Carvedilol (Antihypertensive)

Question 1

What are the brand name(s) of carvedilol?

Answer 1

Coreg & Coreg CR

Question 2

What tablet strengths are available for Coreg?

Answer 2

3.125mg, 6.25mg, 12.5mg, 25mg

Question 3

What strength capsules (CR) are available for Coreg CR?

Answer 3

10mg, 20mg, 40mg & 80mg

Question 4

What is the FDA approved dose for Coreg when used to manage essential hypertension when used alone or in combination with another antihypertensive agent?

Answer 4

Start with 6.25mg BID. After 7-14 days and using systolic standing pressure one hours after dosing as a guide, increase dosage to 12.5mg BID. Further dosage increases to 25mg BID may be made after another 7-14 days

Question 5

What dose of Carvedilol is approved to treat mild to moderate heart failure for ischemic cardiomyopathy origin?

Answer 5

Start with 3.125mg BID for 14 days
Dose may be doubles every 14 days to the highest level tolerated by the patient. The maximum dose is 25mg BID for patients weighting less than 85kg and is 50mg BID for patients weighing more than 85kg. Take with food to slow the ate of absorption and decrease orthostatic effects

Question 6

What is the dose of carvedilol for treating left ventricular dysfunction?

Answer 6

Start patient after they are hemodynamically stable and fluid retention has been minimized. Start with 6.25mg BID. Increase the dose after 3-10 days t0 12.5mg BID and again after 3-10 to the target dose of 25mg BID. A lower starting dose may be used in patients with low BP or heart rate, or mild fluid retention.

Question 7

What should the providers monitor when a patient is taking Carvedilol?

Answer 7

Blood Pressure
Liver Function Test
Blood Glucose

Question 8

What is the mechanism of action for Coreg?

Answer 8

it is a non-selective beta-adrenergic blocking agent with alpha-1-adrenergic blocking activity

Question 9

What are the drug interactions of carvedilol?

Answer 9

• Rifampin significantly decrease Coreg plasma levels.
• Cimetidine increases steady-state AUC but not Cmax.
• Quinidine, fluoxetine, paroxetine, and propafenone may increase plasma levels.
• Use with respiring,clindine, digoxin, or monoamine oxidase inhibitors may produce significant hypotension or bradycardia
• Use with diltiazem or verapamil may cause conduction disturbances.
• May increase digoxin plasma levels
• Use with inhibitors of CYP2C9 (amiodarone or fluconazole) may exacerbate bradycardia

Question 10

What are the contraindications of Coreg?

Answer 10

• Use is contraindicated in patients with NYHA class IV decompensated cardiac failure reporting IV inotropic therapy, bronchial asthma, or related bronchospasmic conditions, second- or third- degree AV block, sick sinus syndrome, cariogenic shocker severe bradycardia.
• Use with caution in patients with hepatic impairment
• DC use at the first site of hepatic dysfunction, anorexia right upper quadrant tenderness, or unexplained flu-like symptoms
• Use with caution in patients with peripheral vascular disease (can aggravate symptoms) in diabetics (can mask hypoglycemia) and in thyrotoxicosis (can mask hyperthyroidism)
• Use caution during anesthesia (due to bradycardia)

Question 11

What are the adverse effects of Carvedilol?

Answer 11

Dizziness, diarrhea, Bradycardia, hypotension, hyperglycemia, and visual abnormalities occur entreatment of CHF. The same effects occur in the treatment of hypertension bu at apex. the same rate as seen in placebo

Question 12

What should the RPh tell the patient when counseling on Carvedilol/Coreg?

Answer 12

• If s dose is missed, take it ASAP. If time is closer to next dose than missed dose, skip the missed dose
• Take with food to decrease orthostatic hypotension
• Contact lens seared may experience decreased agrimation
• May cause drowsiness, Use caution when operating machinery.
• Patient with diabetes need to be award that this agent can cause masking of hypoglycemic symptoms