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In the U.S.—

Coreg

• Antihypertensive
• congestive heart failure treatment adjunct

Carvedilol (KAR-ve-dil-ole) belongs to a group of medicines called beta-adrenergic blocking agents, beta-blocking agents, or, more commonly, beta-blockers. Beta-blockers work by affecting the response to some nerve impulses in certain parts of the body. As a result, they decrease the heart's need for blood and oxygen by reducing its workload. They also help the heart to beat more regularly.

Carvedilol is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Carvedilol also is used to prevent further worsening of congestive heart failure. Carvedilol may also be used for other conditions as determined by your doctor.

This medicine is available only with your doctor's prescription, in the following dosage form(s):

Oral
• Tablets (U.S.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For carvedilol, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to carvedilol. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Carvedilol has not been studied in pregnant women. However, studies in animals have shown that large doses of carvedilol can cause decreased body weight and skeletal problems in rat fetuses. Before taking this medicine, make sure your doctor knows if you are pregnant or may become pregnant.

Breast-feeding—It is not known if carvedilol passes into breast milk; however, it passes into the milk of lactating rats. Because nursing infants may have a serious reaction to carvedilol, breast-feeding is not recommended in women who are taking this medicine.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of carvedilol in children with use in other age groups.

Older adults—Although this medicine has not been shown to cause different side effects or problems in older people than it does in younger adults, blood levels of carvedilol may be increased in the elderly. Elderly patients also may experience dizziness more frequently than will younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking carvedilol, it is especially important that your health care professional know if you are taking any of the following:

• Antidiabetic agents, sulfonylurea (acetohexamide [e.g., Dymelor], chlorpropamide [e.g., Diabinese], gliclazide [e.g., Diamicron], glipizide [e.g., Glucotrol], glyburide [e.g., DiaBeta, Glynase, or Micronase], tolazamide [e.g., Tolinase], or tolbutamide [e.g., Orinase]) or
• Insulin—Carvedilol may further decrease blood sugar levels

• Calcium channel blocking agents, especially diltiazem (e.g., Cardizem) or verapamil (e.g., Calan)—Carvedilol may make side effects of these medicines worse

Other medical problems—The presence of other medical problems may affect the use of carvedilol. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergic reaction, severe (that involved facial swelling and/or difficulty breathing), history of or
• Asthma or
• Related bronchospastic conditions, other—Carvedilol may cause a greater reaction to substances that aggravate these conditions and less of a response to treatment of the reaction

• Angina (severe chest pain)—Carvedilol may provoke chest pain

• Bronchial conditions, nonallergic or
• Bronchitis, chronic or
• Emphysema—Carvedilol may aggravate these conditions

• Bradycardia (unusually slow heartbeat) or other heart rate problems or
• Heart or blood vessel disease—Carvedilol may make problems resulting from these conditions worse

• Diabetes mellitus (sugar diabetes) or
• Low blood sugar (hypoglycemia)—Carvedilol may aggravate low blood sugar (hypoglycemia) levels caused by insulin and may delay recovery of blood sugar levels; in patients with diabetes and heart failure, carvedilol may further increase blood sugar levels; in addition, if your diabetes medicine causes your blood sugar to be too low, beta-blockers may cover up some of the symptoms (fast heartbeat)

• Kidney disease or
• Liver disease—Effects of carvedilol may be increased because of slower removal from the body

• Overactive thyroid—Carvedilol may cover up symptoms of this condition, such as a fast heartbeat; suddenly stopping carvedilol may provoke symptoms of this condition

Take this medicine exactly as directed. This medicine works best if you take it at the same time each day; however, do not take more of this medicine and do not take it more often than your doctor ordered. Do not miss any doses.

Take this medicine with food.

Do not interrupt or stop taking this medicine without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are taking before stopping completely. Some conditions may become worse when the medicine is stopped suddenly, which can be dangerous.

Dosing—

The dose of carvedilol will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of carvedilol. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking carvedilol.

• For oral dosage form (tablets):
  • Congestive heart failure:
    • Adults—3.125 mg two times a day, taken with food. Your doctor may increase your dose if needed.
    • Children—Use and dose must be determined by your doctor.
  • Hypertension:
    • Adults—6.25 mg two times a day, taken with food. Your doctor may increase your dose if needed.
    • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, it it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

It is important that your doctor check your progress at regular visits. This is to make sure the medicine is working for you and to allow the dosage to be changed if needed.

Do not take other medicines unless they have been discussed with your doctor.

This medicine may cause dizziness, lightheadedness, or fainting. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you experience these effects.

Dizziness, lightheadedness, or fainting can also occur when standing quickly. Sitting or lying down may help alleviate these effects.

Check with your doctor if you become dizzy or if you faint. Your dosage may need to be adjusted.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine.

For diabetic patients:

• This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of hypoglycemia (low blood sugar), such as a rapid pulse rate. Check with your physician if you experience these problems.

For congestive heart failure patients:

• Check with your physician if you experience weight gain or increased shortness of breath. These may be signs of a worsening of your condition.

For patients who wear contact lenses:

• Carvedilol may cause your eyes to form tears less than they do normally. Check with your physician if you experience dry eyes.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• More common
  • Allergy;  chest pain;  dizziness, lightheadedness or fainting;  pain;  shortness of breath;  slow heartbeat ;  generalized swelling or swelling of feet, ankles or lower legs;  weight gain 
  
  

• Less common
  • Blood in urine;  fever;  itching, dark urine, decreased appetite, yellow eyes or skin, flu-like symptoms, and/or tenderness on upper right side of body;  mental depression;  unusual bleeding or bruising 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• More common
  • Back pain;  diarrhea;  prickling or tingling sensation;  unusual tiredness or weakness 
  
  

• Less common
  • Abdominal pain;  blurred vision;  decreased tearing;  headache;  increased sweating;  joint or muscle pain;  nausea;  sore throat ;  stuffy or runny nose;  trouble sleeping;  vomiting 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Developed: 08/13/1998