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|Carvedilol Carvedilol

Carvedilol

Generic name: Carvedilol
Brand names: Coreg

Why is Carvedilol prescribed?

Carvedilol lowers blood pressure and increases the output of the heart. It is prescribed for people with congestive heart failure to increase survival and reduce the need for hospitalization. Carvedilol may be prescribed if you have survived a heart attack and now suffer from left ventricular dysfunction, a condition where the left side of the heart no longer pumps properly. It is also used to control high blood pressure. It is often used with other drugs.

Most important fact about Carvedilol

In some people, Carvedilol causes a drop in blood pressure when they first stand up, resulting in dizziness or even fainting. If this happens, sit or lie down and notify your doctor. Taking the drug with food reduces the chance of this problem. Even so, during the first month of therapy, or after a change in your dose, be careful about driving and operation of dangerous machinery.

How should you take Carvedilol?

Take Carvedilol twice a day with food. If you are taking the drug for high blood pressure, there should be improvement within 7 to 14 days.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Carvedilol should be stored at room temperature, away from light and moisture. Keep the container tightly closed.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Carvedilol.

• More common side effects may include:
  Anemia, back pain, bronchitis, cough, diarrhea, dizziness, fainting, fatigue, fluid in the lungs, headache, increased blood sugar levels, increased cholesterol, joint pain, low blood pressure, nausea, pain, shortness of breath, sinus problems, slow heartbeat, swelling, upper respiratory infection, vision changes, vomiting, weakness, weight gain, wheezing

Why should Carvedilol not be prescribed?

Avoid Carvedilol if you have asthma, certain serious heart conditions, or liver disease. Do not take the drug if it causes an allergic reaction.

Special warnings about Carvedilol

Carvedilol sometimes aggravates chronic bronchitis and emphysema. If you have either condition, make sure the doctor is aware of it. You"ll need to use the drug cautiously. Report any weight gain or shortness of breath to your doctor immediately.

Liver damage is a rare side effect of the drug. Notify your doctor immediately if you develop these signs of liver disorder: appetite loss, dark urine, flu-like symptoms, itching, pain in your side, or yellowing of the skin. You will need to be switched from Carvedilol.

Make sure your doctor knows if you have diabetes or low blood sugar. Carvedilol can interfere with the effectiveness of diabetes drugs and can cover up the symptoms of low blood sugar. Monitor your blood sugar regularly, and report any changes to your doctor.

A few people starting Carvedilol therapy for heart failure suffer dizziness, light-headedness, or even fainting within an hour after taking each dose. The problem is most likely to occur during the first 30 days of treatment, and especially after a dosage increase. If Carvedilol has this effect on you, avoid driving or hazardous tasks for the hour following each dose.

When Carvedilol is taken for heart failure, there is also a slight chance that it will interfere with the kidneys. If this reaction seems likely, the doctor will monitor your kidney function and, if necessary, change your dosage--or take you off the drug. Your heart failure may continue to get worse during the first 3 months of treatment, possibly requiring a temporary reduction in the dose of Carvedilol. After that, Carvedilol"s benefits should begin to appear.

If you have circulation problems in the arms and legs, Carvedilol may aggravate your symptoms. Use it with care and report any changes to your doctor.

Under no circumstances should you abruptly stop taking Carvedilol on your own. Notify the doctor if you miss even a few doses of Carvedilol. Your symptoms could return with a vengeance; and if you have an overactive thyroid, those symptoms could be aggravated as well. If needed, the doctor will taper you off the drug gradually over a period of 1 to 2 weeks. During this time you should keep your physical activity to a minimum. If your angina worsens or heart problems occur, notify your doctor immediately; you may need to begin taking Carvedilol again, at least temporarily.

If you wear contact lenses, you should know that Carvedilol can dry your eyes.

Possible food and drug interactions when taking Carvedilol

If Carvedilol is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Carvedilol with any of the following:

Calcium channel blockers (blood pressure and heart medications such as Calan, Cardizem, Isoptin, and Verelan)
Cimetidine (Tagamet)
Clonidine (Catapres)
Cyclosporine (Neoral, Sandimmune)
Diabetes pills such as Diabinese, Glucophage, and Rezulin
Drugs classified as MAO inhibitors, including the antidepressants Nardil and Parnate
Digoxin (Lanoxin)
Fluoxetine (Prozac)
Insulin
Paroxetine (Paxil)
Propafenone (Rythmol)
Quinidine (Quinaglute)
Reserpine (Ser-Ap-Es)
Rifampin (Rifadin)

Special information if you are pregnant or breastfeeding

Carvedilol has not been adequately studied in pregnant women; and it is not known whether the drug appears in breast milk. If you are pregnant or plan to become pregnant, check with your doctor immediately.

Recommended dosage

ADULTS

Hypertension

The starting dose is 6.25 milligrams twice a day with food. Your doctor may raise the dosage every 1 or 2 weeks to a maximum of 50 milligrams a day.

Congestive Heart Failure

The starting dose is 3.125 milligrams twice a day with food. Your doctor may increase the dosage every 2 weeks. The maximum dosage, for people weighing over 187 pounds, is 100 milligrams a day.

Left Ventricular Dysfunction Following a Heart Attack

The starting dose ranges from 3.125 to 6.25 milligrams twice a day with food. Your doctor may increase the dosage after 3 to 10 days to 12.5 milligrams twice a day. Based on your response, the doctor may again increase the dose up to a maximum of 25 milligrams twice a day.

CHILDREN

The safety and effectiveness of Carvedilol have not been studied in children under 18.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical treatment immediately.

• Symptoms of Carvedilol overdose may include:
  Breathing difficulties, loss of consciousness, seizures, heart problems, slow heartbeat, very low blood pressure, vomiting