ewe	32%	Ewe	10%
Ukudinwa	Ewe	24%	Ewe	10%
Uxinzelelo lwegazi	Ewe	9%	Ewe	1%
Urhudo	Ewe	12%	Ewe	5%
Hyperglycemia	Ewe	12%	Ewe	*
Ubuthathaka	Ewe	7%	Ewe	10%
Ukubetha kwentliziyo kancinci	Ewe	9%	Ewe	3%
Ukutyeba kwakho	Ewe	10%	Ewe	*
Ukuqhawukelwa ngumphefumlo	Ewe	*	Ewe	3%
Iziphelo ezibandayo	Hayi	-	Ewe	1%
Uxinzelelo	Ewe	<1%	Ewe	5%
Ukurhawuzelela	Ewe	<1%	Ewe	5%

* akuxelwa
Ukuphindaphinda akusekelwanga kwidatha ukusuka kuvavanyo lwentloko ukuya entloko. Olu alunakuba luluhlu olupheleleyo lweziphumo ezibi ezinokwenzeka. Nceda ujonge ugqirha wakho okanye umboneleli wezempilo ukuze ufunde okungakumbi.
Umthombo: DailyMed ( ICarvedilol ), Yonke imihla ( Imitha )

Ukudibana kweziyobisi kwe-carvedilol vs metoprolol

Zombini i-carvedilol kunye ne-metoprolol zinokwehlisa uxinzelelo lwegazi kunye nokubetha kwentliziyo kancinci. Ke ngoko, banokusebenzisana namanye amayeza aneziphumo ezifanayo. Zombini i-carvedilol kunye ne-metoprolol, njengabaninzi be-beta-blockers, banokusebenzisana ne-arhente yokwehlisa uxinzelelo lwegazi, ii-monoamine oxidase inhibitors (MAOIs), kunye ne-calcium channel blockers. Ukuthatha la mayeza kunye kunokunyusa umngcipheko woxinzelelo lwegazi olusezantsi okanye ukubetha kwentliziyo.

I-Carvedilol kunye ne-metoprolol zenziwa ikakhulu kwisibindi yi-CYP2D6 enzyme. Iziyobisi ezithintela le enzyme zinokusebenzisana ne-carvedilol kunye ne-metoprolol, enokuthi ikhokelele kwinqanaba elonyukayo le-carvedilol okanye i-metoprolol. Ukunyusa amanqanaba egazi e-carvedilol okanye i-metoprolol kunokukhokelela kumngcipheko owandileyo weziphumo ebezingalindelekanga.

I-Beta-blockers inokunyusa iswekile esehlisa isiphumo sokunyanga amayeza e-hypoglycemic anjenge-glipizide, metformin, okanye i-insulin. Isilumkiso kufuneka sicetyiswe xa la mayeza ethathwa kunye.

Jonga le theyibhile ingezantsi ngolunye unxibelelwano lweziyobisi.

Iziyobisi	Iklasi yeziyobisi	ICarvedilol	Imitha
Clonidine IGuanethidine Hlaziya ngokutsha	Iimpawu zeAlpha-adrenergic	Ewe	Ewe
Selegiline Isocarboxazid IPhenelzine	I-Monoamine oxidase inhibitors (MAOIs)	Ewe	Ewe
Amlodipine Nifedipine	Isithinteli seCalcium blocker	Ewe	Ewe
IFluvoxamine IFluoxetine Chlorpromazine Iquinidine Ritonavir I-Terbinafine	CYP2D6 inhibitors	Ewe	Ewe
IGlipizide IMetformin Rosiglitazone Isitagliptin	Umlomo wehypoglycemics	Ewe	Ewe
Dihydroergotamine Ergotamine	I-Erkot alkaloids	Ewe	Ewe
IHydralazine	IVasodilators	Ewe	Ewe
I-Digoxin	Glycosides zentliziyo	Ewe	Ewe
ICclosporine	Amajoni omzimba	Ewe	Ewe
I-Dipyridamole	IiPlatelet inhibitors	Ewe	Ewe

Nxibelelana noochwephesha kwezonyango malunga nolunye unxibelelwano lweziyobisi

Izilumkiso zecarvedilol kunye ne-metoprolol

I-Beta-blocker akufuneki iyekwe ngesiquphe. Endaweni yoko, kufuneka ngokuthe ngcembe zifakwe kwiidosi ezisezantsi. Kunokubakho umngcipheko owandayo wesifo se-coronary disease, i-angina, i-myocardial infarction, kunye ne-ventricular arrhythmias emva kokuyeka ngokukhawuleza i-beta-blocker.

