Monograph Details
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Cardiovascular System
> CHF and arrhythmias
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COREG CR |
| 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 (as phosphate) 10mg, 20mg, 40mg, 80mg; ext-rel caps. |
| Also |
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• COREG
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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 in the AM. Swallow whole or may open caps and sprinkle beads on a spoonful of applesauce and take immediately. ≥18yrs: HF: initally 10mg once daily for 2 weeks, may double dose every 2 weeks if tolerated; max 80mg once daily. Reduce dose if pulse<55. Post-MI: initially 20mg once daily; increase to 40mg once daily after 3–10 days if tolerated; then to target dose of 80mg once daily. Low BP or heart rate, or fluid retention: may start at 10mg once daily. Switching from immediate-release carvedilol: see literature. |
| 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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