Carvedilol

The usual recommended starting dose for Carvedilol is 3.125 mg 2 times daily in order to allow the body to get used to it. Your doctor will then increase the dose every 2 weeks until the most effective dose is reached.

Carvedilol should be taken with food at approximately the same times every day.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to use Carvedilol exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take 2 doses within 6 hours of one another. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice. If you miss more than 2 doses in a row, contact your doctor for instructions on re-starting the medication.

Store Carvedilol at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause diarrhea; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause unusual tiredness; it may cause nausea or, rarely, vomiting; it could cause water retention and swelling; it may cause vision problems. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

3.125 mg
Each white, oval, film-coated tablet, imprinted with the "P" logo on one side, contains 3.125 mg of carvedilol. Nonmedicinal ingredients: colloidal silicon dioxide, crospovidone, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polydextrose, polyethylene glycol, povidone, titanium dioxide, and triethyl citrate.

6.25 mg
Each white, oval, film-coated tablet, imprinted with the "P" logo on one side and "6.25" on the other side, contains 6.25 mg of carvedilol. Nonmedicinal ingredients: colloidal silicon dioxide, crospovidone, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polydextrose, polyethylene glycol, povidone, titanium dioxide, and triethyl citrate.

12.5 mg
Each white, oval, film-coated tablet, imprinted with the "P" logo on one side and "12.5" on the other side, contains 12.5 mg of carvedilol. Nonmedicinal ingredients: crospovidone, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polydextrose, polyethylene glycol, povidone, titanium dioxide, and triethyl citrate.

25 mg
Each white, oval, film-coated tablet, imprinted with the "P" logo on one side and "25" on the other side, contains 25 mg of carvedilol. Nonmedicinal ingredients: crospovidone, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polydextrose, polyethylene glycol, povidone, titanium dioxide, and triethyl citrate.

Do not take carvedilol if you:

• are allergic to carvedilol or to any of the ingredients of the medication
• have a certain type of heart valve disease
• have a type of heart failure known as decompensated heart failure
• have a very slow heart rate
• have bronchial Asthma or certain other breathing conditions
• have cardiogenic shock
• have certain types of heart rhythm problems
• have certain types of liver disease
• have mental incapacity, unless closely supervised by an appropriate caregiver
• have serious heart block (second- or third-degree AV block)
• have an irregular heart rhythm that requires intravenous medication to support the heart beat
• have very Low Blood Pressure

There may be an interaction between carvedilol and any of the following:

• Abiraterone acetate
• Aldesleukin
• Aliskiren
• alpha agonists (e.g., Clonidine, methyldopa)
• alpha blockers (e.g., Alfuzosin, Doxazosin, Silodosin, Tamsulosin)
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, lisdexamphetamine)
• angiotensin-converting enzyme inhibitors (ACEIs; Captopril, Enalapril, Ramipril)
• angiotensin receptor blockers (ARBs; e.g., candasartan, Irbesartan, Losartan)
• anti-cancer medications (e.g., Doxorubicin, Topotecan, Vincristine)
• antidiabetes medications (e.g., insulin, Metformin, Gliclazide)
• anti-malarial medications (e.g., chloroquine, hydroxychloroquine, Primaquine)
• anti-psychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, olanzepine, Quetiapine, Risperidone)
• “azole” antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• beta-2 agonists (e.g., formoterol, salmeterol, salbutamol)
• brentuximab
• brimonidine
• Bupropion
• calcium channel blocking agents (e.g., Diltiazem, Verapamil)
• Carbamazepine
• Celecoxib
• Ceritinib
• cetirizine
• chloroquine
• chlorpromazine
• ciprofloxacin
• Cobicistat
• Colchicine
• Cyclosporine
• dabigatran
• Darifenacin
• Dexamethasone
• Digoxin
• Dipyridamole
• Disopyramide
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Donepezil
• Dronedarone
• epinephrine
• ergot products (e.g., ergotamine, ergonovine)
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• Etoposide
• Everolimus
• Fenofibrate
• Fentanyl
• Fingolimod
• Galantamine
• Gemfibrozil
• “gliptin” diabetes medications (e.g., Linagliptin, Saxagliptin, Sitagliptin)
• grapefruit juice
• grass pollen extract
• Guanfacine
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• certain HIV protease inhibitors (e.g., indinavir, ritonavir, tipranavir)
• Hydrocortisone
• insulin
• Lanreotide
• Leflunomide
• levodopa
• lidocaine
• Lomitapide
• Loperamide
• losartan
• macrolide antibiotics (e.g., azithromycin, clarithromycin)
• Mefloquine
• Methadone
• methyldopa
• Methylphenidate
• milk thistle
• Mirabegron
• Minoxidil
• nefazodone
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, Ibuprofen, Naproxen)
• norepinephrine
• Octreotide
• Omeprazole
• Ondansetron
• Paliperidone
• Pasireotide
• Phenytoin
• phosphodiesterase-5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pilocarpine
• Prazosin
• primidone
• Progesterone
• Propranolol
• certain protein kinase inhibitors (e.g., Bosutinib, Crizotinib, imatinib, Lapatinib, Nilotinib)
• Prucalopride
• pyrimethamine
• quinidine
• Ranitidine
• rifampin
• Rituximab
• Rivaroxaban
• Rivastigmine
• Romidepsin
• St. John's wort
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Duloxetine, Fluoxetine, Paroxetine, Sertraline)
• Sirolimus
• "statin" anti-cholesterol medications (e.g., Atorvastatin, Lovastatin, Simvastatin)
• sulphonamide antibiotics (e.g., sulfadiazine, sulfamethoxazole, sulfisoxazole)
• sulfonylureas (e.g., gliclazide, Glyburide, Tolbutamide)
• Tacrolimus
• terbinafine
• theophyllines (e.g., Aminophylline, Oxtriphylline, Theophylline)
• Ticagrelor
• Tizanidine
• tolbutamide
• Tolvaptan
• tricyclic antidepressants (e.g., Amitriptyline, Nortriptyline)
• Trimethoprim
• Zafirlukast

