Carvedilol
Risk Factor: CM*
Class: CARDIOVASCULAR DRUGS
/ Antihypertensives
/ Other Antihypertensives
Contents of this page:
Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers
Fetal Risk Summary
Carvedilol is a combined a/b-adrenergic blocking agent that is used for the treatment of hypertension and mild to moderate heart failure. The a1-adrenoreceptor blocking activity has been associated with vasodilation and a reduction in peripheral vascular resistance (1). Some of the metabolites of carvedilol have greater b-receptor blocking activity than the parent drug. No reports of its use in human pregnancy have been located.
Reproduction studies in rats and rabbits at 50 and 25 times the maximum recommended human dose based on body surface area (MRHD), respectively, revealed post-implantation loss in both species (1). The dose in rats, which was maternally toxic, was also associated with a decrease in fetal weight and an increase in frequency of fetuses with delayed skeletal development (missing or stunted 13th rib). The no-observed-effect levels for developmental toxicity in the test animals was 10 times the MRHD for rats and 5 times the MRHD for rabbits (1). Toxicity (sedation, reduced weight gain) and impaired fertility were observed in adult rats at 32 times the MRHD, including a reduced number of successful matings, prolonged mating time, fewer implants per dam, and complete resorption of 18% of the litters (1).
It is not known if carvedilol crosses the human placenta. The molecular weight (about 407) is low enough, however, that passage to the fetus should be expected. The drug and/or its metabolites cross the placenta in rats (1).
In summary, the lack of human pregnancy experience limits any assessment of fetal risk that might occur with the use of carvedilol (2). Based on animal studies and the experience with other, similar agents, the risk of teratogenicity appears to be low. Intrauterine growth retardation (IUGR), however, has been reported with another a/b-blocker (see Labetalol) when the drug was used for the treatment of mild preeclampsia. Some b-blockers have also caused IUGR and reduced placental weight (e.g., see Atenolol and Propranolol). Treatment beginning early in the 2nd trimester results in the greatest reductions. This toxicity has not been consistently demonstrated in other agents within this class or with labetalol. This lack of toxicity documentation may reflect the number and type of patients studied, the duration of therapy, the dosage used, or other pharmacologic characteristics of the drugs. Although growth retardation is a serious concern, the benefits of maternal therapy with carvedilol (or other a/b-blockers) may, in some cases, outweigh the risks to the fetus and must be judged on a case-by-case basis.
[*Risk Factor D if used in 2nd or 3rd trimesters.]
Breast Feeding Summary
No reports describing the use of carvedilol during human lactation have been located. The molecular weight (about 407) is low enough that excretion into breast milk should be expected. The drug and/or its metabolites are found in the milk of lactating rats. Increased pup mortality at 1 week postpartum was observed when pregnant rats were treated with carvedilol at 10 times the MRHD during the last trimester and continued through day 22 of lactation (1).
Although there are no reports of human exposure during lactation, nursing infants of women who are consuming carvedilol should be closely monitored for bradycardia, hypotension, and other symptoms of a/b-blockade. A similar agent, labetalol, is considered by the American Academy of Pediatrics to be compatible with breast feeding (see Labetalol).
References
- Product information. Coreg. SmithKline Beecham Pharmaceuticals, 2000.
-
Frishman WH. Carvedilol. N Engl J Med 1998;339:175965.
Questions and Answers
Can Carvedilol be used in someone with COPD?, This is a case study.
The patient is a 62 y/o man complaining of decreased exercise tolerance. He suffered an MI 2 years ago for which he received PCI and a bare metal stent.. He has DM type II, COPD, and hyperlipidemia. Pertinent meds are verapamil ER 240mg daily, ISDN 30mg daily. He also takes NPH insulin for DM and albuterol and ipratropium for COPD. Also he is on aspirin 81mg daily.
