Dosing & Uses
Dosage Forms & Strengths
capsule, extended release
- 10mg
- 20mg
- 40mg
- 80mg
tablet
- 3.125mg
- 6.25mg
- 12.5mg
- 25mg
Congestive Heart Failure
Immediate release
- 3.125 mg PO q12hr for 2 weeks, then increased every 2 weeks as tolerated to 6.25 mg, 12.5 mg, or 25 mg PO twice daily
- Maximum recommended dosage (mild-to-moderate heart failure): <85 kg, 25 mg PO q12hr; >85 kg: 50 mg PO twice daily
- Maximum recommended dosage (severe heart failure): 25 mg PO twice daily
Extended release
- 10 mg/day PO; maintained for 1-2 weeks if tolerated; may be increased to 20 mg/day, 40 mg/day, or 80 mg/day PO if necessary
Hypertension
Immediate release: 6.25 mg PO twice daily initially; after 7-14 days, increased as tolerated, first to 12.5 mg PO twice daily and then to 25 mg PO twice daily
Extended release: 20 mg/day PO; maintained for 1-2 weeks if tolerated; may be increased to 40 mg/day PO if necessary; not to exceed 80 mg/day PO
Left Ventricular Dysfunction Following Myocardial Infarction
Immediate release: 3.125-6.25 mg PO q12hr initially; after 3-10 days, increased as tolerated, first to 12.5 mg PO q12hr and then to 25 mg PO q12hr (target dosage)
Extended release: 10-20 mg/day PO; increased every 3-10 days as tolerated up to 80 mg/day PO (target dosage)
Angina pectoris
25-50 mg PO twice daily
Dosing Modifications
Renal impairment: No dosage adjustments necessary
Hepatic impairment: Contraindicated in severe liver impairment
Conversion to Extended Release Form
3.125 mg twice daily: Administer 10 mg PO qDay
6.25 mg twice daily: Administer 20 mg PO qDay
12.5 mg twice daily: Administer 40 mg PO qDay
25 mg twice daily: Administer 80 mg PO qDay
Administration
To be taken with food
May break capsule and sprinkle on spoonful of applesauce; to be eaten immediately
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (46)
- acebutolol
acebutolol and carvedilol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- afatinib
carvedilol increases levels of afatinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Reduce afatinib daily dose by 10 mg if not tolerated when coadministered with P-gp inhibitors.
- artemether/lumefantrine
artemether/lumefantrine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
- atenolol
atenolol and carvedilol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- betaxolol
betaxolol and carvedilol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- bisoprolol
bisoprolol and carvedilol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- bosutinib
carvedilol increases levels of bosutinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
- celiprolol
carvedilol and celiprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- chlorpromazine
carvedilol, chlorpromazine. Either increases levels of the other by decreasing metabolism. Contraindicated. Not all beta blockers share this interaction (e.g., atenolol, nadolol, sotalol do not interact).
- colchicine
carvedilol will increase the level or effect of colchicine by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Avoid use of colchicine with P-gp inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with P-gp inhibitors is contraindicated in patients with renal or hepatic impairment.
- dacomitinib
dacomitinib will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities.
- edoxaban
carvedilol will increase the level or effect of edoxaban by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Dose adjustment may be required with strong P-gp inhibitors. DVT/PE treatment: Decrease dose to 30 mg PO once daily. NVAF: No dose reduction recommended
- efavirenz
efavirenz will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug.
- erdafitinib
erdafitinib will increase the level or effect of carvedilol by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration unavoidable, separate administration by at least 6 hr before or after administration of P-gp substrates with narrow therapeutic index.
- esmolol
carvedilol and esmolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- fluoxetine
fluoxetine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
- givosiran
givosiran will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.
- iobenguane I 131
carvedilol will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.
- ivosidenib
ivosidenib will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2C9 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.
- labetalol
carvedilol and labetalol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- lasmiditan
lasmiditan increases levels of carvedilol by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
- lofexidine
lofexidine, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.
- lumefantrine
lumefantrine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
- metoprolol
carvedilol and metoprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- nadolol
carvedilol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- nebivolol
carvedilol and nebivolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- paroxetine
paroxetine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
- penbutolol
carvedilol and penbutolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- pindolol
carvedilol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- pomalidomide
carvedilol increases levels of pomalidomide by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
- propranolol
carvedilol and propranolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- quinidine
quinidine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
- repotrectinib
carvedilol will increase the level or effect of repotrectinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
- rimegepant
carvedilol will increase the level or effect of rimegepant by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
- riociguat
carvedilol will increase the level or effect of riociguat by decreasing metabolism. Avoid or Use Alternate Drug. Coadministration of riociguat (substrate of CYP isoenzymes 1A1, 2C8, 3A, 2J2) with strong CYP inhibitors may require a decreased initial dose of 0.5 mg PO TID; monitor for signs of hypotension and reduce dose if needed
- sotalol
carvedilol and sotalol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- sotorasib
sotorasib will decrease the level or effect of carvedilol by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If use is unavoidable, refer to the prescribing information of the P-gp substrate for dosage modifications.
- talazoparib
carvedilol will increase the level or effect of talazoparib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration with certain P-gp inhibitors (ie, amiodarone, carvedilol, clarithromycin, itraconazole, verapamil) cannot be avoided, reduce talazoparib dose to 0.75 mg qDay. Once P-gp inhibitors are discontinued, increase talazoparib dose (after 3-5 half-lives of the inhibitor) to dose used prior to initiating the P-gp inhibitor(s).
- tepotinib
tepotinib will increase the level or effect of carvedilol by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If concomitant use unavoidable, reduce the P-gp substrate dosage if recommended in its approved product labeling.
