GENERIC NAME: Carvedilol

COMMON BRANDS: Coreg, Dilatrend

Carvedilol is an oral prescription drug belongs to a class of medications called non-selective beta blockers with α1-blocking activity. It is sold under the common brand name “Coreg” used to treat mild-to-severe heart failure, left ventricular dysfunction (LVD) and for high blood pressure. It is available as a generic drug. Generic drugs usually cost less.

Carvedilol work by preventing adrenaline (norepinephrine) from acting on beta-adrenoreceptors that are present in blood vessels and the heart. This causes blood vessels to relax and slow down the heart rate to improve blood flow, decrease blood pressure and reduce strain on the heart.

What is Carvedilol used for?

Congestive Heart Failure:

This drug is used to treat mild-to-severe heart failure following a heart attack along with diuretics, ACE inhibitors, and digitalis, to increase survival if your heart is not pumping well and to reduce the risk of hohospitalization

Left Ventricular Dysfunction (Heart is unable to pump sufficient blood):

This drug is used to treat left ventricular dysfunction and to reduce cardiovascular mortality after a heart attack.

Hypertension:

This drug is used to treat hypertension in adults either alone or in combination with other antihypertensive medications (such as thiazide diuretics). Lowering blood pressure helps to prevent strokes, heart attacks, and kidney problems.

How to use Carvedilol?

Take carvedilol tablet orally with food, as directed by the doctor, usually, take twice a day. The dose of this drug depends on your medical condition and response to the treatment.

To help you remember to take this drug at the same time each day. Carefully follow all the directions on your prescription label, and ask your doctor or pharmacist to explain any part you do not understand. Take carvedilol precisely as directed.

Your blood pressure or a heart condition may not be controlled if you alter your dose or use it more frequently than prescribed by your doctor.

Use this medication regularly as instructed by your doctor to get the most benefit from it. It is essential to continue this drug even if you feel better. Many people with high blood pressure do not feel sick.

If you suddenly discontinue taking carvedilol, you may experience serious heart problems like heart attack.

You may require at least two weeks to observe the full benefit of this medicine. Inform your doctor if your medical condition remains unchanged or if it worsens (for example, if your blood pressure continues to remains high, or you have worsening symptoms of heart failure like increased shortness of breath).

What are the side effects of Carvedilol?

The common side effects observed with the use of this drug include dizziness, tiredness, low blood pressure, nausea, diarrhoea, high blood sugar, lack of energy/weakness, slower heart rate, weight gain, impotence, dry eyes, dry, itchy skin, headache, If any of these effects remain or worsen, inform your doctor/pharmacist immediately.

Get up slowly from a sitting/lying position, as this may help to lessen the risk of dizziness and lightheadedness.

Carvedilol may decrease the flow of blood to your hands and feet, causing them to feel cold. Avoid smoking or chewing of tobacco as this may worsen this effect.

This drug is used to treat heart failure but, in some cases, it develops new or worsening symptoms of heart failure at the beginning of treatment. Inform your doctor right away if you develop any of these severe side effects such as shortness breathlessness, swelling ankles/feet, unusual tiredness, sudden weight gain.

Get emergency medical assistance right away if you notice any of the following severe side effects, such as signs of heart failure (breathlessness, swelling ankles/feet, unusual tiredness, sudden weight gain), bluish color of the fingers/toes/nails, mental/mood changes (e.g., hallucination, confusion, depression, memory problems), seizures, pain/cramps in the muscles/joints, numbness/tingling, vision changes, slow/irregular/fast heartbeat, severe dizziness/fainting.

A severe allergic reaction to this drug is very rare. However, symptoms of a severe allergic reaction such as rashes, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing may occur. Get emergency medical assistance immediately if you notice any of the above side effects.

This is not a complete record of all possible side effects. Inform your doctor at the earliest, if you notice any of the side effects that are not mentioned in this article.

See also Warning and Precautions sections.

What are the precautions while using Carvedilol?

