carvedilol
Carvedilol (Coreg) is used to treat high blood pressure, manage heart failure, and help with heart problems after a heart attack. It belongs to the beta blocker drug class. This medication comes as a tablet that's taken by mouth twice daily, and as an oral extended-release (ER) capsule (brand name Coreg CR) that's taken once daily. Common side effects include dizziness, feeling tired, and diarrhea.
What is Carvedilol (Coreg)?
What is Carvedilol (Coreg) used for?
- High blood pressure
- Heart failure
- Lower the risk of death from heart-related problems after a heart attack
How Carvedilol (Coreg) works
Carvedilol (Coreg) is an alpha and beta blocker medication. It lowers blood pressure by relaxing your blood vessels and slowing down your heart rate.
Drug facts
Side effects of Carvedilol (Coreg)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness (6%)
Please note: These side effects were reported by people who took carvedilol (Coreg) in clinical studies for high blood pressure.
Less Common Side Effects
- Orthostatic hypotension (drop in blood pressure when you stand up from sitting or lying down)
- Trouble sleeping
- Diarrhea
Carvedilol (Coreg) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reaction: skin rash; swelling of the face, lips, tongue, or throat; difficulty breathing
- Heart failure: trouble breathing, fast weight gain, feeling very tired, chest pain, swelling in the legs, ankles, or feet
- Bronchospasm: tightness in the chest, trouble catching your breath, difficulty breathing, wheezing, cough, dizziness, extreme tiredness
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The following Carvedilol (Coreg) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Allergy
chest pain, discomfort, tightness, or heaviness
dizziness, lightheadedness, or fainting
generalized swelling or swelling of the feet, ankles, or lower legs
shortness of breath
slow heartbeat
Less common
Ankle, knee, or great toe joint pain
arm, back, or jaw pain
blood in the urine
bloody, black or tarry stools
chills
cloudy urine
cold sweats
coma
confusion
convulsions
cool pale skin
dark urine
decreased appetite
decreased frequency or amount of urine
difficulty with breathing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying position
fainting
fast or irregular heartbeat
flu-like symptoms
flushed, dry skin
fruit-like breath odor
headache, sudden and severe
inability to speak
increased blood pressure
increased hunger
increased thirst
increased urination
joint stiffness or swelling
large amount of cholesterol in the blood
loss of appetite
loss of consciousness
lower back, side, or stomach pain
mental depression
muscle pain or cramps
nervousness
nightmares
noisy, rattling breathing
numbness or tingling in the hands, feet, or lips
pinpoint red or purple spots on the skin
pounding in the ears
pounding, slow heartbeat
rapid breathing
seizures
shakiness
slurred speech
stomachache
sweating
swelling of the fingers or hands
temporary blindness
tenderness on the upper right side of the body
trouble with breathing even at rest
unexplained weight loss
unusual bleeding or bruising
weakness in the arm and/or leg on one side of the body, sudden and severe
weakness or heaviness of the legs
yellow eyes or skin
Incidence not known
Sores, ulcers, or white spots on the lips or in the mouth
swollen or painful glands
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Abdominal or stomach pain
bleeding gums
blurred vision
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
changes in vision
cold hands and feet
decreased interest in sexual intercourse
decreased tearing
difficulty with moving
feeling of constant movement of self or surroundings
general feeling of discomfort or illness
headache
inability to have or keep an erection
increased sweating
joint or muscle pain
lack or loss of strength
loose teeth
loss of sexual ability, desire, or performance
loss of strength or energy
muscle aches, stiffness, or weakness
persistent breath odor or bad taste in your mouth
redness and swelling of the gums
sensation of spinning
sleepiness or unusual drowsiness
stuffy or runny nose
sugar in the urine
trouble sleeping
unusual weak feeling
vomiting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Carvedilol (Coreg)
Pros
- Taken by mouth
- Comes as a once-daily extended-release formulation
- Dose can be adjusted based on your response
- Available as a lower-cost generic
Cons
- Need to take with food
- Can cause you to feel more tired
- Can cause dry eyes if you wear contact lenses
- Shouldn't be taken if you have asthma or an asthma-related condition
Pharmacist tips for Carvedilol (Coreg)
- You'll want to take carvedilol (Coreg) with food to lower your risk of experiencing a drop in blood pressure when you stand up from sitting or lying down.