- thioridazine
carvedilol, thioridazine. Either increases levels of the other by decreasing metabolism. Contraindicated. Not all beta blockers share this interaction (e.g., atenolol, nadolol, sotalol do not interact).
- thiothixene
carvedilol, thiothixene. Either increases levels of the other by decreasing metabolism. Contraindicated. Not all beta blockers share this interaction (e.g., atenolol, nadolol, sotalol do not interact).
- timolol
carvedilol and timolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- topotecan
carvedilol will increase the level or effect of topotecan by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Product labeling for PO topotecan recommends avoiding concomitant use of P-gp inhibitors; the interaction with IV topotecan may be less severe but is still likely of clinical significance
- umeclidinium bromide/vilanterol inhaled
carvedilol, umeclidinium bromide/vilanterol inhaled. pharmacodynamic antagonism. Avoid or Use Alternate Drug. If a beta-blocker must be used in patients with COPD taking a beta-agonist, consider using a beta-blocker that is beta-1 selective .
- venetoclax
carvedilol will increase the level or effect of venetoclax by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If a P-gp inhibitor must be used, reduce the venetoclax dose by at least 50%. Monitor more closely for signs of venetoclax toxicities.
- vilanterol/fluticasone furoate inhaled
carvedilol, vilanterol/fluticasone furoate inhaled. pharmacodynamic antagonism. Avoid or Use Alternate Drug. If a beta-blocker must be used in patients with COPD taking a beta-agonist, consider using a beta-blocker that is beta-1 selective .
Monitor Closely (251)
- abiraterone
abiraterone increases levels of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.
- acebutolol
acebutolol and carvedilol both increase serum potassium. Use Caution/Monitor.
- aceclofenac
carvedilol and aceclofenac both increase serum potassium. Use Caution/Monitor.
aceclofenac decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - acemetacin
carvedilol and acemetacin both increase serum potassium. Use Caution/Monitor.
acemetacin decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - albuterol
carvedilol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - aldesleukin
aldesleukin increases effects of carvedilol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- alfuzosin
alfuzosin and carvedilol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- aluminum hydroxide
aluminum hydroxide decreases levels of carvedilol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- amifostine
amifostine, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.
- amiloride
carvedilol and amiloride both increase serum potassium. Modify Therapy/Monitor Closely.
- amiodarone
amiodarone will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
amiodarone will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Monitor for signs of bradycardia or heart block when amiodarone and a beta adrenergic blocker are coadministered. Amiodarone should be used with caution in patients receiving a beta adrenergic blocker, particularly if there is suspicion of underlying dysfunction of the sinus node, such as bradycardia or sick sinus syndrome, or if there is partial AV block.
amiodarone, carvedilol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of cardiotoxicity with bradycardia. - amlodipine
carvedilol and amlodipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- amobarbital
amobarbital will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
amobarbital decreases levels of carvedilol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of amobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers. - apalutamide
apalutamide will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Coadministration of apalutamide, a weak CYP2C9 inducer, with drugs that are CYP2C9 substrates can result in lower exposure to these medications. Evaluate for loss of therapeutic effect if medication must be coadministered.
apalutamide will decrease the level or effect of carvedilol by increasing elimination. Use Caution/Monitor. Apalutamide induces UGT and may decrease systemic exposure of drugs that are UGT substrates. - arformoterol
carvedilol increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of arformoterol by pharmacodynamic antagonism. Use Caution/Monitor. - asenapine
asenapine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
asenapine and carvedilol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. - aspirin
carvedilol and aspirin both increase serum potassium. Use Caution/Monitor.
aspirin decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - aspirin rectal
carvedilol and aspirin rectal both increase serum potassium. Use Caution/Monitor.
aspirin rectal decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
carvedilol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - atazanavir
atazanavir increases effects of carvedilol by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypotension, bradycardia, AV block, and prolonged PR interval. Consider lowering beta blocker dose.
- atenolol
atenolol and carvedilol both increase serum potassium. Use Caution/Monitor.
- avanafil
avanafil increases effects of carvedilol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- bendroflumethiazide
carvedilol increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- berotralstat
carvedilol increases levels of berotralstat by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Reduced berotralstat dose to 110 mg/day when coadministered with P-gp inhibitors.
berotralstat will increase the level or effect of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor or titrate P-gp substrate dose if coadministered. - betaxolol
betaxolol and carvedilol both increase serum potassium. Use Caution/Monitor.
- betrixaban
carvedilol increases levels of betrixaban by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Decrease betrixaban dose to 80 mg PO once, then 40 mg PO qDay if coadministered with a P-gp inhibitor.
- bismuth subsalicylate
bismuth subsalicylate, carvedilol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Blockage of renal prostaglandin synthesis; may cause severe hypertension.
- bisoprolol
bisoprolol and carvedilol both increase serum potassium. Use Caution/Monitor.
- bosentan
bosentan will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- bosutinib
bosutinib increases levels of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- bretylium
carvedilol, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.
- bumetanide
carvedilol increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bupropion
bupropion will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- butabarbital
butabarbital will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
butabarbital decreases levels of carvedilol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butabarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers. - butalbital
butalbital will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
butalbital decreases levels of carvedilol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butalbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers. - calcium acetate
calcium acetate decreases effects of carvedilol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium carbonate
calcium carbonate decreases effects of carvedilol by unspecified interaction mechanism. Use Caution/Monitor.
calcium carbonate decreases levels of carvedilol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours. - calcium chloride
calcium chloride decreases effects of carvedilol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium citrate
calcium citrate decreases effects of carvedilol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium gluconate
calcium gluconate decreases effects of carvedilol by unspecified interaction mechanism. Use Caution/Monitor.
