What Happens If You Miss A Dose Of Carvedilol? 6 Tips for Taking This Beta Blocker

Carvedilol (Coreg) is a beta blocker medication. It treats high blood pressure and heart failure, and it can also lower the risk of death after a heart attack. It works by decreasing the stress on your heart, widening your blood vessels, and decreasing inflammation. 

If you’re prescribed carvedilol, taking it correctly is vital to getting the most out of this medication. Asking your healthcare team questions like, “What happens if I miss a dose of carvedilol?” and “When’s the best time of day to take it?” can ensure that you understand everything there is to know about taking this important medication. Here, we’ll answer these questions and more.

1. If you miss a dose of carvedilol, take it right when you remember unless its close to your next dose

If you accidentally miss a dose of carvedilol, don’t panic. Just take the missed dose right when you remember, unless it’s close to your next dose. In that case, skip the missed dose and return to your usual dosing schedule

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Even if you miss a carvedilol dose, never take more than one dose at a time. This increases your risk of side effects, such as a very low heart rate or extreme dizziness.

If you often miss carvedilol doses, you can try a few methods to help you remember. For example, try setting a daily alarm on your phone at the time of your dose(s). You can also download a medication reminder app if you have a smartphone. If you take multiple medications, using a pill organizer can help.

If you’ve missed multiple carvedilol doses in a row, check with your prescriber about what to do next. They may want you to check your heart rate and blood pressure, since missing multiple doses in a row can increase these numbers.

2. Unlike some other beta blockers, carvedilol is typically taken twice a day

Many beta blockers, such as extended-release (ER) metoprolol (Toprol XL, Kapspargo Sprinkle), propranolol ER (Inderal LA, Inderal XL, Innopran XL), and atenolol (Tenormin) are taken once a day. But immediate-release (IR) carvedilol tablets are typically taken twice a day. 

If possible, it’s best to leave 12 hours in between carvedilol doses. So if you take your morning dose at 8AM, aim to take your evening dose at 8PM. If this isn’t possible for you, try to get as close to 12 hours in between doses as possible.

However, there is an ER form of carvedilol that comes as a capsule (Coreg CR). Carvedilol ER lasts longer in the body, so it’s only taken once a day.

EXPERT PICKS: WHAT TO READ NEXT

• Carvedilol side effects: Learn about managing carvedilol side effects, like dizziness and fatigue.

• Carvedilol interactions: If you take carvedilol, knowing about its drug interactions can keep you safe.

• Comparing beta blockers: Several beta blockers are available on the market, but they have some differences to consider.

3. The best time to take carvedilol is when you’ll remember to take it

There’s no specific time of day that’s best to take carvedilol. But if you’re taking it twice a day, you’ll want to take one dose in the morning and one dose in the evening. The specific times don’t matter as long as you take it twice a day (as close to 12 hours apart as possible). Each carvedilol dose should be taken with food to slow down its absorption. We’ll talk more about this in the next section.

If you’re taking carvedilol ER once a day, decide what time of day you’re most likely to remember to take it. Anytime works. If at some point you want to switch the timing of your dose, it’s best to work with your prescriber or pharmacist on how to make the switch safely.

4. Take your carvedilol doses with food

Some medications should be taken with food, while others can be taken on an empty stomach. Often, this is because having food in your stomach can affect how medications are absorbed.

Carvedilol, though, is a medication that should be taken with food. This helps your dose be absorbed more gradually, which lowers the risk of your blood pressure dropping too low. You could take your carvedilol dose with a meal or a snack.

If you take another medication that’s best taken on an empty stomach, it’s possible that you’ll need to separate the dose from your other medications, including carvedilol. For example, a thyroid medication called levothyroxine (Synthroid, Levoxyl) should be taken 4 hours before or after other medications in most cases. So check with your prescriber or pharmacist about whether any of your medications have a similar requirement.

5. Some medications and foods may interact with carvedilol

You may need to avoid certain medications, foods, and drinks if you take carvedilol. This is because carvedilol can cause drug interactions.

Medication interactions

Carvedilol interactions may increase your risk of side effects like low blood pressure or low heart rate. Examples include:

• Heart rhythm medications, such as amiodarone (Pacerone)

• Some antidepressants, such as fluoxetine (Prozac) and paroxetine (Paxil)

• Digoxin (Lanoxin)

• Calcium channel blockers, such as diltiazem (Cardizem) and verapamil

Some interactions may also make carvedilol less effective. For example, rifampin (Rifadin) can decrease carvedilol levels in the body, which may prevent carvedilol from having its full effects. And what’s more, carvedilol can also impact levels of other medications in the body. For example, carvedilol may increase levels of cyclosporine (Sandimmune) if these two medications are taken together.

Creating an up-to-date medication list and giving it to your healthcare team can help them screen for potential carvedilol interactions.

Food and drink interactions

Depending on your individual situation, there may be some drinks and foods to avoid while taking carvedilol. Some examples include:

• Grapefruit and grapefruit juice can decrease carvedilol levels in the blood, making it less effective

• Coffee and other caffeine-containing drinks can counteract the effects of carvedilol by increasing your heart rate and blood pressure

• Alcohol can counteract the effects of carvedilol and worsen side effects such as dizziness

• Foods with too much salt can raise your blood pressure, making carvedilol less effective

• High-potassium foods may need to be avoided if you already have high potassium levels

You don’t necessarily need to avoid all these foods while taking carvedilol. Talk to your prescriber about your specific situation and health history. They can help you decide if any foods need to be eliminated from your diet.

6. Carvedilol can cause side effects such as low blood pressure

In addition to drug interactions, carvedilol can cause side effects. Common side effects include low blood pressure (hypotension), slow heart rate, and dizziness. Fatigue and nausea may also occur. 

Often, these side effects are mild and resolve on their own. In the meantime, take steps to avoid falls or injuries that can happen if you have low blood pressure and dizziness. Move slowly when switching positions, such as going from sitting or lying down to standing. Additionally, try to avoid driving or doing any activities that need your full attention when you first start carvedilol. After a few days, you can see if you feel dizzy or unsteady. If not, you may be ready to resume these activities.

Rare but serious carvedilol side effects include swelling, rapid weight gain, and trouble breathing (especially if you have asthma or other lung conditions). If you notice any of these side effects while taking carvedilol, contact your healthcare team right away. If your symptoms seem life-threatening, call 911 or go to the nearest emergency room.

How to save on carvedilol

Carvedilol IR and ER are available as lower-cost generics. GoodRx can help you navigate the many ways to save on your prescription.

• Save with GoodRx. Generic carvedilol IR at certain pharmacies may be as low as $10.20 with a free GoodRx discount. And you may be able to get generic carvedilol ER for $77.42 with a free GoodRx discount.

• Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, brand-name Coreg IR and Coreg ER (called Coreg CR) are as little as $5 if you use the manufacturer’s savings card.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Alex Brewer, PharmD, MBA

Alex Brewer, PharmD, MBA, is a licensed pharmacist specializing in chronic disease and health and wellness. Upon completing his residency, he worked in the managed care field, conducting medication therapy management and adherence counseling sessions with Medicaid, Medicare, and private insurance patients, before transitioning to a career in medical writing.

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