Carvedilol

(kar' ve dil ol)

Brand Name(s): Coreg^®, Coreg^® CR; also available generically

WHY is this medicine prescribed?

Carvedilol is used alone or in combination with other medications to treat heart failure (condition in which the heart cannot pump enough blood to all parts of the body) and high blood pressure. It also is used to improve survival after a heart attack. Carvedilol is often used in combination with other medications. Carvedilol is in a class of medications called beta-blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure

High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Carvedilol comes as a tablet and an extended-release (long-acting) capsule to take by mouth. The tablet is usually taken twice a day with food. The extended-release capsule is usually taken once a day in the morning with food. Try to take carvedilol at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take carvedilol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the extended-release capsules whole. Do not chew or crush the capsules, and do not divide the beads inside a capsule into more than one dose. If you are unable to swallow the capsules, you may carefully open a capsule and sprinkle all of the beads it contains over a spoonful of cool or room temperature applesauce. Swallow the entire mixture immediately without chewing.

Your doctor will probably start you on a low dose of carvedilol and gradually increase your dose to allow your body to adjust to the medication. Talk to your doctor about how you feel and about any symptoms you experience during this time.

Carvedilol may help to control your condition but will not cure it. Continue taking carvedilol even if you feel well. Do not stop taking carvedilol without talking to your doctor. If you suddenly stop taking carvedilol, you may experience serious heart problems such as severe chest pain, a heart attack, or an irregular heartbeat. Your doctor will probably want to decrease your dose gradually over 1 to 2 weeks. Your doctor will watch you carefully and will probably tell you to avoid physical activity during this time.

What SPECIAL PRECAUTIONS should I follow?

Before taking carvedilol,

The following nonprescription or herbal products may interact with carvedilol: St. John's Wort. Be sure to let your doctor and pharmacist know that you are taking this medication before you start taking carvedilol. Do not start this medication while taking carvedilol without discussing with your healthcare provider.

• tell your doctor and pharmacist if you have are allergic to carvedilol, any other medications, or any of the ingredients in carvedilol tablets and extended- release capsules. Ask your pharmacist for a list of the ingredients.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, herbal products, and nutritional supplements you are taking or plan to take while taking carvedilol. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you have or have ever had asthma or other breathing problems, a slow or irregular heartbeat, heart failure, or liver disease. Your doctor may tell you not to take carvedilol.

• tell your doctor if you have or have ever had problems with blood flow in your feet or legs, diabetes or any other condition that causes you to have low blood sugar, hyperthyroidism (condition in which there is too much thyroid hormone in the body), low blood pressure, Prinzmetal's angina (chest pain that comes at rest with no obvious cause), pheochromocytoma (a tumor that develops on a gland near the kidneys and may cause high blood pressure and fast heartbeat), or heart, kidney, or liver disease. Also tell your doctor if you have ever had a serious allergic reaction to a food or any other substance.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking carvedilol, call your doctor.

• you should know that this medication may make you feel tired, dizzy, or lightheaded, especially when you start taking carvedilol and when your dose is increased. Do not drive a car or operate machinery until you know how this medication affects you. Be especially careful during the first hour after you take the medication.

• you should know that carvedilol may cause dizziness, lightheadedness, and fainting, especially when you get up too quickly from a lying position. This is more common when you first start taking carvedilol. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

• you should know that carvedilol may increase the risk of hypoglycemia (low blood sugar) and prevent the warning signs and symptoms that would tell you that your blood sugar is low. Let your doctor know if you are unable to eat or drink normally or are vomiting while you are taking carvedilol. You should know the symptoms of low blood sugar and what to do if you have these symptoms.

• you should know that if you have allergic reactions to different substances, your reactions may be worse while you are taking carvedilol, and your allergic reactions may not respond to the usual doses of injectable epinephrine.

• if you wear contact lenses, your eyes may become dry during your treatment with carvedilol. Tell your doctor if this becomes bothersome.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Carvedilol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• tiredness
• weakness
• lightheadedness
• dizziness
• headache
• diarrhea
• nausea
• vomiting
• vision changes
• joint pain
• difficulty falling asleep or staying asleep
• stuffy or runny nose
• cough
• dry eyes
• numbness, burning, or tingling in the arms or legs

Some side effects may be serious. If you experience any of the following symptoms, call your doctor immediately:

• fainting
• shortness of breath
• weight gain
• swelling of the arms, hands, feet, ankles, or lower legs
• chest pain
• slow or irregular heartbeat
• rash
• hives
• itching
• swelling of the face, lips, tongue, or throat
• difficulty breathing and swallowing

Carvedilol may cause other side effects. Tell your doctor if you experience any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• slow heartbeat
• dizziness
• fainting
• difficulty breathing
• cough or wheezing
• vomiting
• loss of consciousness
• seizures

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain laboratory tests to check your body's response to carvedilol.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: August 15, 2023.