- candesartan
candesartan and carvedilol both increase serum potassium. Use Caution/Monitor.
carvedilol, candesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - cannabidiol
cannabidiol will increase the level or effect of carvedilol by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C9 activity. Consider reducing the dose when concomitantly using CYP2C9 substrates.
- carbamazepine
carbamazepine will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- carbenoxolone
carvedilol increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbidopa
carbidopa increases effects of carvedilol by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.
- celecoxib
celecoxib will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
carvedilol and celecoxib both increase serum potassium. Use Caution/Monitor.
celecoxib decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - celiprolol
carvedilol and celiprolol both increase serum potassium. Use Caution/Monitor.
- ceritinib
carvedilol increases levels of ceritinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- chloroquine
chloroquine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- chlorothiazide
carvedilol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorthalidone
carvedilol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- choline magnesium trisalicylate
carvedilol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
choline magnesium trisalicylate decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - cimetidine
cimetidine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
cimetidine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. - citalopram
citalopram increases levels of carvedilol by decreasing metabolism. Use Caution/Monitor.
- clevidipine
carvedilol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- clobazam
clobazam will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly.
- cobicistat
cobicistat will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- crizotinib
crizotinib increases levels of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- cyclopenthiazide
carvedilol increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dabigatran
carvedilol will increase the level or effect of dabigatran by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Atrial fibrillation: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <30 mL/min. DVT/PE treatment: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <50 mL/min
- darifenacin
darifenacin will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- darunavir
darunavir will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- desflurane
desflurane, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- desvenlafaxine
desvenlafaxine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mg
- dichlorphenamide
dichlorphenamide and carvedilol both decrease serum potassium. Use Caution/Monitor.
- diclofenac
carvedilol and diclofenac both increase serum potassium. Use Caution/Monitor.
diclofenac decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - diflunisal
carvedilol and diflunisal both increase serum potassium. Use Caution/Monitor.
diflunisal decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - digoxin
carvedilol and digoxin both increase serum potassium. Use Caution/Monitor.
carvedilol increases levels of digoxin by enhancing GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
carvedilol increases levels of digoxin by decreasing renal clearance. Use Caution/Monitor.
carvedilol increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Enhanced bradycardia. - diltiazem
carvedilol and diltiazem both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- diphenhydramine
diphenhydramine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- dobutamine
carvedilol increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of dobutamine by pharmacodynamic antagonism. Use Caution/Monitor. - dopexamine
carvedilol increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of dopexamine by pharmacodynamic antagonism. Use Caution/Monitor. - doxazosin
doxazosin and carvedilol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- dronedarone
dronedarone will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- drospirenone
carvedilol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.
- duvelisib
carvedilol will increase the level or effect of duvelisib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- elagolix
elagolix will increase the level or effect of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- eliglustat
eliglustat increases levels of carvedilol by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect.
eliglustat increases levels of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect. - elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.
elvitegravir/cobicistat/emtricitabine/tenofovir DF decreases levels of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Elvitegravir is a moderate CYP2C9 inducer. - ephedrine
carvedilol increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of ephedrine by pharmacodynamic antagonism. Use Caution/Monitor. - epinephrine
carvedilol increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of epinephrine by pharmacodynamic antagonism. Use Caution/Monitor. - epinephrine racemic
carvedilol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. - eprosartan
eprosartan and carvedilol both increase serum potassium. Use Caution/Monitor.
carvedilol, eprosartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - esmolol
carvedilol and esmolol both increase serum potassium. Use Caution/Monitor.
- ethacrynic acid
carvedilol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ethanol
ethanol increases levels of carvedilol by Other (see comment). Use Caution/Monitor. Comment: ETOH may affect the release rate of extended-release carvedilol (Coreg CR), resulting in higher peak plasma concentration. Separate by 2 hr. Immediate-release carvedilol (Coreg) not affected.
- ether
carvedilol, ether. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both beta blockers and ether depress the myocardium; consider lowering beta blocker dose if ether used for anesthesia.
- etodolac
carvedilol and etodolac both increase serum potassium. Use Caution/Monitor.
etodolac decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - etomidate
etomidate, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- etrasimod
etrasimod, carvedilol. pharmacodynamic synergism. Use Caution/Monitor. Transient decrease in heart rate and AV conduction delays may occur when initiating etrasimod. Concomitant use of etrasimod in patients receiving stable beta-blocker treatment did not result in additive effects on heart rate reduction. However, risk of additive heart rate reduction following initiation of beta-blocker therapy with stable etrasimod treatment or concomitant use with other drugs that may decrease heart rate is unknown. .
- etravirine
etravirine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- fedratinib
fedratinib will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary.
- felbamate
felbamate will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- felodipine
carvedilol and felodipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- fenbufen
carvedilol and fenbufen both increase serum potassium. Use Caution/Monitor.
- fenoprofen
carvedilol and fenoprofen both increase serum potassium. Use Caution/Monitor.
fenoprofen decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - fingolimod
carvedilol increases effects of fingolimod by pharmacodynamic synergism. Use Caution/Monitor. Both medications decrease heart rate. Monitor patients on concomitant therapy, particularly in the first 6 hours after fingolimod is initiated or after a treatment interruption of at least two weeks, for bradycardia and atrioventricular block. To identify underlying risk factors of bradycardia and AV block, obtain a new or recent ECG in patients using beta-blockers prior to starting fingolimod.
- fluconazole
fluconazole will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- fluoxetine
fluoxetine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- flurbiprofen
carvedilol and flurbiprofen both increase serum potassium. Use Caution/Monitor.
flurbiprofen decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - fluvoxamine
fluvoxamine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- formoterol
carvedilol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - fostamatinib
fostamatinib will increase the level or effect of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Concomitant use of fostamatinib may increase concentrations of P-gp substrates. Monitor for toxicities of the P-gp substrate drug that may require dosage reduction when given concurrently with fostamatinib.