Inform your doctor/pharmacist before taking carvedilol, if you are allergic to it; or if you have other allergies. This drug may also contain some inactive ingredients that can cause allergic reactions or other problems. Talk to your doctor/pharmacist for further information.

Inform your doctor/pharmacist about all the products you are using including prescription, non-prescription, vitamins, nutritional supplements, and herbal products.

This drug may cause you dizzy or drowsy and even cause you to faint. This is most likely to happen at the beginning of your treatment or whenever your doctor increases your dose, especially notice within 1 hour after taking your dose. During these times, avoid driving or operating any heavy machinery until you can do it safely.

Alcohol or marijuana can make you further dizzy or drowsy. Avoid alcoholic beverages. Discuss with your doctor if you are using marijuana.

Before starting treatment with carvedilol, inform your doctor about your medical history, mainly of some types of heart rhythm problems (like slow/irregular heartbeat, sick sinus syndrome, second or third degree atrioventricular block), breathing problems (like chronic bronchitis, asthma, emphysema), heart failure problem requiring hospitalization, liver disease, kidney disease, blood circulation problems (like Raynaud’s disease, peripheral vascular disease), severe allergic reactions, hyperthyroidism, pheochromocytoma (a type of tumour) other heart problems (like Prinzmetal’s variant angina), muscle disease (myasthenia gravis), eye problems (cataracts, glaucoma).

Contact lens wearers may experience decreased lacrimation.

This drug can make it difficult to control your blood sugar level. Monitor your blood sugar levels regularly share the results with the doctor. Notify your doctor quickly if you notice any symptoms of hyperglycemia (high blood sugar level) such as an increase in thirst or urination. Your doctor may recommend you exercises, diet or may adjust your diabetes medication.

If you have diabetes, carvedilol may mask the symptoms of hypoglycemia (sudden fall in blood sugar level) such as fast/pounding heartbeat you would usually feel when you are hypoglycemic. Other symptoms of hypoglycemia such as sweating and dizziness, does not change by this drug.

An older adult is more sensitive to the side effects of this drug especially dizziness, due to impaired kidney and liver function.

During pregnancy, carvedilol should be used only when benefits outweigh the risk. It may be harmful to the foetus. This drug can also cross into breast milk and for more information about the safety of drug talk to your doctor.

What are the drug interactions of Carvedilol?

Carvedilol may interact with other medications, herbs, or vitamins you may be using. A drug interaction is when a substance changes the way a drug works which can be harmful or hinder the drug from working well.

Do not start, stop, or alter the dose of the drug without discussing your doctor because your doctor may be monitoring you for possible drug interactions.

Taking heart rhythm drugs (amiodarone, bretylium, quinidine, digoxin, disopyramide, encainide) with carvedilol can cause more severe side effects like low your heart rate or blood pressure, or worsen a heart blockage. Your doctor may oversee you for these effects or adjust the dosage of carvedilol or your heart rhythm drug.

Carvedilol should not be used with other beta-blocker (acebutolol, atenolol, bisoprolol, metoprolol, propranolol) as this combination may further lower your heart rate and blood pressure.

Calcium channel blocker (diltiazem, verapamil) may interact with carvedilol, required regular monitoring for blood pressure and heart rhythm.

Taking clonidine along with carvedilol can further lower your blood pressure and heart rate. Your doctor closely monitors you if these drugs are used together or switching required from one drug to other.

NSAIDs (such as diclofenac, ibuprofen, indomethacin, ketorolac, nabumetone, naproxen), a nasal decongestant (such as phenylephrine, pseudoephedrine), cough-and-cold products, may decrease the effectiveness of carvedilol. Fingolimod may also interact with the drug.

WARNINGS:

Stopping the drug:

Do not suddenly discontinue this medication without informing your doctor. Some conditions may become dangerous when you suddenly stop this drug. In some people who have abruptly terminated taking similar drugs have had chest pain, heart attack, and even irregular heartbeat. If your doctor recommends you to stop this drug, your doctor may ask you to reduce your dose gradually.

