Carivalan Contraindications

Hypersensitivity to the active substances or to any other beta-blockers or to any of the excipients; Severe hepatic impairment; Acute or unstable/decompensated heart failure; Unstable angina; Prinzmetal's angina; AV-block of 2nd and 3rd degree; Sick sinus syndrome (including sino-atrial block); Symptomatic or severe bradycardia (<50 bpm); Acute myocardial infarction; Cardiogenic shock; Pacemaker dependent (heart rate imposed exclusively by the pacemaker); Severe peripheral vascular disease (e.g. Raynaud's phenomenon); Severe hypotension (systolic arterial blood pressure <90 mmHg, diastolic arterial blood pressure <50 mmHg); Chronic obstructive pulmonary disease associated with bronchial obstruction; History of bronchospasm or asthma; Metabolic acidosis; Untreated pheochromocytoma; Combination with verapamil or diltiazem which are moderate CYP3A4 inhibitors with heart rate reducing properties; Combination with strong cytochrome P450 3A4 inhibitors such as azole antifungals (ketoconazole, itraconazole), macrolide antibiotics (clarithromycin, erythromycin per os, josamycin, telithromycin), HIV protease inhibitors (nelfinavir, ritonavir) and nefazodone; Pregnancy, lactation and women of child-bearing potential not using appropriate contraceptive measures.