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Carvedilol

 

Carvedilol (generic Coreg) Review

brand name: Coreg
generic name: Carvedilol

How does it work?

This medicine contains the active ingredient carvedilol, which is a type of medicine called a beta-blocker.

Beta-blockers block beta-receptors in the heart, lungs and other organs of the body. Blocking these receptors prevents the action of two chemicals called noradrenaline and adrenaline that occur naturally in the body. These are often referred to as the 'fight or flight' chemicals, as they are responsible for the body's reaction to stressful situations.

Carvedilol mainly blocks beta-receptors in the heart, which causes the heart to beat more slowly and with less force. This means that the heart uses less energy and so requires less oxygen from the blood. The pain of angina is caused by not enough oxygen reaching the heart when it's workload is increased, eg during exercise. Carvedilol prevents this pain by decreasing the oxygen demand of the heart, so that it always has a sufficient supply.

Due to the heart beating more slowly and with less force, the pressure at which blood is pumped out of the heart to the rest of the body is reduced. This is one way in which carvedilol reduces blood pressure.

Carvedilol also blocks receptors called alpha-receptors that are present on the walls of blood vessels. Blocking these receptors causes the blood vessels to widen, which means that there is more space and less resistance in the blood vessels. This is another mechanism by which the pressure in the blood vessels is lowered.

The widened blood vessels also allow more blood to reach the heart, which is another way in which carvedilol prevents the pain of angina.

Overall, carvedilol decreases the effort required by the heart to pump blood around the body and so can also be used to treat chronic heart failure, where the pumping action of the heart has become less effective.

Because carvedilol widens the blood vessels and maintains the blood flow to the extremities, it rarely causes the cold extremities (hands and feet) that can occur in people taking other beta-blockers.

What other drugs will affect Carvedilol (Coreg)?

Before taking Carvedilol (Coreg), tell your doctor if you are using:

• cold medicines, stimulant medicines, or diet pills.
• medicine for asthma or other breathing disorders, such as Bricanyl), Brethine, terbutaline (Brethaire, pirbuterol (Maxair), metaproterenol (Alupent), bitolterol (Tornalate), Proventil), albuterol (Ventolin, and theophylline (Theo-Dur, Theolair); or
• a heart medication such as diltiazem (Cartia, Isoptin), Verelan, verapamil (Calan, reserpine (Serpasil), Adalat), nifedipine (Procardia, Cardizem);
• a diabetes medication such as chlorpropamide (Diabinese), glipizide (Glucotrol), Glynase), Micronase, glyburide (Diabeta, insulin, or metformin (Glucophage);
• an MAO inhibitor such as or selegiline (Eldepryl, phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), Emsam);
• guanabenz (Wytensin);
• clonidine (Catapres);
• allergy treatments (or if you are undergoing allergy skin-testing);

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

If you are using any of these drugs, you may not be able to take Carvedilol (Coreg), or you may need dosage adjustments or special tests during treatment.

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15 degrees and 30 degrees C (59 degrees and 86 degrees F). Protect from moisture. Throw away any unused medicine after the expiration date.

Special information if you are pregnant or breastfeeding

Coreg 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.

Not to be used in

• Very low blood pressure (severe hypotension)
  
  
• Tumour of the adrenal gland (phaeochromocytoma), unless this is first treated with an alpha-blocker medicine
  
  
• Slow heart rate of less than 50 beats per minute (bradycardia)
  
  
• Serious defect in the heart's electrical message pathways (2nd or 3rd degree heart block), unless an artificial pacemaker is fitted
  
  
• Marked fluid retention requiring treatment with intravenous heart medicines (inotropes, eg digoxin)
  
  
• Increased acid levels in the blood (metabolic acidosis)
  
  
• History of breathing difficulties due to a narrowing of the airways (bronchospasm)
  
  
• History of asthma
  
  
• Failure of the heart to maintain adequate circulation of blood (cardiogenic shock)
  
  
• Failure of the electrical impulse that causes the heart to beat to leave the pacemaker of the heart, resulting in decreased heart function (sino-atrial heart block)
  
  
• Decreased liver function
  
  
• Chronic obstructive pulmonary disease (COPD)
  
  
• A problem common in the elderly, related to poor control of the working of the heart (sick sinus syndrome)
  
  

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Special information if you are pregnant or breastfeeding

Coreg 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.