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Coreg
Coreg (Carvedilol)
Coreg (Carvedilol) is used to treat high blood pressure and heart failure.
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Drug Name

Coreg (Carvedilol)


Drug Uses

This medication is an alpha- and beta-blocker, used to treat high blood pressure and heart failure. It is also used after an acute heart attack to improve survival. Lowering high blood pressure helps prevent strokes, heart attacks and kidney problems. This drug works by blocking the action of certain natural chemicals in your body (such as epinephrine) that affect the heart and blood vessels. This results in lowering of heart rate, blood pressure, and strain on the heart.


How to use

Take this medication by mouth with food, usually twice daily, or as directed by your doctor. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day. Take this drug exactly as prescribed. Do not increase or decrease the dose on your own. The dosage is based on your medical condition and response to therapy. If you are being treated for high blood pressure, it may take 1 or 2 weeks before the full benefit of this drug takes effect. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick. Do not suddenly stop taking this medication without consulting your doctor. Your condition may become worse when the drug is suddenly stopped.


Drug Class and Mechanism

Coreg is used for treating high blood pressure and congestive heart failure. It is related to labetalol (Normodyne, Trandate). Coreg blocks receptors of the adrenergic nervous system, the system of nerves in which epinephrine (adrenalin) is active. Nerves from the adrenergic system enter the heart and release an adrenergic chemical (norepinephrine) that attaches to receptors on the heart's muscle and stimulates the muscle to beat more rapidly and forcefully. By blocking the receptors, coreg reduces the heart's rate and force of contraction and, thereby, reduces the work of the heart. Coreg also blocks adrenergic receptors on arteries and causes the arteries to relax and the blood pressure to fall. The drop in blood pressure further reduces the work of the heart since it is easier to pump blood against a lower pressure.


Missed Dose

If you miss a dose of Zyvox, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.


Storage

Store at room temperature below 86 degrees F (30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.


Possible Side Effects

You may experience dizziness, lightheadedness, drowsiness, tiredness, diarrhea, unusual dreams, trouble sleeping, dry eyes, or vision problems as your body adjusts to the medication. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. 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 your doctor has prescribed this medication because 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 immediately if any of these unlikely but serious side effects occur: symptoms of a very slow heartbeat (e.g., persistent dizziness, fainting, unusual fatigue), fainting, bluish discoloration of the fingers and toes, numbness/tingling/swelling of the hands or feet, decreased sexual ability, reversible hair loss, mental/mood changes, worsening of heart failure symptoms (e.g., cough, trouble breathing, sudden weight gain), change in the amount of urine, increased thirst, increased urination. Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: easy bruising or bleeding, persistent sore throat or fever, yellowing skin or eyes, stomach pain, dark urine, persistent nausea. In the unlikely event you have a serious allergic reaction to this drug, seek medical attention immediately. Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.



More Information

Do not share this medication with others. Lifestyle changes such as stress reduction programs, exercise and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you. Have your blood pressure and pulse checked regularly while taking this medication. It may be best to learn how to monitor your own blood pressure and pulse. Discuss this with your doctor. Laboratory and/or medical tests may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.


Warnings/Precautions

Do not stop using this drug without first consulting your doctor. Your condition may become worse when the drug is suddenly stopped, especially if you have chest pain (angina) or heart disease (e.g., coronary artery disease, ischemic heart disease, heart failure, high blood pressure). If your doctor decides you should no longer use this drug, you must gradually decrease your dose according to your doctor's instructions. When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Seek immediate medical attention if you develop: worsening chest pain, tightness or pressure in the chest, chest pain spreading to the jaw/neck/arm, sweating, trouble breathing or fast/irregular heartbeat. Before taking coreg, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: asthma, certain types of irregular heartbeats (e.g., sinus bradycardia, second or third degree atrioventricular block), cardiogenic shock, severe heart failure (overt or decompensated type), liver disease. Before using this medication, tell your doctor or pharmacist your medical history, especially of: other breathing problems (e.g., chronic obstructive lung disease), other heart problems (e.g., Prinzmetal's variant angina), diabetes, overactive thyroid disease (hyperthyroidism), kidney disease, blood circulation problems (e.g., Raynaud's disease), skin conditions (e.g., psoriasis), mental/mood disorders (e.g., depression), a certain type of tumor (pheochromocytoma), certain muscle disease (myasthenia gravis). Before having surgery, tell your doctor or dentist that you are taking this medication. If you have diabetes, this medication may mask the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of a low blood sugar level such as dizziness or sweating are unaffected by this drug. This drug may make you dizzy, drowsy, or faint, especially when you first start using this drug or if your doctor increases your dose. Use caution engaging in activities requiring alertness such as driving or using machinery. The manufacturer recommends avoiding these activities during periods of adjustment in your dose. Limit alcoholic beverages. To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position. Taking this medication with food will also help decrease these effects. Caution is advised when using this drug in the elderly because they may be more sensitive to its effects, especially dizziness and lightheadedness. This medication should be used only when clearly needed during pregnancy. Discuss the risks (e.g., low birth weight) and benefits with your doctor. Based on information from related drugs, this medication may pass into breast milk. Therefore, consult your doctor before breast-feeding.