- furosemide
carvedilol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- gentamicin
carvedilol increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- glecaprevir/pibrentasvir
carvedilol will increase the level or effect of glecaprevir/pibrentasvir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
glecaprevir/pibrentasvir will increase the level or effect of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - glucagon
glucagon decreases toxicity of carvedilol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.
- glucagon intranasal
glucagon intranasal decreases toxicity of carvedilol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.
- haloperidol
haloperidol will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- hydralazine
hydralazine increases effects of carvedilol by pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects.
carvedilol increases effects of hydralazine by pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects. - hydrochlorothiazide
carvedilol increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ibuprofen
carvedilol and ibuprofen both increase serum potassium. Use Caution/Monitor.
ibuprofen decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ibuprofen IV
ibuprofen IV decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
carvedilol and ibuprofen IV both increase serum potassium. Use Caution/Monitor. - imatinib
imatinib will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
imatinib will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. - indapamide
carvedilol increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- indomethacin
carvedilol and indomethacin both increase serum potassium. Use Caution/Monitor.
indomethacin decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - insulin degludec
carvedilol, insulin degludec. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- insulin degludec/insulin aspart
carvedilol, insulin degludec/insulin aspart. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- insulin inhaled
carvedilol, insulin inhaled. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- iodixanol
carvedilol increases toxicity of iodixanol by unspecified interaction mechanism. Use Caution/Monitor. Use of beta-blockers lowers the threshold for and increases the severity of contrast reactions, and reduces the responsiveness of treatment of hypersensitivity reactions with epinephrine. .
- irbesartan
irbesartan and carvedilol both increase serum potassium. Use Caution/Monitor.
carvedilol, irbesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - isoproterenol
carvedilol increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of isoproterenol by pharmacodynamic antagonism. Use Caution/Monitor. - isradipine
carvedilol and isradipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- istradefylline
istradefylline will increase the level or effect of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of P-gp substrates in clinical trials. Consider dose reduction of sensitive P-gp substrates.
- ivabradine
ivabradine, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Most patients receiving ivabradine will also be treated with a beta-blocker. The risk of bradycardia increases with coadministration of drugs that slow heart rate (eg, digoxin, amiodarone, beta-blockers). Monitor heart rate in patients taking ivabradine with other negative chronotropes.
- ivacaftor
ivacaftor increases levels of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Ivacaftor and its M1 metabolite has the potential to inhibit P-gp; may significantly increase systemic exposure to sensitive P-gp substrates with a narrow therapeutic index.
- ketamine
ketamine, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- ketoconazole
ketoconazole will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- ketoprofen
carvedilol and ketoprofen both increase serum potassium. Use Caution/Monitor.
ketoprofen decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ketorolac
carvedilol and ketorolac both increase serum potassium. Use Caution/Monitor.
ketorolac decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ketorolac intranasal
carvedilol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - labetalol
carvedilol and labetalol both increase serum potassium. Use Caution/Monitor.
- lasmiditan
carvedilol increases effects of lasmiditan by pharmacodynamic synergism. Use Caution/Monitor. Lasmiditan has been associated with a lowering of heart rate (HR). In a drug interaction study, addition of a single 200-mg dose of lasmiditan to propranolol decreased HR by an additional 5 bpm compared to propranolol alone, for a mean maximum of 19 bpm.
- leflunomide
leflunomide will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- levalbuterol
carvedilol increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of levalbuterol by pharmacodynamic antagonism. Use Caution/Monitor. - levodopa
levodopa increases effects of carvedilol by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.
- levoketoconazole
levoketoconazole will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- lomitapide
lomitapide increases levels of carvedilol by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing dose when used concomitantly with lomitapide.
- lorcaserin
lorcaserin will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- lornoxicam
carvedilol and lornoxicam both increase serum potassium. Use Caution/Monitor.
lornoxicam decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - losartan
losartan and carvedilol both increase serum potassium. Use Caution/Monitor.
carvedilol, losartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - lumacaftor/ivacaftor
lumacaftor/ivacaftor, carvedilol. affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C9 substrates. .
- lurasidone
lurasidone increases effects of carvedilol by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.
- maraviroc
maraviroc will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- marijuana
marijuana will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- meclofenamate
meclofenamate decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
carvedilol and meclofenamate both increase serum potassium. Use Caution/Monitor. - mefenamic acid
carvedilol and mefenamic acid both increase serum potassium. Use Caution/Monitor.
mefenamic acid decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - mefloquine
mefloquine increases levels of carvedilol by decreasing metabolism. Use Caution/Monitor. Risk of arrhythmia.
- meloxicam
carvedilol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - metaproterenol
carvedilol increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of metaproterenol by pharmacodynamic antagonism. Use Caution/Monitor. - methyclothiazide
carvedilol increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- metolazone
carvedilol increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metoprolol
carvedilol and metoprolol both increase serum potassium. Use Caution/Monitor.
- metronidazole
metronidazole will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- miconazole vaginal
miconazole vaginal will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- mirabegron
mirabegron will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- moxisylyte
moxisylyte and carvedilol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nabumetone
carvedilol and nabumetone both increase serum potassium. Use Caution/Monitor.
nabumetone decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - nadolol
carvedilol and nadolol both increase serum potassium. Use Caution/Monitor.
- naldemedine
carvedilol increases levels of naldemedine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor naldemedine for potential adverse effects if coadministered with P-gp inhibitors.
- naproxen
carvedilol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - nateglinide
nateglinide will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- nebivolol
carvedilol and nebivolol both increase serum potassium. Use Caution/Monitor.
