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- What is carvedilol, and how does it work (mechanism of action)?
- What brand names are available for carvedilol?
- Is carvedilol available as a generic drug?
- Do I need a prescription for carvedilol?
- What are the side effects of carvedilol?
- What is the dosage for carvedilol?
- Which drugs or supplements interact with carvedilol?
- Is carvedilol safe to take if I'm pregnant or breastfeeding?
- What else should I know about carvedilol?
What is the dosage for carvedilol?
Carvedilol tablets are usually given twice daily. For high blood pressure, the dose is 6.25 mg twice daily to a maximum of 25 mg twice daily.
For congestive heart failure, the dose is 3.25 mg twice daily to a maximum of 25 mg twice daily. A maximum dose of 50 mg twice daily has been used in persons weighing more than 85 kg (187 pounds).
Carvedilol should be taken with food to slow its absorption and reduce the occurrence of low blood pressure when rising from a sitting or sleeping position (orthostatic hypotension). 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.
The dose range for treating heart failure or high blood pressure with extended release capsules is 10 to 80 mg once daily.
Which drugs or supplements interact with carvedilol?
Carvedilol can mask early warning symptoms of low blood sugar (hypoglycemia) 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 monitor their blood sugar more often.
Reserpine, monoamine oxidase inhibitors (phenelzine or isocarboxazid) and clonidine (Catapress), 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.
Rifampin (Rifadin) can sharply decrease the carvedilol blood level. Therefore, in patients taking rifampin, the dose of carvedilol may need to be increased.
Carvedilol shares a common pathway for elimination by the liver with several other drugs such as quinidine (Quinaglute), fluoxetine (Prozac), paroxetine (Paxil), or propafenone (Rythmol). Use of these drugs may block the elimination of carvedilol. No studies have been done to confirm these effects on the elimination of carvedilol; however, carvedilol blood levels may be increased (along with the risk for carvedilol's side effects) if patients are taking any of these drugs.
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