Carvedilol (Coreg) Considerations for Use*
US/FDA Approved Indication: Heart Rate Control for Atrial Fibrillation
|Black Box Warning*||Abrupt cessation may exacerbate angina pectoris and MI.|
Mechanism of Action
Blocks binding of catecholamines to postsynaptic alpha - 1, beta - 1, and beta - 2 receptors
Non-acute setting or maintenance - Immediate release: 3.125 to 25 mg PO every 12 hrs (up to 50 mg every 12 hrs for patients >85 kg).
Non-acute setting or maintenance - Extended-release: 10 to 80 mg PO daily
Hepatic Impairment: Not recommended for clinically - evident hepatic impairment
Renal Impairment: No dosage adjustments are needed
|Major Side Effects||
hypotension, bradycardia, bronchospasm , HF
|Dosage forms and Strengths||
PO: 3.125 mg, 6.25 mg, 12.5 mg, 25 mg immediate - release tablets (Coreg®) 10 mg, 20 mg, 40 mg, 80 mg extended - release capsules (Coreg® CR )
Abrupt cessation my precipitate angina, MI, arrhythmias, or rebound HTN; discontinue by tapering over 1-2 weeks.
Do not abruptly discontinue without physician’s advice.
Take with food and eight ounces of water at the same time every day
Separate extended - release formulation and alcohol by at least 2 hours
Take controlled - release formulation in the morning; the contents may be sprinkled over applesauce and consumed immediately
* Refer to prescribing information for more complete information.
†Dosages given in the table may differ from those recommended by the manufacturers.
- American College of Cardiology (ACC), American Heart Association (AHA), and the European Society of Cardiology (ESC). ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation. Washington, DC: American College of Cardiology.
- Heart Rhythm Society. AF360 Pocket Guide: Practical Rate and Rhythm Management of Atrial Fibrillation. 2010, Washington, DC: Heart Rhythm Society.
- Tarascon Pocket Pharmacopoeia® 2012.