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- What are the uses 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 carvedilol? How does it work (mechanism of action)?
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 adrenalin (epinephrine) 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.
What are the uses for carvedilol?
- Carvedilol is a diuretic or "water pill" used to control high blood pressure (hypertension). In addition to treating high blood pressure, carvedolil is prescribed to treat:
- Carvedilol may be used in combination with other drugs to manage mild or moderate congestive heart failure. When it is 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.
- Carvedilol is also used for treating angina (chest pain from heart disease).
What are the side effects of carvedilol?
The most common side effects of carvedilol are:
- Edema (fluid accumulation)
- Decreased heart rate
- Low blood pressure
- Weight gain
- increased blood glucose levels (hyperglycemia)
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 an irregular heart rhythm and vision abnormalities.
Carvedilol should be used cautiously in patients who use diuretics or who are elderly or that have:
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 doctor because 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 that are 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 (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.
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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Is carvedilol safe to take if I'm pregnant or breastfeeding?
What else should I know about carvedilol?
- Is available in generic form.
- Needs a prescription from your doctor.
- Is available as:
- Tablets of 3.125, 6.25, 12.5, and 25 mg.
- Capsules (Extended Release) of 10, 20, 40, 80 mg
- Tablets should be stored at room temperature, 15 C and 30 C (59 F and 86 F).
Brand names available for carvedilol in the US are Coreg and Coreg CR (extended release).
Carvedilol (Coreg, Coreg CR) drug prescribed to control high blood pressure in addition to a diuretic. Carvedilol also may be prescribed in addition with other drugs to manage mild to moderate congestive heart failure and heart disease for patients who have suffered a recent heart attack. Side effects, drug interactions, dosage, storage, and pregnancy safety information should be reviewed prior to taking this medication.
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Congestive Heart Failure (CHF)
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include: Smoking High blood pressure High cholesterol Diabetes Family history Obesity Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
High Blood Pressure Treatment (Natural Home Remedies, Diet, Medications)
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
Heart failure (congestive) is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats. There are two types of congestive heart failure, systolic or left-sided heart failure; and diastolic or right-sided heart failure. Treatment, prognosis, and life-expectancy for a person with congestive heart failure depends upon the stage of the disease.
Angina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
Atrial Fibrillation (AFib) Treatment Drugs
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Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus bradycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-Parkinson-White syndrome, brachycardia, or heart blocks. Treatment is dependent upon the type of heart rhythm disorder.
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Heart Attacks in Women
Heart disease, particularly coronary artery disease is the leading cause of heart attacks. Women are more likely to die from a heart attack than men. High cholesterol, high blood pressure, obesity, and high triglycerides are contributors to heart disease. Some of the common symptoms of a heart attack in women include chest pain, shortness of breath, nausea, feeling faint or woozy, and more. Heart disease can be prevented by lifestyle changes and controlling high blood pressure, cholesterol, weight, and diseases such as diabetes.
Heart Disease in Women
Heart disease in women has somewhat different symptoms, risk factors, and treatment compared to heart disease in men. Many women and health professionals are not aware of the risk factors for heart disease in women and may delay diagnosis and treatment. Lifestyle factors such as diet, exercise, tobacco use, overweight/obesity, stress, alcohol consumption, and depression influence heart disease risk in women. High blood pressure, high cholesterol, and diabetes also increase women's risk of heart disease. Electrocardiogram (EKG or ECG), stress-ECG, endothelial testing, ankle-brachial index (ABI), echocardiogram, nuclear imaging, electron beam CT, and lab tests to assess blood lipids and biomarkers of inflammation are used to diagnose heart disease. Early diagnosis and treatment of heart disease in women saves lives. Heart disease can be prevented and reversed with lifestyle changes.
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