Carvedilol

Carvedilol is a prescription medication used to treat heart failure and high blood pressure. Carvedilol belongs to a group of drugs called beta blockers. It works to decrease blood pressure, heart rate, and the workload of the heart by blocking beta receptors.

This medication comes in tablet form and is taken twice a day with food and a full glass of water.

It is also available in controlled release capsules which are to be swallowed whole once a day with food and a full glass of water.  Do not chew, divide or crush carvedilol controlled release capsules.  

Common side effects of carvedilol include low blood pressure, weight gain, and fatigue. Carvedilol can cause dizziness. Do not drive a car or operate machinery until you know how carvedilol affects you.
 

Carvedilol is a prescription medication used to treat:

• heart failure
• left ventricular dysfunction following myocardial infarction in clinically stable patients
• high blood pressure (hypertension)

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Carvedilol may be found in some form under the following brand names:

• Coreg

• Coreg CR

Serious side effects have been reported with carvedilol. See the “Carvedilol Precautions” section.

Common side effects of carvedilol include the following:

• Low blood pressure (which may cause dizziness or fainting when you stand up). If these happen, sit or lie down right away and tell your doctor.
• Tiredness. If you feel tired or dizzy you should not drive, use machinery, or do anything that needs you to be alert.
• Bradycardia (slow heart rate)
• Changes in your blood sugar. If you have diabetes, tell your doctor if you have any changes in your blood sugar levels.
• Carvedilol may hide some of the symptoms of low blood sugar, especially a fast heartbeat.
• Carvedilol may mask the symptoms of hyperthyroidism (overactive thyroid).
• Worsening of severe allergic reactions. Rare but serious allergic reactions (including hives or swelling of the face, lips, tongue, and/or throat that may cause difficulty in breathing or swallowing) have happened in patients who were on carvedilol. These reactions can be life-threatening.
• Shortness of breath
• Weight gain
• Diarrhea
• Fewer tears or dry eyes that become bothersome if you wear contact lenses.

This is not a complete list of carvedilol side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• beta blockers such as metoprolol (Toprol XL, Lopressor), bisoprolol (Zebeta), betaxolol (Kerlone), nebivolol (Bystolic), propranolol (Inderal)
• digoxin (Lanoxin)
• verapamil (Calan, Isoptin, Covera, Verelan)
• diltiazem (Cardizem)
• amiodarone (Cordarone, Pacerone)
• insulin and oral hypoglycemics
• medications such as reserpine (Serpalan), isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Emsam, Eldepryl, Zelapar), rasagiline (Azilect), clonidine (Catapres)

This is not a complete list of carvedilol drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with carvedilol including the following:

• Acute exacerbation of coronary artery disease upon cessation of therapy: Do not abruptly discontinue carvedilol.
• Bradycardia (slow heart rate). Tell your healthcare provider right away if you experience any new or increasing irregularities in your heart rate.
• Hypotension. Hypotension, or low blood pressure, may cause you to feel faint or dizzy. Inadequate fluid intake, excessive sweating, diarrhea, or vomiting can lead to an excessive fall in blood pressure too. Lie down if you feel faint or dizzy. Call your doctor right away.
• Worsening heart failure. Tell your healthcare provider right away if you experience any of the following symptoms:
  • sudden weight gain
  • worsening shortness of breath
  • increased swelling of your feet, legs, or abdomen
  • needing to use more pillows to go to sleep or sleeping in a recliner
  • waking from sleep to catch your breath
  • a cough that does not go away
  • new or increasing irregularities in your heart rate
• Non-allergic bronchospasm (e.g., chronic bronchitis and emphysema): Avoid using carvedilol in patients with these conditions. 
• Diabetes: Monitor glucose as carvedilol may mask symptoms of hypoglycemia or worsen hyperglycemia.

Carvedilol can cause you to feel dizzy, tired, or faint. Do not drive a car, use machinery, or do anything that needs you to be alert if you have these symptoms.

Do not take carvedilol if you:

• Have severe heart failure and are hospitalized in the intensive care unit or require certain intravenous medications that help support circulation (inotropic medications)
• Are prone to asthma or other breathing problems
• Are allergic to carvedilol or to any of its ingredients
• Have a slow heartbeat or a heart that skips a beat (irregular heartbeat)
• Have liver problems

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of carvedilol, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking carvedilol, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• Are allergic to carvedilol or to any of its ingredients
• Have asthma or other lung problems (such as bronchitis or emphysema).
• Have problems with blood flow in your feet and legs (peripheral vascular disease) carvedilol can make some of your symptoms worse.
• Have diabetes
• Have thyroid problems
• Have a condition called pheochromocytoma
• Have had severe allergic reactions
• Are pregnant or trying to become pregnant. It is not known if carvedilol are safe for your unborn baby. You and your doctor should talk about the best way to control your high blood pressure during pregnancy.
• Are breastfeeding. It is not known if carvedilol passes into your breast milk. You should not breastfeed while using carvedilol.
• Are scheduled for surgery and will be given anesthetic agents
• Are taking prescription or non-prescription medicines, vitamins, and herbal supplements. Carvedilol and certain other medicines can affect each other and cause serious side effects. Carvedilol may affect the way other medicines work. Also, other medicines may affect how well carvedilol works.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Carvedilol falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if carvedilol crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using carvedilol.

Take carvedilol exactly as prescribed.

Carvedilol comes in tablet form and is taken twice every day with food and a full glass of water.

Carvedilol is available in controlled release capsules which are to be swallowed whole once a day with food and a full glass of water. Do not chew, divide or crush carvedilol controlled release capsules.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of carvedilol at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• how you respond to this medication

The recommended target dose of carvedilol tablets for heart failure, left ventricular dysfunction following myocardial infarction, and hypertension (high blood pressure) is 25 mg twice daily.

The recommended dose range of carvedilol controlled release capsules for the treatment of heart failure is 10-80 mg/day.

The recommended dose range of carvedilol controlled release capsules for the treatment of Left Ventricular Dysfunction Following Myocardial Infarction and hypertension is 20-80 mg/day.

If you take too much carvedilol, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store carvedilol tablets at 20º to 25 º C (68 º to 77 ºF).
• Store carvedilol capsules at 25°C (77°F).
• Keep the tablets dry.
• Keep carvedilol and all medicines out of the reach of children.