I-Beta-blockers zinokuzifihla iimpawu zehypoglycemia okanye hyperthyroidism , njengokukhawuleza kwentliziyo. Izigulana ezineswekile kunye nabo baneengxaki ze-thyroid banokufuna ukulumkisa nge-beta-blockers.

Zombini i-carvedilol kunye ne-metoprolol ziphethe izilumkiso ze-bronchospasm, ngakumbi kwezo zinezifo ezingapheliyo zokuphazamiseka kwemiphunga (COPD) okanye ezinye iingxaki zokuphefumla. Nangona kunjalo, izifundo Ndibonisile ukuba i-beta-blocker inokunciphisa ukonyusa kunye nokwandisa ukusinda kwabo bane-COPD.

Xelela umboneleli wakho wezempilo ukuba unembali yokusilela kwentliziyo, isifo sombefu, ukubetha kwentliziyo kancinci, iingxaki zesibindi, okanye iimpendulo ezichasayo kwizithako ezikwi-carvedilol okanye kwi-metoprolol. Qhagamshelana nomboneleli wezempilo malunga nezinye izilumkiso kunye nezilumkiso ezinxulumene nokusetyenziswa kwe-carvedilol okanye i-metoprolol.

Imibuzo ebuzwa rhoqo malunga ne-carvedilol vs metoprolol

Yintoni icarvedilol?

ICarvedilol lunyango lwe-beta-blocker olusetyenziselwa ukunyanga ukusilela kwentliziyo kunye noxinzelelo lwegazi. Ingasetyenziselwa ukwandisa ukusinda emva kokuhlaselwa kwentliziyo. ICarvedilol iza ngokukhutshwa kwangoko kunye neefom zokukhululwa ezandisiweyo. Kwakuyi-FDA evunyiweyo ngo-1995.

Yintoni metoprolol?

I-Metoprolol yonyango lwe-beta-blocker elinokunyanga ukusilela kwentliziyo, uxinzelelo lwegazi kunye nentlungu engapheliyo yesifuba. I-Metoprolol succinate, uhlobo olwandisiweyo lokukhululwa kwe-metoprolol nayo i-FDA ivunyelwe ukunyanga ukusilela kwentliziyo. Ukukhululwa kwangoko kwe-metoprolol iqulethe i-metoprolol tartrate. I-Metoprolol ekuqaleni yayivunywa yi-FDA ngo-1978.

Ngaba icarvedilol kunye ne-metoprolol ziyafana?

Zombini i-carvedilol kunye ne-metoprolol zi-beta-adrenergic receptor blockers, okanye i-beta-blockers. Zombini zisetyenziselwa ukunyanga ukusilela kwentliziyo engapheliyo kunye noxinzelelo lwegazi. Nangona kunjalo, ziqulathe izinto ezahlukeneyo ezisebenzayo kwaye zisebenza ngeendlela ezahlukeneyo. ICarvedilol ayiyikhethi i-beta-blocker kunye ne-metoprolol yi-beta-1 ekhethiweyo ye-beta-blocker.

Ngaba icarvedilol okanye i-metoprolol ingcono?

ICarvedilol kunye ne-metoprolol zombini ziyeza ezisebenzayo xa kuthelekiswa ne-placebo. ICarvedilol inokuba ngcono kwizigulana ezithile ezinesifo sentliziyo, ngokwe Uvavanyo lweCOMET . I-Carvedilol kunye ne-metoprolol ngokufanayo zisebenza ngokunyusa ukusinda emva kokuhlaselwa sisifo sentliziyo. Izikhokelo ukusuka kwiKholeji yaseMelika yeCardiology (i-ACC) kunye neAmerican Heart Association (AHA) bacebisa ukuba kusetyenziswe i-carvedilol, i-metoprolol succinate, okanye i-bisoprolol kwizigulana ezinesifo sentliziyo kunye neqhekeza elincitshisiweyo. Nxibelelana nomboneleli wezempilo ukuze ufumane olona nyango lulungileyo kwimeko yakho ethile.

