Adult Dosing
Hypertension
Immediate release
- Start 6.25 mg PO bid, may increase to 12.5 mg bid, then 25 mg bid at intervals of 1-2weeks
- Max: 25 mg bid
Extended release
- Start 20 mg PO qd
- May increase to 40 mg qd, then 80 mg qd at 1-2wk intervals
- Max: 80 mg/day
CHF
Immediate release
- Start 3.125 mg PO bid x 2 wks
- If tolerated, increase dose to 6.25, 12.5, and 25 mg PO bid over successive intervals of at least 2 weeks
- Max: 25 mg bid (< 85 kgs); 50 mg bid (> 85 kgs)
- Note: Minimize fuid retention prior to therapy
Extended release
- Start 10 mg PO qd
- May increase to 20 mg qd, then 40 mg qd, then 80 mg qd at 2wk intervals
- Max: 80 mg/day
- Note: Minimize fluid retention prior to therapy
Cardiovascular event prevention, post-MI
Immediate release
- Start 6.25 mg PO bid as soon as possible after the patient is stable
- Increase after 3-10 days to 12.5 PO bid, then to target dose of 25 mg PO bid
- Note: Minimize fluid retention prior to therapy, start lower dose and slower titration if hypotension, bradycardia, fluid retention
Extended release
- Start 20 mg PO qd as soon as possible after the patient is stable
- Then increase to 40 mg qd, then 80 mg qd at 3-10 day intervals
- Note: Info: Minimize fluid retention prior to therapy; start 10 mg qd and titrate slowly if hypotension, fluid retention, or bradycardia
Conversion from IR form to ER form
- If receiving 6.25 mg/day IR, convert to 10 mg/day ER
- If receiving 12.5 mg/day IR, convert to 20 mg/day ER
- If receiving 25 mg/day IR, convert to 40 mg/day ER
- If receiving 50 mg/day IR, convert to 80 mg/day ER
- If receiving 6.25 mg/day IR, convert to 10 mg/day ER
- In patients >65 yrs or at risk of hypotension, dizziness, or syncope taking 25 mg/day IR or 50 mg/day IR, switch to 20 mg/day ER or 40 mg/day ER, respectively. Dose may be then increased q2 wks
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Severe exacerbation of angina and the occurrence of myocardial infarction and ventricular arrhythmias have been reported in angina patients following the abrupt discontinuation of therapy with beta-blockers. Carefully observe and advise patients to limit physical activity to a minimum if discontinuation is planned. Discontinue over 1 to 2 weeks whenever possible. If the angina worsens or acute coronary insufficiency develops, it is promptly reinstituted therapy at least temporarily. Since coronary artery disease may be unrecognized, it may be prudent not to discontinue therapy abruptly even in patients treated only for hypertension
- Monitor CHF patients for orthostatic hypotension (eg, dizziness, light-headedness, change in BP) for 1 hr after first dose and at dose titration
- Worsening heart failure or fluid retention may occur during up-titration. Increase dose of diuretics and do not increase carvedilol dose until patient is clinically stable Occasionally it may be necessary to lower the carvedilol dose or temporarily discontinue it
- Deterioration of renal function may occur in patients with heart failure. Patients at risk appear to be those with low blood pressure, IHD, and diffuse vascular disease, and/or underlying renal insufficiency
- Generally, patients with bronchospastic disease should not receive beta-blocker therapy. In patients who do not respond to, or cannot tolerate, other antihypertensive agents, carvedilol may be used with great caution in the smallest effective dose
- If carvedilol is continued perioperatively, use with caution with anesthetic agents that depress myocardial function
- Mild hepatocellular injury may occur. Perform laboratory testing at first signs or symptoms of liver dysfunction
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Major surgery
- Diabetes mellitus
- Myasthenia gravis
- Severe anaphylactic reactions history
- Thyroid disorder
- Pheochromocytoma
- Prinzmetal’s Angina
- WPW syndrome
- Peripheral vascular disease
- Pregnancy 2nd or 3rd trimester
- Lactation
- Poor CYP2D6 metabolizer
- Elderly patients
Pregnancy Category:C
Breastfeeding: Safety unknown, other agents might be preferred. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 19 May 2010).
US Trade Name(s)
US Availability
carvedilol (generic)
- TABS: 3.125, 6.25, 12.5, 25 mg
Coreg
- TABS: 3.125, 6.25, 12.5, 25 mg
Coreg CR
Canadian Trade Name(s)
Canadian Availability
carvedilol (generic)
- TABS: 3.125, 6.25, 12.5, 25 mg
UK Trade Name(s)
UK Availability
carvedilol (generic)
- TABS: 3.125, 6.25, 12.5, 25 mg
Eucardic
- TABS: 3.125, 6.25, 12.5, 25 mg
Australian Trade Name(s)
- Dilasag
- Dilatrend
- Kredex
- Vedilol
Australian Availability
carvedilol (generic)
- TABS: 3.125, 6.25, 12.5, 25 mg
Dilasag, Dilatrend, Kredex, Vedilol
- TABS: 3.125, 6.25, 12.5, 25 mg
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Coreg 3.125 MG TABS [Bottle] (GLAXO SMITH KLINE)
60 mg = $138.99
180 mg = $394.98 - Coreg CR 20 MG CP24 [Bottle] (GLAXO SMITH KLINE)
30 mg = $141.99
90 mg = $402.97 - Coreg 12.5 MG TABS [Bottle] (GLAXO SMITH KLINE)
60 mg = $155
180 mg = $425.95 - Coreg 25 MG TABS [Bottle] (GLAXO SMITH KLINE)
60 mg = $157.99
180 mg = $458.95 - Carvedilol 25 MG TABS [Bottle] (ZYDUS PHARMACEUTICALS (USA))
30 mg = $15.99
90 mg = $44.96 - Coreg 6.25 MG TABS [Bottle] (GLAXO SMITH KLINE)
30 mg = $78.99
60 mg = $150.97 - Coreg CR 10 MG CP24 [Bottle] (GLAXO SMITH KLINE)
30 mg = $141.99
90 mg = $402.97 - Coreg CR 40 MG CP24 [Bottle] (GLAXO SMITH KLINE)
30 mg = $141.99
90 mg = $402.97 - Carvedilol 12.5 MG TABS [Bottle] (DR.REDDY'S LABORATORIES)
INC. mg = $30
mg = $90 - Coreg CR 80 MG CP24 [Bottle] (GLAXO SMITH KLINE)
30 mg = $143.98
90 mg = $409.97 - Carvedilol 6.25 MG TABS [Bottle] (GLENMARK PHARMACEUTICALS)
30 mg = $14.99
90 mg = $39.98 - Carvedilol 3.125 MG TABS [Bottle] (ZYDUS PHARMACEUTICALS (USA))
30 mg = $25.99
60 mg = $34.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