- nicardipine
carvedilol and nicardipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nifedipine
carvedilol and nifedipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nilotinib
nilotinib will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
nilotinib will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. - nintedanib
carvedilol increases levels of nintedanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. If nintedanib adverse effects occur, management may require interruption, dose reduction, or discontinuation of therapy.
- nisoldipine
carvedilol and nisoldipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nitisinone
nitisinone will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Nitisinone inhibits CYP2C9. Caution if CYP2C9 substrate coadministered, particularly those with a narrow therapeutic index.
- nitroglycerin rectal
nitroglycerin rectal, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Beta-blockers blunt the reflex tachycardia produced by nitroglycerin without preventing its hypotensive effects. If beta-blockers are used with nitroglycerin in patients with angina pectoris, additional hypotensive effects may occur.
- norepinephrine
carvedilol increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of norepinephrine by pharmacodynamic antagonism. Use Caution/Monitor. - olmesartan
olmesartan and carvedilol both increase serum potassium. Use Caution/Monitor.
carvedilol, olmesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - olodaterol inhaled
carvedilol, olodaterol inhaled. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor. Beta-blockers and olodaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.
- oxaprozin
carvedilol and oxaprozin both increase serum potassium. Use Caution/Monitor.
oxaprozin decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - oxymetazoline topical
oxymetazoline topical increases and carvedilol decreases sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- parecoxib
parecoxib will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
carvedilol and parecoxib both increase serum potassium. Use Caution/Monitor.
parecoxib decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - patiromer
patiromer will decrease the level or effect of carvedilol by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- penbutolol
carvedilol and penbutolol both increase serum potassium. Use Caution/Monitor.
- pentobarbital
pentobarbital will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
pentobarbital decreases levels of carvedilol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of pentobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers. - perphenazine
perphenazine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- phenobarbital
phenobarbital will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
phenobarbital decreases levels of carvedilol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of phenobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers. - phenoxybenzamine
phenoxybenzamine and carvedilol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- phentolamine
phentolamine and carvedilol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- pindolol
carvedilol and pindolol both increase serum potassium. Use Caution/Monitor.
- pirbuterol
carvedilol increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of pirbuterol by pharmacodynamic antagonism. Use Caution/Monitor. - piroxicam
carvedilol and piroxicam both increase serum potassium. Use Caution/Monitor.
piroxicam decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ponatinib
ponatinib increases levels of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- ponesimod
ponesimod and carvedilol both increase pharmacodynamic synergism. Use Caution/Monitor. Beta-blockers may have additive effects on lowering HR. Consider resting HR before initiating ponesimod in patients on stable dose of beta-blocker. Refer to the ponesimod prescribing information for more dosing information.
- potassium acid phosphate
carvedilol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium chloride
carvedilol and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium citrate
carvedilol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- prazosin
prazosin and carvedilol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- primidone
primidone will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
primidone decreases levels of carvedilol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of primidone. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers. - propafenone
propafenone will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- propofol
propofol, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- propranolol
carvedilol and propranolol both increase serum potassium. Use Caution/Monitor.
- quinacrine
quinacrine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- ranolazine
ranolazine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- rifabutin
rifabutin decreases levels of carvedilol by increasing metabolism. Use Caution/Monitor.
- rifampin
rifampin will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
rifampin decreases levels of carvedilol by increasing metabolism. Use Caution/Monitor. - rifapentine
rifapentine will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
rifapentine decreases levels of carvedilol by increasing metabolism. Use Caution/Monitor. - rifaximin
carvedilol increases levels of rifaximin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- ritonavir
ritonavir will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- rolapitant
rolapitant will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.
- rucaparib
rucaparib will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C9 substrates, if clinically indicated.
- sacubitril/valsartan
sacubitril/valsartan and carvedilol both increase serum potassium. Use Caution/Monitor.
carvedilol, sacubitril/valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - salicylates (non-asa)
carvedilol and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor.
salicylates (non-asa) decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - salmeterol
carvedilol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. - salsalate
carvedilol and salsalate both increase serum potassium. Use Caution/Monitor.
salsalate decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - saquinavir
saquinavir, carvedilol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Use alternatives if available. Increased risk of PR prolongation and cardiac arrhythmias.
- sarecycline
sarecycline will increase the level or effect of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor for toxicities of P-gp substrates that may require dosage reduction when coadministered with P-gp inhibitors.
- secobarbital
secobarbital will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
secobarbital decreases levels of carvedilol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of secobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers. - sertraline
sertraline will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- sevoflurane
sevoflurane, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- sildenafil
carvedilol increases effects of sildenafil by additive vasodilation. Use Caution/Monitor. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy.
- silodosin
silodosin and carvedilol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- siponimod
siponimod, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Caution when siponimod is initiated in patients receiving beta-blocker treatment because of additive effects on lowering heart rate. Temporary interruption of beta-blocker may be needed before initiating siponimod. Beta-blocker treatment can be initiated in patients receiving stable doses of siponimod.
- sodium bicarbonate
sodium bicarbonate decreases levels of carvedilol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- sodium citrate/citric acid
sodium citrate/citric acid decreases levels of carvedilol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- sotalol
carvedilol and sotalol both increase serum potassium. Use Caution/Monitor.
- sparsentan
sparsentan will decrease the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Sparsentan (a CYP2C9 inducer) decreases exposure of CYP2C9 substrates and reduces efficacy related to these substrates.
- spironolactone
carvedilol and spironolactone both increase serum potassium. Modify Therapy/Monitor Closely.
- stiripentol
stiripentol will increase the level or effect of carvedilol by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.
- succinylcholine
carvedilol and succinylcholine both increase serum potassium. Use Caution/Monitor.
