What is Carvedilol: How to Use, Side Effects, Dosage

What is Carvedilol: How to Use, Side Effects, Dosage

What is Carvedilol

Carvedilol gets used to treat high blood pressure and heart failure. It is used after a heart attack to improve the chance of survival if your heart is not pumping well, either. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is related to labetalol (Normodyne). 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 decrease 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. Carvedilol belongs to a class of drugs known as alpha and beta blockers.

Carvedilol is a nonselective β-adrenergic blocking agent with α1-blocking activity. It is (±)-1(Carbazol-4-yloxy)-3-[[2-(o-methoxyphenoxy) ethyl] amino]-2-propanol. Carvedilol is a racemic mixture with the below structure:

Carvedilol is a white to off-white powder with a molecular weight of 406.5 and a molecular formula of C24H26N2O4. It is freely soluble in dimethylsulfoxide; soluble in methylene chloride and methanol; sparingly soluble in 95% ethanol and isopropanol; slightly soluble in ethyl ether; and practically insoluble in water, gastric fluid (simulated, TS, pH 1.1), and intestinal fluid (simulated, TS without pancreatin, pH 7.5).

Carvedilol may also be used for purposes not listed in this medication guide.

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How to use Carvedilol

Read the Patient Information Leaflet if available from your doctor before you start taking carvedilol and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this drug by mouth with food as directed by your doctor, usually twice daily.

The dosage is based on your medical condition and response to treatment. To decrease your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Your doctor's instructions should be followed carefully.

Take this medication in specific times to get the most benefit from it. To help you remember, take it at the same times each day.

For the treatment of high blood pressure, it may take 1 to 2 weeks before you get the full benefit of this drug. It is important to continue taking this drug even if you feel well. Most people with high blood pressure do not feel sick.

Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings remain high or increase, or you have worsening symptoms of heart failure like increased shortness of breath).

COREG should get taken with food to slow the rate of absorption and decrease the incidence of orthostatic effects.

Patients should be advised that initiation of treatment and (to a lesser extent) dosage increases may be associated with transient symptoms of dizziness or lightheadedness (and rarely syncope) within the first hour after dosing. During these periods, patients should avoid situations such as driving or hazardous tasks, where symptoms could result in injury.

Fluid retention (with or without transient worsening heart failure symptoms) should be treated by an increase in the dose of diuretics.

Dosage of Carvedilol

The dose of Cravedilol should be reduced if patients experience bradycardia (heart rate less than 55 beats per minute).

Hypertension

DOSAGE MUST BE INDIVIDUALIZED. The suggested starting dose of Carvedilol is 6.25 mg twice daily. If this dose is tolerated, using standing systolic pressure measured about 1 hour after dosing as a guide, the dose should be maintained for 7 to 14 days, and then increased to 12.5 mg twice daily if it is needed, based on trough blood pressure, again using standing systolic pressure 1 hour after dosing as a guide for tolerance. This dose should also be maintained for 7 to 14 days and can then be adjusted upward to 25 mg twice daily if tolerated and needed. The full antihypertensive effect of COREG is seen within 7 to 14 days. Total daily dose should not exceed 50 mg.

Hepatic Impairment

COREG should not be given to patients with severe hepatic impairment.

Take carvedilol exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Symptoms of overdose

Overdose symptoms may domain uneven heartbeats, shortness of breath, bluish-colored fingernails, dizziness, weakness, fainting, and seizure (convulsions).

Carvedilol

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Side effects of Carvedilol

Dizziness, lightheadedness, drowsiness, diarrhea, impotence, or tiredness may occur. If any of these effects persist or gets worse, tell your doctor or pharmacist promptly.

To decrease the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. The risk of dizziness is highest within 1 hour after you take your dose. Taking this drug with food and starting treatment with a low dose and slowly increasing your dose as directed by your doctor help to reduce the risk of dizziness.

This drug may reduce blood flow to your hands and feet, making them to feel cold. Smoking may worsen this effect. Dress warmly and avoid using of tobacco.