- If you're taking carvedilol (Coreg) extended-release capsules, you can swallow the capsules whole or carefully open them and sprinkle the contents on a spoonful of cold applesauce. Make sure to eat the mixture right away and don't save any for later.
- Carvedilol (Coreg) can cause dizziness, especially when you first start this medication or right after your provider raises your dose. Avoid driving a car, using machinery, or doing anything that requires your full attention until you're feeling better and know how the medication affects you.
- It can take about 1 to 2 weeks to see the full blood pressure-lowering effects of carvedilol (Coreg). Check your blood pressure 1 week after starting this medication, and tell your provider if it hasn't improved.
- If you have diabetes, you might need to monitor your blood sugar levels more often. Carvedilol (Coreg) can hide symptoms of low blood sugar levels (especially a fast heartbeat), so you might not feel any of the typical symptoms of low blood sugar.
- Don't stop taking carvedilol (Coreg) and don't change the amount of the medication you take without talking to your provider, as this can cause chest pain and/or a heart attack.
- If you miss a dose of carvedilol (Coreg), take your dose as soon as you remember. But if it's time for your next dose, skip the forgotten dose and continue with your normal dosing schedule. Never take two doses at the same time because this could cause serious side effects.
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Common questions about Carvedilol (Coreg)
The immediate-release version of carvedilol (Coreg) is taken twice a day because the effects of each dose don't last the entire day. This is different from the extended-release (ER) version that's taken once a day since the medication is slowly released throughout the day.
No, carvedilol (Coreg) isn't a blood thinner and it shouldn't affect the way your blood clots. It belongs to a class of medications called beta blockers.
After taking your last dose of carvedilol (Coreg), it takes about 1 to 2 days for your body to get rid of most of the medication. This estimate is based on the half-life of carvedilol (Coreg). It can differ from person to person, depending on different factors, such as your age or what medical conditions you have.
In clinical studies, people taking 25 mg of carvedilol (Coreg) twice daily experienced a drop in their systolic blood pressure by 9 mm Hg. Keep in mind that everyone responds differently to the medication. When you first start carvedilol (Coreg), it can take some time before you and your provider find a dose that works best for you. You'll need to continue taking a particular dose for 1 to 2 weeks before knowing how it affects you.
Yes, carvedilol (Coreg) can lower your heart rate. People taking 50 mg of carvedilol (Coreg) every day for blood pressure during clinical studies experienced a drop in their heart rate by about 8 beats per minute. If you experience dizziness, fainting, chest pain, trouble exercising, or excessive tiredness, your heart rate might be too low. If this happens to you, contact your provider so they can make sure you're taking the correct dose.
Carvedilol (Coreg) can cause weight gain as a side effect. To minimize weight gain, try your best to stick with an exercise routine that works for you. If you notice rapid weight gain while taking this medication, contact your provider. This could be a sign of heart failure or other medical conditions that you'll want to get checked out.
There aren't any foods that have known interactions with carvedilol (Coreg). But there are certain foods you should avoid or limit if you have high blood pressure or heart failure. For example, you should avoid foods that are high in salt levels, such as pickles, canned foods, and sauces, because they can raise your blood pressure or worsen swelling. If possible, you should also cut out or limit drinks like alcohol or coffee because they can also raise your blood pressure. Instead, stick with a low-salt and heart-healthy diet with foods like leafy greens, yogurt, and whole grains.
The caffeine in coffee can raise your blood pressure temporarily. But drinking 1 to 2 cups of coffee a day isn't known to cause long-term affects on your blood pressure. If you drink coffee regularly, let your provider know. Depending on how much coffee you drink each day, your provider might ask you to limit your coffee intake while you're taking carvedilol (Coreg).
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Risks and warnings for Carvedilol (Coreg)
Carvedilol (Coreg) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Worsening chest pain and heart attacks
- Risk factors: Stopping carvedilol (Coreg) suddenly | Coronary artery disease (CAD)
Don’t stop taking carvedilol (Coreg) suddenly as this can raise your risk of chest pain or heart attack. Some common symptoms of a heart attack include chest pain and tightness, pain that spreads to arms and neck, shortness of breath, lightheadedness, and fatigue. If you need to stop taking carvedilol (Coreg) for any reason, let your healthcare provider know. They can work with you to lower your dose safely over time (which typically occurs over 1-2 weeks).
