carvedilol, Coreg (cont.)
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.
Carvedilol may increase the levels in the blood of
cyclosporin (Sandimmune, Neoral), and the dose cyclosporin may need to be
adjusted when the two drugs are used together.
Amiodarone
(Cordarone) may increase carvedilol levels in the blood, increasing
the effects and potential for toxicity of carvedilol.
PREGNANCY: Safe use of carvedilol during
pregnancy has not
been established.
NURSING MOTHERS: No studies with carvedilol are available
in nursing mothers; however, use is not recommended due to the risk
of a slow heart rate in the infant.
SIDE EFFECTS AND PRECAUTIONS: The most common side effects
of carvedilol are dizziness, edema (fluid accumulation), decreased
heart rate, diarrhea and
postural hypotension (a
rapid decrease in blood pressure when going from the seated to the standing
position that causes lightheadedness and/or fainting). Taking carvedilol
with food minimizes the risk of postural hypotension.
Other common side effects of carvedilol are irregular heart rhythm,
and abnormalities of vision.
Carvedilol should be used cautiously in patients who use diuretics or
who are elderly or have cirrhosis, asthma,
peripheral vascular
disease, hyperthyroidism, Prinzmetal's variant angina (angina at
rest), and kidney disease.
Reference: FDA Prescribing Information
Last Editorial Review: 1/6/2009
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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