His current ejection fraction is 30% and BP is 118/86. HR is 74 bpm, Scr is 1.4. BUN is 24 and Na and K are in normal limits.
I think the verapamil should be discontinued and replaced with carvedilol since it has been studied more in heart failure, but I'm worried about it affecting his COPD status. Can you tell me what suggestions you have? Please include references (or links) if you are using web resources.
Serious answers only please. Thank You!
The correct answer seems to be yes and no.Coreg is contraindicated for asthma, however research indicates beta blockers do not have to be avoided in COPD patients.I would think Toprol xl would be the better choice to replace Verapamil.
What shape is the tablet called Carvedilol (or Coreg). I'm on vacation and cannot find it in with my meds ?, If the tablet is the shape of a violin, then I know what it is.
Thanks and please send response ASAP.
Annie
There are a ton of generic carvediol tablets, there should be some numbers printed on it and maybe some letters as well.
What is the Carvedilol Tablet dissolution method?,
See if this helps
http://www.fda.gov/cder/dmethods/FAQ.htm
If the doctor says they "generally" double coreg/carvedilol dosage, what does this mean?, I've been on 3.125mg ever since starting it.
Coreg is usually given twice daily.
You'll need to ask your doctor for the answer to your question. What he/she said / thought is too hard to guess.
I am taking enalapril and carvedilol for high blood pressure. Can I take them both at the same time., I also take glyburide and loratadine. Can I take any of them together?
Your best bet would be to contact a local pharmacist and ask them for recommendations. They will give you a free consultation on the medication you were given and what not to take with what.
does carvedilol (generic coreg) get you high, or messed up?, Just wondering
No. It's a heart medication used for blood pressure and/or heart failure.
Good Day. What happen if 3 years old kid took Carvedilol 6.25mg accidentally?,
Are you conducting experiments on kids? Call the Emergency ward ffs!
what is carvedilol and its details ?,
Carvedilol is a combined beta-1, beta-2, and alpha-1 blocker. It is primarily used for the treatment of congestive heart failure, as the beta-1 and beta-2 blockade slow the heart down and prevent arrythmias, while the alpha-1 blockade lowers peripheral resistance such that the heart does not have to work so hard to get blood out.
Medication has a doctor any sugestions .I am told that I am on max medication .?, My clinical history is as follows
1982 Triple by pass of coronary arteries.
1996 Triple by pass ( same ones that were blocked again )
1997 AAA repair . The last by pass opp was to get my heart in better shape to withstand the AAA.
2001 Diagnose Diabetes type 2.
MY medication is as follows.
Telmisarten 120mg per day.
Carvedilol 50mg per day
Nicorandil 40mg per day
Diltiazem 240mg per day.
Fruzimide 160mg per day
Cloidogrel 75mg per day
Diaformin 3 per day
Glimepiride 1mg per day.
Pariet for reflux 20mg per day
Piroxicam for arthritis 20mg per day.
Symtoms . I funtion satisfactory most of the time but suffer from constant fatigue , lack of energy , and sleepyness. I sometimes get angina mildly if I get up during night to toilet .spmetimes if I exert my self in the evening like wheeling out garbage bins or early morn. The angina responds to the nitro spray. At the time of my by pass grafts I was told that I was not suitable for stents or balloon angioplasty.
At the risk of suggesting yet another pill, there is a new class of antianginal on the market and the medication has the tradename Ranexa. I have used it with great success in 2 patients, and my partners (who jump on new meds more readily than I do) have had many patients do extremely well on it. The reason I suggest it is that it may allow you to cut down on some other medications, but it is very costly. Ask your cardiologist is he is familiar with it.
sharp chest pain on the left side for 10 hrs?, left side under nipple to the left for 10 hours now , in the last 3 months I have had ekg perfect, stress great, echo should a weakness in the left ventrical, so than a angiogram that should no blockage. i am on lisinopril and carvedilol and prolesic for gas what gives
A E pal asap play safe