If you are taking any of these, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Carvedilol. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Carvedilol.

Circulation problems: Carvedilol can cause blood vessels in the extremities to become narrowed. The smaller blood vessels may narrow enough that blood cannot flow through easily, causing discoloration and numbness in the areas beyond where the blood vessel closes off. If you notice coldness, waxiness, or numbness in the fingers and toes, with or without pain, contact your doctor as soon as possible.

Diabetes: Carvedilol may hide the symptoms of low blood sugar, such as shakiness or rapid heart beat. It can also cause the blood sugar to drop, making it more difficult for people with diabetes to control their blood sugar. If you have diabetes or low blood sugar, discuss with your doctor how Carvedilol may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Carvedilol, and whether any special monitoring is needed.

Dizziness/fainting: Dizziness and fainting are side effects of carvedilol and may occur after first starting Carvedilol. Do not drive a car or do anything that requires alertness until you know how Carvedilol affects you.

Heart failure: Beta-blockers like carvedilol can worsen existing heart failure. It is important to take carvedilol exactly as prescribed by your doctor to decrease the chance of this happening.

Kidney function: Rarely, carvedilol can cause decreased kidney function and kidney failure. If you have reduced kidney function, discuss with your doctor how Carvedilol may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Carvedilol to build up in the body, causing side effects. It may also cause decreased liver function. If you have liver problems, discuss with your doctor how Carvedilol may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Carvedilol, and whether any special monitoring is needed.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low blood pressure: Occasionally, blood pressure drops too low after taking Carvedilol. This usually happens after the first or second dose or when the dose is increased. To reduce the risk of dizziness, get up slowly from a lying or sitting position. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

Prinzmetal's Angina: Carvedilol may increase the number and duration of angina attacks in patients with Prinzmetal's angina. People who have this condition should be cautious while taking carvedilol.

Primary regurgitative valvular heart disease: The safety and effectiveness of carvedilol have not been well studied for use by people with this condition. People who have this condition should be cautious while taking carvedilol.

Severe allergies: People with allergies severe enough to cause Anaphylaxis (severe allergic reaction) (a severe allergic reaction where swelling of the face, lips, and throat make it difficult to breathe) should talk to their doctor about what to do if they have an allergic reaction. Carvedilol may make it more difficult to treat their allergic reaction with Epinephrine.

Stopping the medication: People with heart disease who stop taking Carvedilol abruptly may experience severe effects, such as chest pain, irregular heartbeat, or Heart Attack. If you have heart disease, do not stop taking Carvedilol without checking with your doctor first. When this medication needs to be stopped, it should be done gradually under supervision of your doctor.

Surgery: Carvedilol interferes with how certain medications used during surgery work in the body. If you are scheduled for surgery, make sure that everyone involved in your care knows about all the medications you use.

Thyroid: Carvedilol can mask the symptoms of too much thyroid hormone in the body, such as a rapid heartbeat or tremor. If you have a thyroid condition, discuss with your doctor how Carvedilol may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Carvedilol, and whether any special monitoring is needed.

Pregnancy: The medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Carvedilol, contact your doctor immediately.

Breast-feeding: Carvedilol passes into breast milk. If you are a breast-feeding mother and are taking Carvedilol, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: Seniors are more likely to experience side effects from this medication.

This medication is typically used twice a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. It is preferable to take this medication with a meal or a snack in order to reduce adverse effects.