section name header

Pronunciation ⬇

kar-VE-di-lole

Classifications ⬆ ⬇

Therapeutic Classification: antihypertensives

Pharmacologic Classification: beta blockers

Indications ⬆ ⬇

REMS

Action ⬆ ⬇

  • Blocks stimulation of beta1(myocardial) and beta2 (pulmonary, vascular, and uterine)-adrenergic receptor sites.
  • Also has alpha1 blocking activity, which may result in orthostatic hypotension.
Therapeutic effects:
  • Decreased heart rate and BP.
  • Improved cardiac output, slowing of the progression of HF and decreased risk of death.

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed but rapidly undergoes extensive first-pass hepatic metabolism, resulting in 25–35% bioavailability. Food slows absorption.

Distribution: Widely distributed to tissues.

Protein Binding: 98%.

Metabolism/Excretion: Extensively metabolized by the liver via the CYP2D6 and CYP2C9 isoenzymes; the CYP2D6 enzyme system exhibits genetic polymorphism; ∼7% of population may be poor metabolizers and may have significantly ↑ carvedilol concentrations and an ↑ risk of adverse effects. Excreted in feces via bile, <2% excreted unchanged in urine.

Half-Life: 7–10 hr.

Time/Action Profile ⬆ ⬇

(cardiovascular effects)

ROUTEONSETPEAKDURATION
POwithin 1 hr1–2 hr12 hr
PO-CRunknown5 hr24 hr



Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

CV: BRADYCARDIA, HF

Derm: itching, rash, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, urticaria

EENT: blurred vision, dry eyes, intraoperative floppy iris syndrome, nasal stuffiness

Endo: hyperglycemia, hypoglycemia

GI: diarrhea, constipation, nausea

GU: erectile dysfunction, ↓libido

MS: arthralgia, back pain, muscle cramps

Neuro: dizziness, fatigue, weakness, anxiety, depression, drowsiness, insomnia, memory loss, mental status changes, nervousness, nightmares, paresthesia

Resp: bronchospasm, PULMONARY EDEMA, wheezing

Misc: drug-induced lupus syndrome, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA)

Interactions ⬆ ⬇

Drug-drug:

Route/Dosage ⬆ ⬇

Hypertension

Heart Failure

Left Ventricular Dysfunction After Myocardial Infarction

Availability ⬆ ⬇

(Generic available)

Assessment ⬆ ⬇

Lab Test Considerations:

Toxicity and Overdose:

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Coreg, Coreg CR

Code ⬆

NDC Code