- sulfamethoxazole
sulfamethoxazole will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- sulfasalazine
carvedilol and sulfasalazine both increase serum potassium. Use Caution/Monitor.
sulfasalazine decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - sulindac
carvedilol and sulindac both increase serum potassium. Use Caution/Monitor.
sulindac decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tadalafil
tadalafil increases effects of carvedilol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- telmisartan
telmisartan and carvedilol both increase serum potassium. Use Caution/Monitor.
carvedilol, telmisartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - terazosin
terazosin and carvedilol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- terbinafine
terbinafine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.
- terbutaline
carvedilol increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of terbutaline by pharmacodynamic antagonism. Use Caution/Monitor. - theophylline
carvedilol, theophylline. Other (see comment). Use Caution/Monitor. Comment: Beta blockers (esp. non selective) antagonize theophylline effects, while at the same time increasing theophylline levels and toxicity (mechanism: decreased theophylline metabolism). Smoking increases risk of interaction.
- thioridazine
thioridazine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- ticlopidine
ticlopidine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- timolol
carvedilol and timolol both increase serum potassium. Use Caution/Monitor.
- tipranavir
tipranavir will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- tolfenamic acid
carvedilol and tolfenamic acid both increase serum potassium. Use Caution/Monitor.
tolfenamic acid decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tolmetin
carvedilol and tolmetin both increase serum potassium. Use Caution/Monitor.
tolmetin decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tolvaptan
carvedilol and tolvaptan both increase serum potassium. Use Caution/Monitor.
- torsemide
carvedilol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- triamterene
carvedilol and triamterene both increase serum potassium. Modify Therapy/Monitor Closely.
- tucatinib
tucatinib will increase the level or effect of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities.
- valproic acid
valproic acid will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- valsartan
valsartan and carvedilol both increase serum potassium. Use Caution/Monitor.
carvedilol, valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - vemurafenib
vemurafenib increases levels of carvedilol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- venlafaxine
venlafaxine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- verapamil
carvedilol and verapamil both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- voriconazole
voriconazole will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- xipamide
xipamide increases effects of carvedilol by pharmacodynamic synergism. Use Caution/Monitor.
- zafirlukast
zafirlukast will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
Minor (30)
- adenosine
carvedilol, adenosine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Bradycardia.
- agrimony
agrimony increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- brimonidine
brimonidine increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- cevimeline
cevimeline increases effects of carvedilol by unspecified interaction mechanism. Minor/Significance Unknown.
- ciprofloxacin
ciprofloxacin increases levels of carvedilol by decreasing metabolism. Minor/Significance Unknown. May also rarely decrease beta blocker levels.
- cocaine topical
carvedilol increases effects of cocaine topical by pharmacodynamic synergism. Minor/Significance Unknown. Risk of angina.
- cornsilk
cornsilk increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- dihydroergotamine
dihydroergotamine, carvedilol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.
- dihydroergotamine intranasal
dihydroergotamine intranasal, carvedilol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.
- dipyridamole
dipyridamole, carvedilol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of bradycardia.
- duloxetine
duloxetine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- escitalopram
escitalopram increases levels of carvedilol by decreasing metabolism. Minor/Significance Unknown.
- fenoldopam
fenoldopam increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
- forskolin
forskolin increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- imaging agents (gadolinium)
carvedilol, imaging agents (gadolinium). Mechanism: unknown. Minor/Significance Unknown. Increased risk of anaphylaxis from contrast media.
- levobetaxolol
levobetaxolol increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- maitake
maitake increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- metipranolol ophthalmic
metipranolol ophthalmic increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- neostigmine
carvedilol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- noni juice
carvedilol and noni juice both increase serum potassium. Minor/Significance Unknown.
- octacosanol
octacosanol increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- omeprazole
omeprazole will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- physostigmine
carvedilol, physostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- pilocarpine
pilocarpine increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- reishi
reishi increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- shepherd's purse
shepherd's purse, carvedilol. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.
- tizanidine
tizanidine increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.
- treprostinil
treprostinil increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- vardenafil
vardenafil increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.
- yohimbe
carvedilol decreases toxicity of yohimbe by pharmacodynamic antagonism. Minor/Significance Unknown.
