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COREG is an alpha-/beta-adrenergic blocking agent indicated for the treatment of:
• mild to severe chronic heart failure (1.1)
• left ventricular dysfunction following myocardial infarction in clinically stable patients (1.2) • hypertension (1.3)
Most common adverse events (6.1):
- Heart failure and left ventricular dysfunction following myocardial infarction (≥10%):
- Dizziness, fatigue, hypotension, diarrhea, hyperglycemia, asthenia, bradycardia, weight increase.
- Hypertension (≥5%): Dizziness.
CYP P450 2D6 enzyme inhibitors may increase and rifampin may decrease carvedilol levels. (7.1, 7.5)
• Hypotensive agents (e.g., reserpine, MAO inhibitors, clonidine) may increase the risk of hypotension and/or severe bradycardia. (7.2)
• Cyclosporine or digoxin levels may increase. (7.3, 7.4)
• Both digitalis glycosides and β-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia. (7.4)
• Amiodarone may increase carvedilol levels resulting in further slowing of the heart rate or cardiac conduction. (7.6)
• Verapamil- or diltiazem-type calcium channel blockers may affect ECG and/or blood pressure. (7.7)
• Insulin and oral hypoglycemics action may be enhanced. (7.8)
Acute exacerbation of coronary artery disease upon cessation of therapy: Do not abruptly discontinue. (5.1)
• Bradycardia, hypotension, worsening heart failure/fluid retention may occur. Reduce the dose as needed. (5.2, 5.3, 5.4)
• Non-allergic bronchospasm (e.g., chronic bronchitis and emphysema): Avoid β-blockers. (4) However, if deemed necessary, use with caution and at lowest effective dose. (5.5)
• Diabetes: Monitor glucose as β-blockers may mask symptoms of hypoglycemia or worsen hyperglycemia. (5.6)