When you gradually decrease the dose of this drug before discontinuing this medication, your doctor may recommend you to restrict physical activity to reduce pressure on your heart. Get medical emergency assistance immediately if you notice symptoms such as chest pain/tightness/pressure, unusual sweating, trouble in breathing, chest pain spreading to the jaw/neck/arm, or fast/irregular heartbeat.

Low heart rate warning:

Carvedilol may decrease your heart rate (heart rate drops below 55 beats per minute), your doctor may reduce your dose of this drug.

Low blood pressure warning:

Carvedilol can severely cause low blood pressure, which may even lead to losing consciousness. This risk is highest after your take first doses and during dosing increases. To decrease this risk take carvedilol with food. Your doctor may prescribe you low dose and gradually increase it.

Other conditions:

Before taking carvedilol, inform your doctor about all of your health conditions such as diabetes, chronic obstructive pulmonary disease (COPD), asthma, poor circulation, heart failure or other heart problems, hyperthyroidism.

What are the forms and strengths of Carvedilol?

Generic: Carvedilol
Form: Oral tablet
Strengths: 3.125mg, 6.25mg, 12.5mg, and 25mg

Brand: Coreg
Form: Oral tablet
Strengths: 3.125mg, 6.25mg, 12.5mg, and 25mg

Brand: Dilatrend
Form: Oral tablet
Strengths: 6.25mg, 12.5mg, 25mg

What is the dosage of Carvedilol?

For Left Ventricular Dysfunction Following Heart Attack:

Adult (18 years and above):

Initial dose: Take 6.25mg twice per day. The dose can be increased after 3 to 10 days to 12.5mg twice per day.
Maximum dose: Take 25mg twice per day. You will be given a low dose if you can’t tolerate higher dosages.

Children (0 to 17 years):

Avoid use of this drug in children below 18 years of age, as the studies have not been established yet.

Special Considerations:

Renal impairment: If you have kidney problems, your doctor will regularly monitor you during treatment. They may reduce your dose or discontinue treatment if your kidney function gets worse.

For people with low blood pressure/heart rate/who are retaining fluid:

At the beginning of treatment, your doctor may prescribe you a small dose of 3.125mg twice per day, and your dose may be increased slowly if needed.

For High Blood Pressure:

Adult (18 years and above):

Initial dose: Take 6.25mg twice per day. The dose can be increased after 7 to 14 days based on your blood pressure level one hour after your dose.
Increase dose: Your dose can be increased to 12.5mg-25mg taken twice per day.
Maximum dose: The maximum dose should not be exceeded over 50mg per day.

Children (0 to 17 years):

Avoid use of this drug in children below 18 years of age, as the studies have not been established yet.

Special considerations:

Renal impairment: If you have kidney problems, your doctor will regularly monitor you during treatment. They may reduce your dose or discontinue treatment if your kidney function gets worse.

For Heart Failure:

Adult (18 years and above):

Initial dose: Take 3.125mg twice per day for two weeks.
Increase dose: The dose can be increased to 6.25mg, 12.5mg, and 25mg taken twice per day over 2-week intervals.

Children (0 to 17 years):

Avoid use of this drug in children below 18 years of age, as the studies have not been established yet.

Special Considerations:

Renal impairment: If you have kidney problems, your doctor will regularly monitor you during treatment. They may reduce your dose or discontinue treatment if your kidney function gets worse.

Most common questions asked about Carvedilol / Q&A’s:

What are the signs of Carvedilol overdose?

Signs of an overdose include slow heartbeat, fainting, difficulty breathing, dizziness, vomiting, seizures and losing consciousness. Seek a medical emergency as soon as possible if you notice any of these symptoms.

Disclaimer

TheMedPharma has made every effort to make sure that all the information is factually correct, comprehensive, and up-to-date. However, this website should not be considered as a substitute for the advice, knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or licensed health care professional before taking any medication. The drug information contained herein is subjected to changes if required. The lack of warnings or other information for a given drug does not mean that the drug or its combination is safe, effective or appropriate for use in all patients.