Carvedilol (Coreg) Considerations for Use*

US/FDA Approved Indication: Heart Rate Control for Atrial Fibrillation

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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

  • Asthma
  • AV block
  • Bradycardia
  • cardiogenic shock
  • decompensated heart failure
  • sick sinus syndrome without pacer
  • hepatic disease
  • 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 )

    Special Notes

    Non-selective beta-blocker.

    Abrupt cessation my precipitate angina, MI, arrhythmias, or rebound HTN; discontinue by tapering over 1-2 weeks.

    Dosing conversion:
    3.125 mg immediate-release BID = 10 mg CR
    6.25 mg immediate - release BID = 20 mg CR
    12.5 mg mg immediate - release BID = 40 mg CR
    25 mg mg immediate - release BID = 80 mg CR


    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.


    1. 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.
    2. Heart Rhythm Society. AF360 Pocket Guide: Practical Rate and Rhythm Management of Atrial Fibrillation. 2010, Washington, DC: Heart Rhythm Society.
    3. Tarascon Pocket Pharmacopoeia® 2012.