What is carvedilol?

Carvedilol is in a group of drugs called beta-blockers. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).

Carvedilol is used to treat heart failure and hypertension (high blood pressure). It is also used to treat or prevent heart attack.

Carvedilol may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about carvedilol?

You should not take this medication if you are allergic to carvedilol, or if you have asthma, bronchitis, emphysema, severe liver disease, or a serious heart condition such as heart block, sick sinus syndrome, or slow heart rate (unless you have a pacemaker).

If you need to have any type of surgery, you may need to temporarily stop using carvedilol. Be sure the surgeon knows ahead of time that you are using carvedilol.

Do not stop taking carvedilol without first talking to your doctor. Stopping suddenly may make your condition worse. Carvedilol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol within 2 hours before or after taking extended-release carvedilol (Coreg CR). Also avoid taking medicines or other products that might contain alcohol. Alcohol may cause the carvedilol in Coreg CR to be released too quickly into the body.

Carvedilol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.

Hypertension often has no symptoms, so you may not even feel that you have high blood pressure. Continue using this medicine as directed, even if you feel well. You may need to use blood pressure medication for the rest of your life.

What should I discuss with my healthcare provider before taking carvedilol?

You should not take this medication if you are allergic to carvedilol, or if you have:
  • asthma, bronchitis, emphysema;

  • severe liver disease; or

  • a serious heart condition such as heart block, sick sinus syndrome, or slow heart rate (unless you have a pacemaker).

Before taking carvedilol, tell your doctor if you have:

  • diabetes (taking carvedilol can make it harder for you to tell when you have low blood sugar);

  • low blood pressure;

  • congestive heart failure;

  • depression;

  • kidney disease;

  • a thyroid disorder;

  • myasthenia gravis;

  • pheochromocytoma; or

  • problems with circulation (such as Raynaud's syndrome).

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category C. Carvedilol may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether carvedilol passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take carvedilol?

Take carvedilol exactly as it was prescribed for you. Do not take the medication in larger amounts or for longer than recommended by your doctor. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Take this medication with a full glass of water. Take carvedilol at the same time every day. Do not skip doses or stop taking carvedilol without first talking to your doctor. Stopping suddenly may make your condition worse.

You may open the carvedilol extended-release capsule and sprinkle the medicine into a spoonful of applesauce to make swallowing easier. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

If you are switched from carvedilol tablets to carvedilol extended-release capsules, your daily total dose of this medicine may be higher or lower than before. Follow your doctor's instructions.

To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. It is important that you not miss any scheduled visits to your doctor.

If you need to have any type of surgery, tell the surgeon that you are using carvedilol. You may need to briefly stop using carvedilol before having surgery.

Carvedilol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.

Hypertension often has no symptoms, so you may not even feel that you have high blood pressure. Continue using this medicine as directed, even if you feel well. You may need to use blood pressure medication for the rest of your life.

Store carvedilol at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If your next dose is less than 4 hours away, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include uneven heartbeats, shortness of breath, bluish-colored fingernails, dizziness, weakness, fainting, and seizure (convulsions).

What should I avoid while taking carvedilol?

Carvedilol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol within 2 hours before or after taking extended-release carvedilol (Coreg CR). Also avoid taking medicines or other products that might contain alcohol. Alcohol may cause the carvedilol in Coreg CR to be released too quickly into the body. Check the labels of any prescription or over-the-counter medicines you take to see if they contain alcohol (also called ethanol).

Carvedilol side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
  • slow or uneven heartbeats;

  • feeling light-headed, fainting;

  • feeling short of breath, even with mild exertion;

  • swelling of your ankles or feet;

  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • depression; or

  • cold feeling in your hands and feet.

Less serious side effects may include:

  • decreased sex drive, impotence, or difficulty having an orgasm;

  • sleep problems (insomnia);

  • tired feeling; or

  • anxiety, nervousness.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect carvedilol?

Before taking carvedilol, tell your doctor if you are using:

  • allergy treatments (or if you are undergoing allergy skin-testing);

  • clonidine (Catapres);

  • cyclosporine (Gengraf, Neoral, Sandimmune);

  • digoxin (digitalis, Lanoxin);

  • guanabenz (Wytensin);

  • rifampin (Rifadin, Rifater, Rifamate);

  • insulin or diabetes medication you take by mouth;

  • an antidepressant such as fluoxetine (Prozac) or paroxetine (Paxil);

  • a beta blocker such as atenolol (Tenormin), esmolol (Brevibloc), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others;

  • an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam);

  • a heart medication such as quinidine (Quinidex, Quinaglute, Quin-Release), propafenone (Rythmol), nifedipine (Procardia, Adalat), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cartia, Cardizem);

  • medicine for asthma or other breathing disorders, such as albuterol (Ventolin, Proventil), bitolterol (Tornalate), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire, Brethine, Bricanyl), and theophylline (Theo-Dur, Theolair); or

  • cold medicines, stimulant medicines, or diet pills.

This list is not complete and there may be other drugs not listed that can affect carvedilol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about carvedilol.
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