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Coreg
Coreg (carvedilol) is a beta-blocker and alpha-blocker combination medication used to treat high blood pressure (hypertension), heart failure, and to improve survival after a heart attack. By reducing the heart’s workload and lowering blood pressure, Coreg helps to improve heart function and prevent further heart damage, especially in patients with weakened hearts.
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Frequently Asked Questions
How long does it take for Coreg to start working?
Coreg may start lowering blood pressure within a few hours of taking the first dose, but it may take 1 to 2 weeks to see the full effects, especially for heart failure.
Can I stop taking Coreg if I feel better?
No, Coreg should not be stopped suddenly, even if you feel better. Stopping it abruptly can lead to serious complications such as increased blood pressure, worsening heart failure, or a heart attack. Always consult your healthcare provider before discontinuing the medication.
Can Coreg be used in people with asthma?
Coreg is not recommended for use in people with asthma or severe COPD, as it can block beta receptors in the lungs and worsen breathing problems.
What should I do if I miss a dose of Coreg?
If you miss a dose, take it as soon as you remember, unless it is close to your next scheduled dose. Do not double up doses. Take the next dose at your regular time.
Can Coreg cause weight gain?
Yes, weight gain is a potential side effect of Coreg, especially in patients with heart failure. If you notice sudden or unexplained weight gain, contact your healthcare provider.
Comprehensive Drug Guide
How Does Coreg Work?
Coreg works by blocking beta-adrenergic receptors and alpha-adrenergic receptors, which reduces the effects of adrenaline on the heart and blood vessels. This results in lower heart rate, reduced force of heart contractions, and widened blood vessels, all of which contribute to improved blood flow and lower blood pressure.
Common Dosages
- Tablets: 3.125 mg, 6.25 mg, 12.5 mg, 25 mg
- Extended-release capsules: 10 mg, 20 mg, 40 mg, 80 mg
Typical Dosing
- For heart failure: The starting dose is 3.125 mg twice daily, which may be gradually increased based on response.
- For hypertension: The usual starting dose is 6.25 mg twice daily, with adjustments based on blood pressure control.
- For post-heart attack: The initial dose may vary, with gradual titration based on heart function and response.
Typical Dosing
FDA Approved Indications
- Hypertension (high blood pressure)
- Heart failure
- Left ventricular dysfunction following a heart attack
Who Shouldn't Take Coreg?
- Known hypersensitivity to carvedilol or any component of the formulation.
- Severe bradycardia (slow heart rate).
- Asthma or severe chronic obstructive pulmonary disease (COPD).
- Severe heart block without a pacemaker.
Advice From The Pharmacist
- Take Coreg with food to reduce the risk of dizziness and improve absorption.
- Do not stop taking Coreg suddenly, as this can lead to a rapid increase in blood pressure or worsen heart failure. Always consult your healthcare provider before making any changes.
- Monitor your blood pressure regularly while taking Coreg, and inform your healthcare provider of any unusual symptoms, such as lightheadedness, fatigue, or shortness of breath.
Side Effects of Coreg
Common Side Effects
- Dizziness
- Fatigue
- Low blood pressure (hypotension)
- Slow heart rate (bradycardia)
- Weight gain (in heart failure patients)
Uncommon/Severe Side Effects
- Heart failure worsening (increased shortness of breath, swelling in the legs)
- Severe allergic reactions (rash, swelling, difficulty breathing)
- Liver problems (yellowing of the skin or eyes)
Risks and Warnings of Coreg
- Heart Failure: Coreg can sometimes worsen symptoms of heart failure in the short term. Contact your healthcare provider if symptoms like shortness of breath, weight gain, or swelling worsen.
- Bronchospasm: Coreg can worsen breathing problems in individuals with asthma or COPD by blocking beta receptors in the lungs, reducing airway relaxation.
- Low Blood Pressure (Hypotension): Coreg may cause blood pressure to drop too low, leading to dizziness or fainting, especially when standing up quickly (orthostatic hypotension). Move slowly when transitioning from sitting to standing to prevent this.
Interactions with Coreg
Common Drug Interactions
- Calcium channel blockers (e.g., verapamil, diltiazem): Taking these medications with Coreg can increase the risk of low heart rate and low blood pressure.
- Insulin and oral diabetes medications: Coreg can mask the symptoms of low blood sugar (hypoglycemia) and affect blood sugar control. Monitor your blood sugar closely if you have diabetes.
- Digoxin: Concurrent use of Coreg with digoxin may increase the risk of bradycardia (slow heart rate) and should be monitored carefully.
Alternatives to Coreg
- Metoprolol (Toprol-XL, Lopressor): A beta-blocker used for similar indications, including hypertension and heart failure.
- Lisinopril: An angiotensin-converting enzyme (ACE) inhibitor used to lower blood pressure and treat heart failure.
- Amlodipine (Norvasc): A calcium channel blocker used to treat hypertension and chest pain (angina).
