Carvedilol

Carvedilol is a medicine used to prevent angina, stroke, and heart diseases. It is also used for high blood pressure. Carvedilol is a beta-blocker that improves the chance of survival for a patient whose heart is not pumping well. The action of certain natural substances in one’s body is blocked by this medicine, such as epinephrine in the blood vessels and heart. Carvedilol is available in tablet form.

Key facts Carvedilol

• Carvedilol aids the heart in pumping blood around the body.
• Carvedilol slows down the heart rate.
• Carvedilol starts working after one hour of intake. For the full effect, it will take some time.
• If you have a heart defect, do not cease carvedilol immediately that can make the situation more terrible.

Who can and cannot take Carvedilol?

• Most adults can take carvedilol. Sometimes, a specialist prescribes it for youngsters.
• Carvedilol is not beneficial for some people. Before starting this medicine, discuss with your doctor if you experience the following problems:

• Allergic to other medications and carvedilol
• Lung disease or asthma
• Slow heartbeat rate and hypertension
• A defect in the liver or lungs
• Raynaud’s

When do individuals take carvedilol, and how?

• Carvedilol can make you dizzy, so the doctor advised you to take the first dose just before going to bed.
• Take medicine in the morning if one’s does not feel giddy after the first dose.
• It is best to take carvedilol at the same time every day. 
• If one takes carvedilol twice a day, they are suggested to take one dose at the start and another at the end of the day.
• Do not chew and crush the carvedilol. Consume it with water.
• Heart failure patients take this medicine with food. While standing, it will decrease the risk of feeling giddy or faint.

Dosage for Carvedilol

There are four different strengths of Carvedilol;

• 3.125 milligram
• 6.25 milligram
• 12.5 milligram
• 25 milligram

Following are the dosage recommendation for different diseases;

• For Angina Patients: The dosage is 12.5 milligram for two days, taken twice daily, which can be increased to 25 mg.
• For High blood pressure: The dosage of carvedilol is 12.5 mg for the first day, which will be increased to 25 mg for the next two days. The doctor may increase the dose to 50 mg daily if your blood pressure does not decrease. This medication can be consumed as one dose or split into two doses.
• For heart Patients: The dosage is 3.125 mg twice daily for two weeks. After every two weeks, the doctor slowly increases the dose to a maximum of 25 milligrams to 50 milligrams (depending on one’s weight).

Missed Dose

If the dose of Carvedilol is missed, consume it immediately but never take two doses simultaneously. Moreover, never take an extra amount for a forgotten medicine.

Overdose

In case of overdosage, blood pressure is lowered, heart rate is slowed down, and one feels difficulty breathing.

Side effects of Carvedilol

In some people, there are many serve side effects caused by carvedilol, but in many people, there is no side effect, or only a few minor effects occur like all other medicines. As your body gets familiar with the treatment, side effects usually improve. 

Following are the side effects of Carvedilol:

• Allergy
• Chest pain
• Discomfort, tightness, 
• Lightheadedness
• Dizziness
• Fainting
• Swelling of the feet, ankles, or lower legs
• Pain
• Slow heartbeat
• Weight gain
• Signs of kidney problem
• Mood changes
• Diarrhea
• Impotence

Tell your doctor immediately if any of these effects carry out or worse.

Severe Effects: Some patients have severe issues from consuming carvedilol. It rarely happens, but if you have these symptoms, tell your doctor immediately.

• The white portion of your eyes turns yellow, and you have yellow skin.
• Bleeding from the nose or minor swellings indicate shortness of blood cells.
• While exercising, you may feel trouble breathing with a cough that becomes severe, or you feel an irregular heartbeat, chest pain, or swollen ankles or legs that may be the signs of other heart defects.
• Chest pain, shortness of breathing, and increased mucus production.

Severe allergic reaction

In rare cases, severe allergic reactions to Carvedilol called anaphylaxis might occur. If individual experiences the following signs, then rush to the Accidents and Emergency Department;

• Itchiness and skin redness
• Dry, scaly, and crusted skin
• Tightness in the throat and chest 
• Difficulty in talking
• Swellings on one’s lips, tongue, face, mouth, or throat
• Gasping

 Management of Carvedilol Side Effects

To handle the side effects of carvediloL, the following precautions should be adopted:

• Feeling dizzy: Do not operate machinery until you are perfectly OK. Do not use alcohol, and never drive when you feel dizzy. Stop doing anything in this situation and always sit or lie down until be cured.
• Headaches: Consult our doctor and ask for a painkiller. Avoid drinking too much alcohol. After the first week of consuming carvedilol, the headaches go away. Make sure to take a lot of rest and drink plenty of water.
• Tiredness:  If you are tired, do not use machinery and drive in this situation. Please do not drink vine.
• To feel ill – Do not eat hot and peppery food. Consume simple meals. Always try to consume the carvedilol drug after a meal. If one’s sick, drink a lot of water to avoid a drought.
• Raynaud’s disease: Massage and wiggle your hands. Fingers and toes. Do not drink caffeine and smoke as it restricts your blood flow and narrower your blood vessels. Avoid wearing bracelets as well as tight watches. Try to wear warm socks and gloves. 
• Use of carvedilol in pregnancy: Carvedilol is not usually recommended for pregnant women.  
• Carvedilol and breastfeeding: It is OK to take carvedilol while breastfeeding. If ones observe that their baby isn’t feeding or always feels sleepy. Talk to your doctor immediately about any other concerns.
• Attentiveness with other medicine: Some other medicines can affect the carvedilol working.

• Taking carvedilol with blood pressure medicines can lower blood pressure too much.
• Some drugs can lower blood pressure, such as antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), and medicines for an enlarged prostate gland like tamsulosin or levodopa (for Parkinson’s disease).
• .Drugs for chronic obstructive pulmonary disease (COPD)
• Medicines for diabetic patients. Check your blood sugar level after exercise.

• Mixing with herbal supplements: Some herbal products cause low blood pressure.

Interactions

Medicines may increase the risk of severe side effects. It does not contain drug interactions. Kindly list all currently used medicines (including prescription or nonprescription drugs and herbal products) and share them with the doctor. Without a doctor’s permission, do not start, stop or change the dosage of any medicines. Carvedilol doesn’t interact with other beta blockers.

Carvedilol is good medicine:

The medicine Coreg (Carvedilol) is suitable for treating high blood pressure and managing heart failure, especially after a heart attack. Coreg also occurs in an oral extended-release (ER) capsule.

Pharmacology of Carvedilol

Carvedilol is a neurohormonal antagonist with multiple activities. It blocks beta one and beta two adrenergic receptors, increases vasodilation via alpha one adrenergic blockage, and, at high concentrations, has ion channel-blocking activities. Carvedilol lacks sympathomimetic activity. Moreover, it has many ancillary activities, including anti-inflammatory, antioxidants, and antiapoptotic properties. 

What should ones avoid while taking Carvedilol?

An individual should avoid salt substitutes while taking Carvedilol. Salt substitutes include potassium, sodium, calcium, and magnesium-rich foods. It may reduce or negate carvedilol’s effect in lowering blood pressure.

Can you drink coffee with Carvedilol?

Avoid products with caffeine and alcohol while taking Coreg (Carvedilol)

Use of Carvedilol before surgery

Before surgery, doctors do not recommend carvedilol as it can lower blood pressure too much when combined with general anesthetics.

Clinical monitoring

While taking Carvedilol, the doctor may check;

• Blood pressure 
• Heart rate
• Weight
• Blood sugar level (for a diabetic patient)
• Liver function 
• Potassium levels
• Cholesterol levels

 References:

• Packer M, Roecker EB, Fowler MB, Coats AJ, Katus HA, Krum H, Mohacsi P, Rouleau JL, Tendera M, Staiger C, Holcslaw TL, Amann-Zalan I, DeMets DL., Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) Study Group. Effects of Carvedilol on the morbidity with severe chronic heart defects: results of the carvedilol prospective randomized cumulative survival (COPERNICUS) study. Circulation. 2002 Oct 22;106(17):2194-9. [PubMed]
•  Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Colvin MM, Drazner MH, Filippatos GS, Fonarow GC, Givertz MM, Hollenberg SM, Lindenfeld J, Masoudi FA, McBride PE, Peterson PN, Stevenson LW, Westlake C. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart defects: A Report of the American College of  Heart Association Task Force on Clinical Practice Guidelines and the Heart defects Society of America. Circulation. 2017 Aug 08;136(6):e137-e161.[PubMed]

• Dargie HJ. Effects of Carvedilol on the outcome of myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomized trial. Lancet. 2001 May 05;357(9266):1385-90. [PubMed]

Koraćević G, Stojanović M, Kostić T, Lović D, Zdravković M, Koraćević M, Pavlović D, Mićić S. Contraindications Differ Widely Among Beta Blockers and Ought to be Cited for an Individual Drug, Not for the Entire Class. Curr Pharm Des. 2021;27(40):4125-4132. [PubMed]