Remember that your doctor has prescribed this drug because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, like: very slow heartbeat, severe dizziness, fainting, unusual weakness, signs of kidney problems (such as change in the amount of urine), numbness/tingling of the hands/feet, blue fingers/toes, easy bruising/bleeding, mental/mood changes (such as confusion, depression), seizures.

Although this drug may be used to cure heart failure, some people may rarely develop new or worsening symptoms of heart failure, especially at the start of carvedilol treatment. Tell your doctor as soon as possible if you develop any of these serious side effects: shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain.

Call your doctor at once if you have a serious side effect such as:

a light-headed feeling, like you might pass out;

slow or uneven heartbeats;

swelling, rapid weight gain, feeling short of breath (even with mild exertion);

cold feeling or numbness in your fingers or toes;

chest pain, dry cough, wheezing, chest tightness, trouble breathing; or

high blood sugar (increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss).

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Drugs that may interact for Carvedilol

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

One product that may interact with this drug is: fingolimod.

Left Ventricular Dysfunction Following Myocardial Infarction

COREG is indicated to reduce cardiovascular mortality in clinically stable patients who have survived the acute phase of a myocardial infarction and have a left ventricular ejection fraction of less than or equal to 40% (with or without symptomatic heart failure) [see Clinical Studies].

Hypertension

COREG is indicated for the management of essential hypertension [see Clinical Studies]. It can be used alone or in combination with other antihypertensive agents, especially thiazide-type diuretics [see DRUG INTERACTIONS].ch as ibuprofen/naproxen).

Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R (+) enantiomer of carvedilol [see CLINICAL PHARMACOLOGY]. Retrospective analysis of side effects in clinical trials showed that poor 2D6 metabolizers had a higher rate of dizziness during up-titration, presumably resulting from vasodilating effects of the higher concentrations of the α-blocking R (+) enantiomer.

Other drugs might interact with carvedilol, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

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.

For whom this drug might not be safe

Do not take carvedilol if you:

have severe heart failure and are hospitalized in the intensive care unit or require certain intravenous medications that help support circulation (inotropic medications).

are allergic to any of the ingredients in COREG. The active ingredient is carvedilol. See the end of this leaflet for a list of all the ingredients in COREG.

are prone to asthma or other breathing issues.

have liver problems.

have a slow heartbeat or a heart that skips a beat (irregular heartbeat).

It is not known whether carvedilol passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are taking carvedilol.

Can you use Carvedilol while pregnancy?

Safe use of carvedilol during pregnancy has not been established yet.

No studies with carvedilol are available in nursing mothers; however, use is not suggested due to the risk of a slow heart rate in the infant.

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details.

Warnings of Carvedilol

Before taking carvedilol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic responses or other problems. Talk to your doctor for more information.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: specified types of heartbeat/heart rhythm problems (such as slow/irregular heartbeat, sick sinus syndrome, second- or third-degree atrioventricular block), breathing problems (such as asthma, chronic bronchitis, emphysema), severe heart failure requiring hospitalization, liver disease, kidney disease, blood circulation problems (such as Raynaud's disease, peripheral vascular disease), serious allergic reactions including those needing treatment with epinephrine, overactive thyroid disease (hyperthyroidism), a certain type of tumor (pheochromocytoma), other heart problems (such as Prinzmetal's variant angina), a certain muscle disease (myasthenia gravis), certain eye problems (cataracts, glaucoma).

If you have diabetes, this product may mask the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar, such as dizziness and sweating, are unaffected by this drug. This product may also make it harder to control your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

People who wear contact lenses may have dry eyes when they are taking this drug.

Before having surgery (including cataract/glaucoma eye surgery), tell your doctor or dentist if you are taking or have ever taken this drug, and about all the other products you use (including prescription drugs, nonprescription drugs, and herbal products).

It is unknown if carvedilol passes into breast milk. However, it is unlikely to pass into breast milk in large amounts. There is a low risk that it may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. Information last revised October 2017. Copyright(c) 2017 First Databank, Inc.

Carvedilol

Please if you have any questions about Carvedilol, you can ask us by commenting below this text, we'll answer you as soon as possible.

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