Adverse Effects
>10%
Dizziness (2-32%)
Fatigue (4-24%)
Hypotension (9-20%)
Weight gain (10-12%)
Hyperglycemia (5-12%)
Diarrhea (1-12%)
1-10% (selected)
Bradycardia (2-10%)
Nausea (2-9%)
Cough (5-8%)
Headache (5-8%)
Atrioventricular block, edema (1-7%)
Angina (1-6%)
Hpercholesterolemia (1-4%)
Hypertriglyceredemia (1%)
Vomiting (1-6%)
Dyspnea (>3%)
Syncope (3%)
Rhinitis (2%)
Frequency Not Defined (selected)
Hypertension
Palpitations
Insomnia
Somnolence
Skin rash
Hepatotoxicity
Impotence
Bronchospasm
Rales
Depression
Decreased exercise tolerance
Raynaud phenomenon
Increased triglyceride levels and insulin resistance with decreased high-density lipoprotein (HDL) levels
Postmarketing Reports
Blood and lymphatic system: Aplastic anemia
Immune system: Hypersensitivity (eg, anaphylactic reactions, angioedema, urticaria) with Coreg and Coreg CR, including cases occurring after initiation of Coreg CR in patients previously treated with Coreg
Kidneys and urinary tract: Urinary incontinence
Respiratory system, thorax, and mediastinum: Interstitial pneumonitis
Skin and subcutaneous tissue: Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme
Warnings
Contraindications
History of serious hypersensitivity reaction (eg, Stevens-Johnson syndrome, anaphylactic reaction, angioedema) to any component of this medication or other medications containing carvedilol
Bronchial asthma, bronchospasm
Chronic obstructive pulmonary disease (COPD)
2°/3° AV block, sick sinus syndrome without permanent pacemaker, cardiogenic shock, severe bradycardia, decompensated heart failure requiring IV inotropic medication
Severe hepatic impairment
Cautions
Use cautioin in anesthesia or surgery (myocardial depression), cerebrovascular insufficiency, diabetes mellitus, hyperthyroidism or thyrotoxicosis, liver disease, peripheral vascular disease (monitor for progression of arterial obstruction), compromised left ventricular function, heart failure, pheochromocytoma, and myasthenia gravis
Avoid beta-blocker use in non-allergic bronchospasm (e.g., chronic bronchitis and emphysema); if deemed necessary, use with caution and at lowest effective dose
Combined incidence of hypotension, syncope, or dizziness reported in elderly patients (>65 years) switched from highest dose of immediate-release carvedilol (25 mg q12hr) to extended-release carvedilol 80 mg/day
When elderly patients are switched from higher doses of immediate-release carvedilol to extended-release carvedilol, a lower starting dose is recommended
Sudden discontinuance can exacerbate angina and lead to myocardial infarction
Increased risk of stroke after surgery
Dosage should be reduced if bradycardia (HR <55 beats/min) develops
May mask hyperthyroidism
May worsen arterial insufficiency in patients with peripheral vascular disease
Use caution in patients with mild to moderate hepatic impairment
Heart failure patients may experience a worsening of renal function, especially during upward titration; dose reduction or temporary discontinuation may be necessary; may also need to adjust other medications
Separate any form of alcohol intake by at least 2 hours (extended-release)
Elderly (liver function)
Intraoperative floppy iris syndrome observed during cataract surgery in some patients treated with alpha1-blocking agents
Beta-blockers may cause induction or exacerbation of psoriasis
Beta-blockers may prevent early warning signs of hypoglycemia, such as tachycardia, and increase risk for severe or prolonged hypoglycemia at any time during treatment, especially in patients with diabetes mellitus or children and patients who are fasting (eg, surgery, not eating regularly, or are vomiting); if severe hypoglycemia occurs, patients should be instructed to seek emergency treatment
Pregnancy & Lactation
Pregnancy
Available data in pregnant women are insufficient to determine whether there are drug-associated risks of adverse developmental outcomes; there are risks to mother and fetus associated with poorly controlled hypertension in pregnancy; the use of beta blockers during third trimester of pregnancy may increase risk of hypotension, bradycardia, hypoglycemia, and respiratory depression in neonates; in animal reproduction studies, there was no evidence of adverse developmental outcomes at clinically relevant doses; observe newborns for symptoms of hypotension, bradycardia, hypoglycemia, and respiratory depression and manage accordingly
Hypertension in pregnancy increases maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (e.g., need for cesarean section and post-partum hemorrhage); hypertension increases fetal risk for intrauterine growth restriction and intrauterine death; pregnant women with hypertension should be carefully monitored and managed accordingly
Lactation
There are no data on presence of carvedilol in human milk, effects on breastfed infant, or on milk production; drug is present in the milk of lactating rats; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from treatment or from underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Nonselective beta-adrenergic and alpha1-adrenergic blocking agent with no intrinsic activity for use in congestive heart failure and hypertension
Absorption
Bioavailability: 25-35% (immediate release)
Onset (antihypertensive): Initial response, 1 hr; peak response, 1-2 hr
Duration: 24 hr
Peak plasma time: 5 hr
Distribution
Protein bound: >98%
Vd: 115-132 L
Metabolism
Metabolized by CYP2D6 and CYP2C9 and, to a lesser extent, by CYP3A4, 2C19, 1A2, and 2E1
Metabolites: 4'-Hydroxyphenyl metabolite is approximately 13 times more potent than carvedilol for beta blockade
Elimination
Half-life: 7-10 hr
Dialyzable: HD, no
Excretion: Feces (60%), urine (16%)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| carvedilol oral - | 12.5 mg tablet |  | |
| carvedilol oral - | 25 mg tablet |  | |
| carvedilol oral - | 12.5 mg tablet |  | |
| carvedilol oral - | 3.125 mg tablet |  | |
| carvedilol oral - | 25 mg tablet |  | |
| carvedilol oral - | 25 mg tablet |  | |
| carvedilol oral - | 3.125 mg tablet |  | |
| carvedilol oral - | 12.5 mg tablet |  | |
| carvedilol oral - | 6.25 mg tablet |  | |
| carvedilol oral - | 3.125 mg tablet |  | |
| carvedilol oral - | 3.125 mg tablet |  | |
| carvedilol oral - | 12.5 mg tablet |  | |
| carvedilol oral - | 3.125 mg tablet |  | |
| carvedilol oral - | 6.25 mg tablet |  | |
| carvedilol oral - | 6.25 mg tablet |  | |
| carvedilol oral - | 3.125 mg tablet |  | |
| carvedilol oral - | 6.25 mg tablet |  | |
| carvedilol oral - | 12.5 mg tablet |  | |
| carvedilol oral - | 25 mg tablet |  | |
| carvedilol oral - | 6.25 mg tablet |  | |
| carvedilol oral - | 25 mg tablet |  | |
| carvedilol oral - | 25 mg tablet |  | |
| carvedilol oral - | 25 mg tablet |  | |
| carvedilol oral - | 12.5 mg tablet |  | |
| carvedilol oral - | 6.25 mg tablet |  | |
| carvedilol oral - | 3.125 mg tablet |  | |
| carvedilol oral - | 12.5 mg tablet |  | |
| carvedilol oral - | 6.25 mg tablet |  | |
| carvedilol oral - | 3.125 mg tablet |  | |
| carvedilol oral - | 25 mg tablet |  | |
| carvedilol oral - | 12.5 mg tablet |  | |
| carvedilol oral - | 6.25 mg tablet |  | |
| carvedilol oral - | 12.5 mg tablet |  | |
| carvedilol oral - | 12.5 mg tablet |  | |
| carvedilol oral - | 3.125 mg tablet |  | |
| carvedilol oral - | 3.125 mg tablet |  | |
| carvedilol oral - | 25 mg tablet |  | |
| carvedilol oral - | 25 mg tablet |  | |
| carvedilol oral - | 25 mg tablet |  | |
| carvedilol oral - | 6.25 mg tablet |  | |
| carvedilol oral - | 6.25 mg tablet |  | |
| Coreg oral - | 6.25 mg tablet |  | |
| Coreg oral - | 12.5 mg tablet |  | |
| Coreg oral - | 3.125 mg tablet |  | |
| Coreg oral - | 25 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
carvedilol oral
CARVEDILOL - ORAL
(KAR-ve-DIL-ol)
COMMON BRAND NAME(S): Coreg
WARNING: Do not stop taking this medication without consulting your doctor. Some conditions may become worse when you suddenly stop this drug. Some people who have suddenly stopped taking similar drugs have had chest pain, heart attack, and irregular heartbeat. If your doctor decides you should no longer use this drug, your doctor may direct you to gradually decrease your dose over 1 to 2 weeks.When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Get medical help right away if you develop chest pain/tightness/pressure, chest pain spreading to the jaw/neck/arm, unusual sweating, trouble breathing, or fast/irregular heartbeat.
