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Coreg CR
Coreg CR (carvedilol phosphate) is an extended-release beta-blocker used to treat high blood pressure (hypertension), heart failure, and to improve survival after a heart attack. Coreg CR works by relaxing blood vessels, slowing heart rate, and reducing the workload on the heart. It helps improve the efficiency of the heart, making it a crucial medication for those with heart conditions. Carvedilol is available in both immediate-release and extended-release forms, with Coreg CR being the extended-release version designed for once-daily dosing.
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Frequently Asked Questions
How long does it take for Coreg CR to start working?
Coreg CR begins to work within a few hours, but full benefits may take several days or weeks of consistent use, especially for heart failure and blood pressure management.
Can I stop taking Coreg CR if I feel better?
No, Coreg CR should not be stopped suddenly, as this can lead to serious heart complications. Always consult your healthcare provider before making any changes to your medication.
What should I do if I miss a dose of Coreg CR?
If you miss a dose, take it as soon as you remember, unless it’s close to the time for your next dose. Do not double up on doses to make up for the missed one.
Can I drink alcohol while taking Coreg CR?
It is best to avoid alcohol while taking Coreg CR, as alcohol can lower your blood pressure and increase the risk of side effects like dizziness.
Is Coreg CR safe for people with diabetes?
Coreg CR can be used in patients with diabetes, but it may mask some of the symptoms of low blood sugar. Blood sugar levels should be monitored regularly, and patients should be aware of this potential effect.
Comprehensive Drug Guide
How Does Coreg CR Work?
Coreg CR works by blocking beta-adrenergic receptors in the heart and blood vessels, which reduces the effects of adrenaline. This action slows the heart rate, decreases the force of contraction, and lowers blood pressure. Additionally, Coreg CR has alpha-blocking activity, which helps dilate blood vessels, further reducing blood pressure and improving blood flow. Together, these effects help reduce the heart's workload and prevent complications such as heart failure and stroke.
Common Dosages
- Extended-release capsules: 10 mg, 20 mg, 40 mg, 80 mg
Typical Dosing
- For hypertension: The usual starting dose is 20 mg once daily. The dose may be increased gradually as needed, with a typical range of 20 to 80 mg once daily.
- For heart failure: The typical starting dose is 10 mg once daily, with gradual increases based on the patient's response and tolerance.
- After heart attack: The usual dose starts at 20 mg once daily and may be increased to 40 mg to 80 mg daily, depending on tolerance.
Typical Dosing
FDA Approved Indications
- Hypertension (high blood pressure)
- Heart failure
- Left ventricular dysfunction following a heart attack
Who Shouldn't Take Coreg CR?
- Severe asthma or chronic obstructive pulmonary disease (COPD)
- Severe liver impairment
- Certain heart rhythm disorders (such as bradycardia or second- or third-degree heart block) without a pacemaker
- Severe heart failure requiring IV inotropic therapy
Advice From The Pharmacist
- Take Coreg CR with food to help reduce the risk of dizziness or low blood pressure, especially when standing up.
- Do not crush or chew the capsules; swallow them whole. If swallowing is difficult, you may open the capsule and sprinkle the contents on a small amount of applesauce, but consume the mixture immediately without chewing.
- Avoid abrupt discontinuation of Coreg CR, as this can cause serious heart issues. Consult your healthcare provider before stopping the medication.
- Monitor your blood pressure and heart rate regularly, and report any signs of dizziness, fainting, or unusually slow heart rate to your doctor.
Side Effects of Coreg CR
Common Side Effects
- Dizziness or lightheadedness
- Fatigue or weakness
- Diarrhea
- Slow heart rate (bradycardia)
- Weight gain due to fluid retention
Uncommon/Severe Side Effects
- Shortness of breath or wheezing
- Severe dizziness or fainting
- Low blood sugar (hypoglycemia), especially in patients with diabetes
- Allergic reactions (rash, swelling, difficulty breathing)
Risks and Warnings of Coreg CR
- Bradycardia: Coreg CR can cause a significant slowing of the heart rate, particularly in patients with pre-existing heart conditions or those taking other heart medications. Monitoring of heart rate is important, and the medication should be discontinued if severe bradycardia occurs.
- Worsening Heart Failure: In some cases, Coreg CR may worsen heart failure symptoms, particularly during the initiation or dosage adjustment phase. Patients should be closely monitored for signs of fluid retention or worsening symptoms.
- Asthma or COPD: Coreg CR may worsen respiratory conditions such as asthma or COPD. It should be used with caution or avoided in individuals with these conditions.
- Masking of Hypoglycemia: Coreg CR can mask the symptoms of low blood sugar, particularly in patients with diabetes. Blood sugar levels should be monitored regularly.
Interactions with Coreg CR
Common Drug Interactions
- Calcium Channel Blockers (Verapamil, Diltiazem): These medications may increase the risk of bradycardia or heart failure when used with Coreg CR.
- CYP2D6 Inhibitors: Medications such as fluoxetine or paroxetine may increase the levels of Coreg CR in the blood, leading to a higher risk of side effects.
- Insulin and Oral Antidiabetics: Coreg CR may mask symptoms of hypoglycemia and increase the risk of blood sugar fluctuations.
- Clonidine: Abrupt withdrawal of clonidine while on Coreg CR may lead to rebound hypertension. Tapering is recommended when discontinuing clonidine.
Alternatives to Coreg CR
- Metoprolol (Toprol XL): Another beta-blocker commonly used to treat hypertension and heart failure.
- Bisoprolol (Zebeta): A beta-1 selective blocker used to manage hypertension and heart failure.
- Atenolol (Tenormin): A beta-1 selective blocker used for the treatment of high blood pressure and angina.
- Lisinopril (Zestril): An ACE inhibitor often used to treat heart failure and high blood pressure.