Ndingayisebenzisa icarvedilol okanye i-metoprolol ngelixa ndikhulelwe?

Beta-blocker zezi esetyenziswa ngokuqhelekileyo kwabasetyhini abakhulelweyo abaneemeko zentliziyo. Nangona kunjalo, abukho bungqina bokuba ii-beta-blocker zikhuselekile ngokupheleleyo okanye ziyingozi ngexesha lokukhulelwa. Zombini i-carvedilol kunye ne-metoprolol zinokuba nomngcipheko wokonzakala kosana olungekazalwa. Nxibelelana nomboneleli wezempilo ngaphambi kokuba usebenzise i-beta-blocker ngexa lokukhulelwa.

Ndingayisebenzisa icarvedilol okanye i-metoprolol ngotywala?

Kunokubakho umngcipheko owandileyo weziphumo ebezingalindelekanga xa udibanisa i-beta-blocker kunye notywala. Ukuthatha i-carvedilol okanye i-metoprolol ngotywala kunokunyusa umngcipheko wozela, isiyezi kunye noxinzelelo lwegazi. Utywala bunokunciphisa ukusebenza kwe-beta-blocker.

Ngaba icarvedilol yehlisa uxinzelelo lwegazi ngaphezulu kwe-metoprolol?

ICarvedilol inokuhlisa uxinzelelo lwegazi ngaphezulu kwe-metoprolol. Kungenxa yokuba i-carvedilol ineepropathi ze-vasodilating ezinceda ukuphumla kwemithambo yegazi kunye noxinzelelo lwegazi olusezantsi. Akukho zifundo ziye ngokuthelekisa ngokuthe gca uxinzelelo lwegazi lwe-carvedilol kunye ne-metoprolol. Nangona kunjalo, icarvedilol inokunceda thintela iziganeko zentliziyo ngaphezu metoprolol kwizigulana unesifo.

Ngaba ungatshintsha ukusuka kwi-metoprolol ukuya kwi-carvedilol? / Ngaba kukhuselekile ukutshintshela iibhloko blocker?

Kukhuselekile ngokubanzi ukutshintshela kwi-beta-blockers ukuba iyafuneka okanye njengoko kucetyisiwe ngumboneleli wezempilo. Kuxhomekeka kwi-beta-blocker, iswitshi inokuba kwangoko okanye idosi ye-beta-blocker yokuqala inokulunyulwa ngelixa ithamo le-beta-blocker entsha inyuswa ngokuthe chu ukuya kwithagethi ekujolise kuyo. Ukutyelela kwakhona kunokufuneka ukuze kuvavanywe ukusebenza kwe-beta-blocker entsha.

Yintoni efanelekileyo yokutshintsha i-carvedilol?

Ukutshintsha kwe-carvedilol ngokufanelekileyo kuya kuxhomekeka kwimeko yokunyangwa. Mibini kuphela amayeza avunyiweyo yi-FDA ukunyanga ukusilela kwentliziyo ngaphandle kwe-carvedilol: i-bisoprolol kunye ne-metoprolol succinate. Eminye imizekelo ye-beta-blockers ibandakanya i-atenolol, i-nebivolol kunye nepropranolol.

Ngaba ikhona i-beta blocker engcono kune-metoprolol?

Ezinye iindlela ezinokubakho zokunyanga ukusilela kwentliziyo kubandakanya i-bisoprolol kunye ne-carvedilol. I-beta blocker engcono iya kuba yeyona isebenza ngcono kuwe. Ezinye izinto zinokudlala indima ekukhetheni i-beta blocker, njengeendleko, iziphumo ebezingalindelekanga, kunye namanye amayeza onokuthi uwathathe.