carvedilol, Coreg
GENERIC NAME: carvedilol
BRAND NAME: Coreg
DRUG CLASS AND MECHANISM: Carvedilol is used for treating
high blood pressure and congestive heart failure. It is related to
labetalol (Normodyne, Trandate). Carvedilol blocks receptors of the
adrenergic nervous system, the system of nerves in which epinephrine
(adrenalin) is active. Nerves from the adrenergic system enter the
heart and release an adrenergic chemical (norepinephrine) that
attaches to receptors on the heart's muscle and stimulates the muscle
to beat more rapidly and forcefully. By blocking the receptors,
carvedilol reduces the heart's rate and force of contraction and
thereby reduces the work of the heart. Carvedilol also blocks
adrenergic receptors on arteries and causes the arteries to relax and
the blood pressure to fall. The drop in blood pressure further
reduces the work of the heart since it is easier to pump blood
against a lower pressure. The FDA first approved carvedilol in 1995.
GENERIC AVAILABLE: yes
PRESCRIPTION: yes
PREPARATION: Tablets, 3.125mg, 6.25mg, 12.5mg, and 25mg.
STORAGE: Tablets should be stored at room temperature, 15-
30 C (59-86 F).
PRESCRIBED FOR: Carvedilol is used by itself or with a
diuretic ("water-pill") to control high blood pressure. Carvedilol
also may be used in combination with other drugs to manage mild or
moderate congestive heart failure. When combined with other treatments for heart disease
among patients with recent heart attacks, carvedilol can reduce the risk of a
second heart attack by 40% and increase survival among patients with congestive
heart failure.
DOSING: Carvedilol usually is given twice daily. For high
blood pressure, the dose may range from 6.25mg twice daily to a
maximum of 25mg twice daily. For congestive heart failure, the dose
may range from 3.25mg twice daily to a maximum of 25mg twice daily in
persons weighing less than 85kg (187 pounds) or 50mg twice daily in
persons weighing more than 85kg (187 pounds). Carvedilol should be
taken with food since this increases the amount of absorbed drug that
reaches the heart and arteries. Stopping and changing doses of
carvedilol should be done under the direction of a physician since
sudden changes in dose can result in serious cardiac complications
such as arrhythmias.
DRUG INTERACTIONS: Carvedilol can mask early warning
symptoms of hypoglycemia (low blood sugar) such as tremors and
increased heart rate. (These symptoms are caused by activation of
the adrenergic nervous system which is blocked by the carvedilol.)
Therefore, patients with diabetes taking medications that lower blood sugar such
as insulin or oral anti-diabetic medications may need to increase the
frequency with which they monitor their blood sugar.
Carvedilol taken with calcium channel blockers such as diltiazem (Cardizem) or verapamil
(Calan) may trigger an irregular heart rhythm
or an increase in blood pressure.
Reserpine, monoamine oxidase inhibitors (phenelzine or isocarboxazid)
and clonidine (Catapres), because they have similar mechanisms of
action as carvedilol, may greatly accentuate the effects of
carvedilol and cause a steep decline in blood pressure and/or heart
rate. Close monitoring of blood pressure and heart rate may be
needed.
Carvedilol may cause an increase in digoxin (Lanoxin) blood levels.
Therefore, in patients receiving digoxin, the digoxin blood level
should be monitored if carvedilol is started, adjusted or
discontinued.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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