II. Indication
- Stable Congestive Heart Failure (Compensated)
III. Mechanism: Third generation Beta Blocker (vasodilatory properties)
-
Beta Adrenergic Receptor Antagonist
- Non-selective Beta Blocker
- Vasodilator (alpha antagonist)
- Blunts sympathetic drive
- Preserves some heart function
- Does not affect Blood Glucose
IV. Dosing: Stable Congestive Heart Failure
- Start: 3.125 mg PO bid with food
- Titrate up by doubling dose every 2 weeks
- Maximum dose
- Weight <85 kg: 25 mg bid
- Weight >85 kg: 50 mg bid
- Conversion from prior Beta Blocker
- No overlap from Metoprolol 50 mg or Atenolol 50 mg
- Start Carvedilol 6.25 mg bid and increase as above
- Overlap from Atenolol 50-150 or Metoprolol 100-200
- Add Carvedilol 3.125 mg bid for 2 weeks
- Raise Carvedilol and lower other Beta Blocker
- Double Carvedilol every two weeks
- Reduce Atenolol or Metoprolol by 50 mg q2 weeks
- When to stop other Beta Blocker
- After 2 weeks on Metoprolol 50 mg or
- After 2 weeks on Atenolol 25 mg
- Follows prior 2 weeks on Atenolol 50 mg
- Reference
- No overlap from Metoprolol 50 mg or Atenolol 50 mg
V. Efficacy
- Carvedilol used in severe Congestive Heart Failure
- Findings
- Mean Ejection Fraction: 23%
- Studied over 6 months
- Overall mortality reduced (3.2% vs 7.8%)
- Reference
- Findings
- Utah Study of Carvedilol in CHF
- Ejection Fraction improved 20% to 33%
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| Carvedilol (on 6/18/2017 at Walmart.com) | ||
| Carvedilol 12.5mg | #60 tablets for $4.00 | $0.07 each |
| Carvedilol 12.5mg | #180 tablets for $10.00 | $0.06 each |
| Carvedilol 25mg | #60 tablets for $4.00 | $0.07 each |
| Carvedilol 25mg | #180 tablets for $10.00 | $0.06 each |
| Carvedilol 3.125mg | #60 tablets for $4.00 | $0.07 each |
| Carvedilol 3.125mg | #180 tablets for $10.00 | $0.06 each |
| Carvedilol 6.25mg | #60 tablets for $4.00 | $0.07 each |
| Carvedilol 6.25mg | #180 tablets for $10.00 | $0.06 each |
| carvedilol (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CARVEDILOL 12.5 MG TABLET | Generic | $0.03 each |
| CARVEDILOL 25 MG TABLET | Generic | $0.03 each |
| CARVEDILOL 3.125 MG TABLET | Generic | $0.03 each |
| CARVEDILOL 6.25 MG TABLET | Generic | $0.02 each |
| coreg (on 2/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| COREG 12.5 MG TABLET | Generic | $0.03 each |
| COREG 25 MG TABLET | Generic | $0.03 each |
| COREG 3.125 MG TABLET | Generic | $0.03 each |
| COREG 6.25 MG TABLET | Generic | $0.02 each |
| COREG CR 10 MG CAPSULE | $8.82 each | |
| COREG CR 20 MG CAPSULE | $8.81 each | |
| COREG CR 40 MG CAPSULE | $8.80 each | |
| COREG CR 80 MG CAPSULE | $8.83 each | |
Ontology: carvedilol (C0054836)
| Definition (NCI_NCI-GLOSS) | A drug used to treat high blood pressure and certain heart problems. It is also being studied in the prevention and treatment of side effects caused by some anticancer drugs. Coreg blocks certain receptors on nerve cells and causes blood vessels to dilate (widen). It is a type of antihypertensive agent and a type of antianginal agent. |
| Definition (NCI) | A synthetic antihypertensive methoxyphenoxy- 2-propanol derivative with no intrinsic sympathomimetic activity, Carvedilol acts as a nonselective beta-adrenoceptor blocking agent (S(-) enantiomer) and as an alpha 1-adrenoceptor blocker (R(+) and S(-) enantiomers). Its acts more strongly on beta-receptors than on alpha 1-receptors, reduces peripheral vascular resistance by vasodilation, and prevents reflex tachycardia (beta-blockade) so that heart rate is either unchanged or decreased. Carvedilol also reduces renin release through beta-blockade. (NCI04) |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C043211 |
| SnomedCT | 108551001, 386870007 |
| LNC | LP171650-7 |
| English | carvedilol, CARVEDILOL, carvedilol (medication), carvedilol [Chemical/Ingredient], Carvedilol, Carvedilol (product), Carvedilol (substance) |
| Spanish | carvedilol (producto), carvedilol (sustancia), carvedilol |
Ontology: Coreg (C0719509)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C043211 |
| English | Coreg, coreg, GlaxoSmithKline brand of carvedilol |