Slow heart rate and low blood pressure
You might notice a slowing of your heart rate when you take carvedilol (Coreg). This could sometimes cause you to feel dizzy when you first take the medication. Carvedilol (Coreg) will lower your blood pressure, which can also cause you to feel dizzy until your body adjusts. Be careful when getting up from either lying down or sitting to avoid falls. Let your provider know if your heart rate goes below 55 beats per minute as they might consider changing your dose.
Heart failure
- Risk factors: Heart failure
People with heart failure shouldn't take carvedilol (Coreg) if their heart failure symptoms aren’t well-managed. That’s because this medication can make your condition worse. But you might be able to take carvedilol (Coreg) if your healthcare provider thinks your symptoms are under control. Keep in mind that, though rare, sometimes taking a beta-blocker, like carvedilol (Coreg) over time might lead to heart failure even in people without this condition. Let your healthcare provider know right away if you experience symptoms of heart failure, such as fluid build-up in different areas of the body including the ankles, legs, and lungs, and difficulty breathing.
Hiding symptoms of low blood sugar
- Risk factors: Diabetes
Taking carvedilol (Coreg) can make it difficult for you to identify symptoms of low blood sugar, such as fast heart beat or tremors. If you’re taking medications, like glipizide or insulin, to lower your blood sugar, you might not be able to rely on all the typical symptoms of low blood sugar (e.g., irritability, sight tremors, confusion, and fast heartbeat) to warn you of a dangerous drop in your sugar levels. Sweating might be the only symptom not affected by taking carvedilol (Coreg). Speak with your healthcare provider about when and how to monitor your blood sugar if you start carvedilol (Coreg).
Risk of difficulty breathing
- Risk factors: Chronic obstructive pulmonary disease (COPD) | Asthma
Carvedilol (Coreg) can cause the vessels in your lung to tighten. This can make breathing difficult, especially in people with breathing problems, like asthma or COPD. Carvedilol (Coreg) might also cause certain medications taken to ease these conditions to not work as well. Let your doctor know if you have any breathing problems before starting carvedilol (Coreg).
Hiding symptoms of high thyroid hormone
- Risk factors: Hyperthyroidism
Carvedilol (Coreg) can hide signs of hyperthyroidism, especially a fast heart rate. It's important to talk to your provider before stopping carvedilol (Coreg) suddenly, since doing so can worsen thyroid problems.
Risk of kidney problems
Though extremely rare, some people who took carvedilol (Coreg) for heart failure experienced kidney problems. This is more likely for people with low blood pressure and blood flow problems. If you have any of those conditions, your provider might need to do lab work regularly to check your kidney health, especially after they raise your dose of carvedilol (Coreg).
Severe allergic reactions
- Risk factors: History of severe allergic reaction
Beta blockers like carvedilol (Coreg) can lessen your response to life-saving treatments of severe allergic reactions (anaphylaxis). They can also cause your allergic reaction to be more severe than usual. Discuss all of your allergies with your provider and a plan on what to do if you experience an allergic reaction while taking carvedilol (Coreg).
Greater risk during surgery
- Risk factors: Major surgery requiring anesthesia
Both beta-blockers and medications used for anesthesia can lower your heart rate. So, if you’re planning to undergo a major surgery that requires anesthesia, tell your surgeon that you’re on carvedilol (Coreg) so that they can monitor your heart closely.
Risk of eye problems during surgery
- Risk factors: Cataract surgery
If you take carvedilol (Coreg) and plan to get cataract eye surgery, let your provider know. In some rare cases, this medication can cause changes to your iris, a condition called Intraoperative floppy iris syndrome (IFIS). You don’t need to stop taking carvedilol (Coreg) before the surgery, but your surgeon might need to adjust how they perform the operation. Letting your provider know ahead of time can help them prepare accordingly.
Carvedilol (Coreg) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 3.125mg | 180 tablets | $14.03 | $0.08 |
| 6.25mg | 180 tablets | $14.35 | $0.08 |
| 12.5mg | 180 tablets | $14.77 | $0.08 |
| 25mg | 60 tablets | $10.70 | $0.18 |
Typical dosage for Carvedilol (Coreg)
Carvedilol (Coreg) comes in both immediate-release (IR) tablets and extended-release (ER) capsules.
High blood pressure
- IR tablets: The typical starting dose is to take 6.25 mg by mouth twice daily. If needed, your provider will raise your dose every 1 to 2 weeks. The maximum recommended dose is 25 mg twice daily.
