Monograph Details
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Cardiovascular System
> CHF and arrhythmias
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COREG |
| Manufacturer |
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GlaxoSmithKline Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Noncardioselective β-blocker/α1-blocker. |
| Generic Name |
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Carvedilol 3.125mg, 6.25mg, 12.5mg, 25mg; tabs. |
| Also |
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• COREG CR
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| Indications |
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Mild to severe heart failure (HF), to increase survival and reduce hospitalization risk. To reduce cardiovascular mortality post-MI with left ventricular ejection fraction ≤40%. |
| Children |
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<18 years: not recommended. |
| Adults |
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Take with food. Monitor dose increases closely. ≥18yrs: CHF: initially 3.125mg twice daily for 2 weeks, may double dose every 2 weeks if tolerated; mild to moderate HF (>85kg): usual max 50mg twice daily. Reduce dose if pulse <55. Post-MI: initially 6.25mg twice daily; increase to 12.5mg twice daily after 3–10 days if tolerated; then to target dose 25mg twice daily. Low BP or heart rate, or fluid retention: may start at 3.125mg twice daily. |
| Contraindications |
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Cardiogenic shock or decompensated HF requiring intravenous inotropic therapy. Asthma, related bronchospastic conditions. 2nd or 3rd-degree AV block, sick sinus syndrome, or severe bradycardia, unless paced. Severe hepatic impairment. |
| Precautions |
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Peripheral vascular disease. Nonallergic bronchospasm. Diabetes (monitor blood glucose). Hyperthyroidism. Monitor renal function in ischemic heart disease, diffuse vascular disease, underlying renal insufficiency, and/or if systolic BP <100 mmHg. Initiation of therapy may temporarily worsen signs and symptoms; benefits may be delayed for several weeks; may need increased diuretic dose at first. Avoid abrupt cessation. Prinzmetal's angina. Pheochromocytoma. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
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May be potentiated by CYP2D6 inhibitors (eg, quinidine, fluoxetine, paroxetine, propafenone), alcohol (separate by 2 hours). Bradycardia, hypotension with catecholamine depletors (eg, reserpine, MAOIs). Carvedilol levels reduced by rifampin. Increased absorption with cimetidine. Caution with drugs that affect cardiac conduction (esp. diltiazem, verapamil). May potentiate antidiabetic agents. Monitor digoxin, cyclosporine when changing carvedilol dose. Anesthesia. |
| Adverse Reactions |
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Dizziness, edema, hypotension, syncope, bradycardia, AV block, GI upset, hyperglycemia, weight gain, abnormal vision. |
| How Supplied |
CR caps—30, 90
Tabs—100 |
| Additional Resources |
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• Related Prescribing Note |
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