Carvedilol Phosphate ER

Carvedilol Phosphate ER is available in extended-release capsules with the following strengths:

• 10 mg
• 20 mg
• 40 mg
• 80 mg

The usual starting dose for heart failure is 10 mg once daily, and the dose is gradually increased based on patient tolerance and response.

Carvedilol Phosphate ER is contraindicated in patients with:

• Severe asthma or other chronic obstructive pulmonary diseases (COPD) with bronchospasm.
• Severe bradycardia (slow heart rate).
• Heart block or cardiogenic shock.
• Decompensated heart failure requiring intravenous inotropic therapy.
• Severe liver disease.
• Hypersensitivity to carvedilol or any of its components.

Patients taking Carvedilol Phosphate ER should be advised to:

• Take the medication with food to reduce the risk of side effects such as dizziness or lightheadedness.
• Avoid abruptly stopping the medication, as this may cause worsening chest pain, irregular heart rhythms, or even a heart attack. Gradual dose reduction is necessary under a doctor’s supervision.
• Be cautious when standing up quickly from a sitting or lying position, as carvedilol can cause dizziness or fainting (orthostatic hypotension), especially at the beginning of treatment or after a dose increase.
• Monitor their blood pressure and heart rate regularly. Report any signs of bradycardia (slow heart rate), such as extreme fatigue or fainting.
• Inform their healthcare provider if they are taking any other medications, as carvedilol may interact with drugs such as calcium channel blockers or anti-diabetic medications.

• Dizziness or lightheadedness, particularly when standing
• Fatigue
• Diarrhea
• Low blood pressure (hypotension)
• Weight gain (especially in patients with heart failure)

• Bradycardia (Slow Heart Rate): Symptoms include dizziness, extreme fatigue, or fainting.
• Hypotension (Low Blood Pressure): This can lead to dizziness, fainting, or blurred vision.
• Heart Failure Worsening: Symptoms include swelling in the legs, rapid weight gain, or shortness of breath.
• Allergic Reactions: Such as rash, itching, swelling, or difficulty breathing.

Bradycardia and Hypotension: Carvedilol Phosphate ER can cause a significant drop in heart rate and blood pressure, especially when first starting the medication or increasing the dose. Patients should be monitored regularly for these effects.

Heart Failure Worsening: Although Carvedilol improves heart function over time, it may initially worsen symptoms of heart failure. Patients should be monitored closely, and dose adjustments may be necessary.

Diabetes Management: Carvedilol can mask symptoms of low blood sugar (hypoglycemia), such as rapid heartbeat, in patients with diabetes. Diabetic patients should monitor their blood sugar levels closely.

Respiratory Issues: As a non-selective beta-blocker, Carvedilol may cause bronchospasm in patients with asthma or other respiratory diseases. Use with caution in these patients.

Carvedilol Phosphate ER may interact with other medications, including:

• Calcium Channel Blockers: Such as verapamil or diltiazem, which can increase the risk of bradycardia and low blood pressure when taken with carvedilol.
• Antidiabetic Medications: Carvedilol can affect blood sugar control and mask symptoms of hypoglycemia, making it more difficult to manage diabetes.
• Other Beta-Blockers: Should not be used in combination with other beta-blockers, as this may increase the risk of bradycardia and hypotension.
• NSAIDs: Non-steroidal anti-inflammatory drugs like ibuprofen may reduce the effectiveness of carvedilol in lowering blood pressure.

Patients should inform their healthcare provider of all medications and supplements they are taking to avoid potential interactions.

Alternative treatments for heart failure and hypertension include:

• Other Beta-Blockers: Such as metoprolol succinate (Toprol XL) or bisoprolol, which may be preferred in certain patients.
• ACE Inhibitors/ARBs: Such as lisinopril or losartan, which can be used to manage heart failure and high blood pressure.
• Calcium Channel Blockers: Such as amlodipine, used for blood pressure control.
• Diuretics: Such as furosemide, which can help manage fluid retention in heart failure patients.