- ER capsules: The typical starting dose is 20 mg by mouth once daily in the morning. If needed, your provider will raise your dose every 1 to 2 weeks. The maximum recommended dose is 80 mg once daily.
Heart failure
- IR tablets: The typical starting dose is to take 3.125 mg by mouth twice daily. If needed, your provider will raise your dose after 2 weeks or longer. Depending on your condition, the maximum dose is up to 50 mg twice daily.
- ER capsules: The typical starting dose is 10 mg by mouth once daily in the morning. If needed, your provider will raise your dose after 2 weeks or longer. The maximum recommended dose is 80 mg once daily.
After heart attack
- IR tablets: The typical starting dose is to take 6.25 mg by mouth twice daily. If needed, your provider will raise your dose after 3-10 days. The maximum recommended dose is 25 mg twice daily.
- ER capsules: The typical starting dose is 20 mg by mouth once daily in the morning. If needed, your provider will raise your dose after 3-10 days. The typical maintenance dose is 80 mg once daily.
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Interactions between Carvedilol (Coreg) and other drugs
More on Carvedilol (Coreg) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Afatinib
- Albuterol
- Amiodarone
- Berotralstat
- Betrixaban
- Bupropion
- Ceritinib
- Crizotinib
- Dabigatran Etexilate
- Digoxin
- Diltiazem
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Dronedarone
- Epinephrine
- Fenoldopam
- Fingolimod
- Fluconazole
- Fluvoxamine
- Formoterol
- Indacaterol
- Iobenguane I 123
- Iobenguane I 131
- Iohexol
- Lacosamide
- Lefamulin
- Levalbuterol
- Miconazole
- Morphine
- Morphine Sulfate Liposome
- Nilotinib
- Olodaterol
- Oxymetazoline
- Paroxetine
- Pixantrone
- Ponesimod
- Relugolix
- Rimegepant
- Rivastigmine
- Salmeterol
- Siponimod
- Sulfaphenazole
- Talazoparib
- Terbutaline
- Topotecan
- Ubrogepant
- Valproic Acid
- Venetoclax
- Verapamil
- Vilanterol
- Vincristine
- Vincristine Sulfate Liposome
- Voriconazole
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Aceclofenac
- Acemetacin
- Albiglutide
- Alfuzosin
- Alogliptin
- Amtolmetin Guacil
- Arbutamine
- Aspirin
- Bromfenac
- Bufexamac
- Bunazosin
- Canagliflozin
- Celecoxib
- Chlorpropamide
- Choline Salicylate
- Cimetidine
- Clonixin
- Dapagliflozin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Dobutamine
- Doxazosin
- Droxicam
- Dulaglutide
- Empagliflozin
- Ertugliflozin
- Etodolac
- Etofenamate
- Etoricoxib
- Exenatide
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Glimepiride
- Glipizide
- Glyburide
- Ibuprofen
- Indomethacin
- Insulin Aspart, Recombinant
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Human Inhaled
- Insulin Human Isophane (NPH)
- Insulin Human Regular
- Insulin Lispro, Recombinant
- Ketoprofen
- Ketorolac
- Linagliptin
- Liraglutide
- Lixisenatide
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Metformin
- Mibefradil
- Miglitol
- Morniflumate
- Moxisylyte
- Nabumetone
- Naproxen
- Nateglinide
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenoxybenzamine
- Phentolamine
- Phenylbutazone
- Piketoprofen
- Pioglitazone
- Piroxicam
- Pramlintide
- Pranoprofen
- Prazosin
- Proglumetacin
- Propyphenazone
- Proquazone
- Repaglinide
- Rifampin
- Rifapentine
- Rofecoxib
- Rosiglitazone
- Salicylic Acid
- Salsalate
- Saxagliptin
- Sitagliptin
- Sodium Salicylate
- St John's Wort
- Sulindac
- Tamsulosin
- Tenoxicam
- Terazosin
- Tiaprofenic Acid
- Tolazamide
- Tolbutamide
- Tolfenamic Acid
- Tolmetin
- Trimazosin
- Urapidil
- Valdecoxib
- Vildagliptin
How much does Carvedilol (Coreg) cost?
Carvedilol (Coreg) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Carvedilol (Coreg) will not be safe for you to take.
- Asthma or other breathing problems
- Extremely slow heart rate
- Heart problems (e.g., certain types of heart block, heart failure, cardiac shock, sick sinus syndrome without pacemaker)
- Severe liver problems
What are alternatives to Carvedilol (Coreg)?
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