USES: Carvedilol is used to treat high blood pressure and heart failure. It is also used after a heart attack to improve the chance of survival if your heart is not pumping well. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.This drug works by blocking the action of certain natural substances in your body, such as epinephrine, on the heart and blood vessels. This effect lowers your heart rate, blood pressure, and strain on your heart. Carvedilol belongs to a class of drugs known as alpha and beta blockers.
HOW TO USE: See also Warning section.Read the Patient Information Leaflet if available from your pharmacist before you start taking carvedilol and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with food as directed by your doctor, usually twice daily.The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.For the treatment of high blood pressure, it may take 1 to 2 weeks before you get the full benefit of this drug. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings remain high or increase, or you have worsening symptoms of heart failure like increased shortness of breath).
SIDE EFFECTS: See also Warning and Precautions sections.Dizziness, lightheadedness, drowsiness, diarrhea, impotence, or tiredness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. The risk of dizziness is highest within 1 hour after you take your dose. Taking this medication with food and starting treatment with a low dose and slowly increasing your dose as directed by your doctor help to reduce the risk of dizziness.This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: very slow heartbeat, severe dizziness, fainting, unusual weakness, signs of kidney problems (such as change in the amount of urine), numbness/tingling of the hands/feet, blue fingers/toes, easy bruising/bleeding, mental/mood changes (such as confusion, depression), seizures.Although this medication may be used to treat heart failure, some people may rarely develop new or worsening symptoms of heart failure, especially at the start of carvedilol treatment. Tell your doctor right away if you develop any of these serious side effects: shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking carvedilol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain types of heartbeat/heart rhythm problems (such as slow/irregular heartbeat, sick sinus syndrome, second- or third-degree atrioventricular block), breathing problems (such as asthma, chronic bronchitis, emphysema), severe heart failure requiring hospitalization, liver disease, kidney disease, blood circulation problems (such as Raynaud's disease, peripheral vascular disease), serious allergic reactions including those needing treatment with epinephrine, overactive thyroid disease (hyperthyroidism), a certain type of tumor (pheochromocytoma), other heart problems (such as Prinzmetal's variant angina), a certain muscle disease (myasthenia gravis), certain eye problems (cataracts, glaucoma).This drug may make you dizzy or drowsy or cause you to faint. This is most likely to occur within 1 hour after taking your dose, especially when you start carvedilol treatment or any time your doctor increases your dose. During these periods, avoid driving and doing hazardous tasks. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).People who wear contact lenses may have dry eyes while taking this medication.Before having surgery (including cataract/glaucoma eye surgery), tell your doctor or dentist if you are taking or have ever taken this medication, and about all the other products you use (including prescription drugs, nonprescription drugs, and herbal products).This product may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). The risk is higher if you have diabetes, or are vomiting, fasting, or not eating regularly. Other symptoms of low blood sugar level, such as dizziness and sweating, are not affected by this drug.If you have diabetes, this product may make it harder to control your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Children may be at greater risk for low blood sugar (hypoglycemia) while using this drug, especially if they are vomiting or not eating regularly. To help prevent low blood sugar, make sure children eat regularly. If your child cannot eat regularly, is vomiting, or has symptoms of low blood sugar (such as sweating, shaking), tell the doctor right away.Older adults may be more sensitive to the side effects of this drug, especially dizziness and lightheadedness.Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using carvedilol. Carvedilol may harm an unborn baby. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.It is unknown if carvedilol passes into breast milk. However, it is unlikely to pass into breast milk in large amounts. There is a low risk that it may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.One product that may interact with this drug is: fingolimod.Some products have ingredients that could raise your heart rate or blood pressure or worsen your heart failure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: very slow heartbeat, severe dizziness, fainting, slow/shallow breathing, seizures.
NOTES: Do not share this medication with others.Lifestyle changes that may help this medication work better include exercising, stopping smoking, and eating a low-cholesterol/low-fat diet. Consult your doctor for more details.Have your blood pressure and pulse (heart rate) checked regularly while taking this medication. Learn how to monitor your own blood pressure and pulse at home, and share the results with your doctor.Lab and/or medical tests (such as kidney/liver function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised April 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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- Compare formulary status to other drugs in the same class.
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