carvedilol (Coreg, Coreg CR) (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

Carvedilol taken with calcium channel blockers (CCBs) 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 (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.

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.

Medically Reviewed by a Doctor on 8/7/2014


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