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Coreg CR (carvedilol) Disease Interactions

There are 22 disease interactions with Coreg CR (carvedilol):

Major

Beta-Blockers (Includes Coreg CR) ↔ Asthma/Copd

Severe Potential Hazard, High plausibility

Applies to: Asthma, Chronic Obstructive Pulmonary Disease

Some beta-adrenergic receptor blocking agents (i.e., beta-blockers) are contraindicated in patients with bronchial asthma or with a history of bronchial asthma, or severe chronic obstructive pulmonary disease. In general, beta-adrenergic receptor blocking agents should not be used in patients with bronchospastic diseases. Beta blockade may adversely affect pulmonary function by counteracting the bronchodilation produced by catecholamine stimulation of beta-2 receptors. If beta-blocker therapy is necessary in these patients, an agent with beta-1 selectivity (e.g., atenolol, metoprolol, betaxolol) is considered safer, but should be used with caution nonetheless. Cardioselectivity is not absolute and can be lost with larger doses.

References

  1. Horvath JS, Woolcock AJ, Tiller DJ, Donnelly P, Armstrong J, Caterson R "A comparison of metoprolol and propranolol on blood pressure and respiratory function in patients with hypertension." Aust N Z J Med 8 (1978): 1-6
  2. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  3. Falliers CJ, Vincent ME, Medakovic M "Effect of single doses of labetalol, metoprolol, and placebo on ventilatory function in patients with bronchial asthma: interaction with isoproterenol." J Asthma 23 (1986): 251-60
  4. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  5. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  6. Morris R, Bulteau P "Respiratory arrest after beta-blocker in an asthmatic patient." Med J Aust 2 (1980): 576
  7. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  8. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  9. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  10. Raine JM, Palazzo MG, Kerr JH, Sleight P "Near-fatal bronchospasm after oral nadolol in a young asthmatic and response to ventilation with halothane." Br Med J 282 (1981): 548-9
  11. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  12. "Product Information. Normodyne (labetalol)." Schering Laboratories, Kenilworth, NJ.
  13. Durant PA, Joucken K "Bronchospasm and hypotension during cardiopulmonary bypass after preoperative cimetidine and labetalol therapy." Br J Anaesth 56 (1984): 917-20
  14. van Zyl AI, Jennings AA, Bateman ED, Opie LH "Comparison of respiratory effects of two cardioselective beta-blockers, celiprolol and atenolol, in asthmatics with mild to moderate hypertension." Chest 95 (1989): 209-13
  15. Adam WR, Meagher EJ, Barter CE "Labetalol, beta blockers, and acute deterioration of chronic airway obstruction." Clin Exp Hypertens A A4 (1982): 1419-28
  16. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  17. Mashford ML, Coventry D, Hecker R, et al. "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust 1 (1982): 416-9
  18. "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals, Wilmington, DE.
  19. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  20. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  21. Benson MK, Berrill WT, Cruickshank JM, Sterling GS "A comparison of four B-adrenoceptor antagonists in patients with asthma." Br J Clin Pharmacol 5 (1978): 415-9
  22. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
  23. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
  24. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
  25. "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  26. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  27. Schoenberger JA, Croog SH, Sudilovsky A, et al "Self-reported side effects from antihypertensive drugs: a clinical trial." Am J Hypertens 3 (1990): 123-32
  28. Chodosh S, Tuck J, Blasucci DJ "The effects of dilevalol, metoprolol, and placebo on ventilatory function in asthmatics." J Cardiovasc Pharmacol 11 (1988): s18-24
  29. Stephen SA "Unwanted effects of propranolol." Am J Cardiol 18 (1966): 463-72
View all 29 references
Major

Beta-Blockers (Includes Coreg CR) ↔ Bradyarrhythmia/Av Block

Severe Potential Hazard, High plausibility

Applies to: Heart Block, Sinus Node Dysfunction

The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to exacerbate these conditions.

References

  1. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
  2. "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  3. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  5. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  6. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  7. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  8. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  9. Treseder AS, Thomas TP "Sinus arrest due to timolol eye drops." Br J Clin Pract 40 (1986): 256-8
  10. Crean PA, Williams DO "Effect of intravenous and oral acebutolol in patients with bundle branch block." Int J Cardiol 10 (1986): 119-26
  11. Frishman WH "Carvedilol." N Engl J Med 339 (1998): 1759-65
  12. Mashford ML, Coventry D, Hecker R, et al. "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust 1 (1982): 416-9
  13. "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals, Wilmington, DE.
  14. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
  15. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  16. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
  17. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  18. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  19. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  20. "Product Information. Normodyne (labetalol)." Schering Laboratories, Kenilworth, NJ.
  21. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 21 references
Major

Beta-Blockers (Includes Coreg CR) ↔ Cardiogenic Shock/Hypotension

Severe Potential Hazard, High plausibility

Applies to: Cardiogenic Shock, Hypotension

The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with hypotension or cardiogenic shock. Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to further depress cardiac output and blood pressure, which can be detrimental in these patients.

References

  1. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  3. "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals, Wilmington, DE.
  4. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  5. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
  6. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  7. Kholeif M, Isles C "Profound hypotension after atenolol in severe hypertension." Br Med J 298 (1989): 161-2
  8. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  9. "Product Information. Normodyne (labetalol)." Schering Laboratories, Kenilworth, NJ.
  10. "Product Information. Acupress (carteolol ophthalmic)." Otsuka American Pharmaceuticals Inc, Rockville, MD.
  11. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  12. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  13. Tirlapur VG, Evans PJ, Jones MK "Shock syndrome after acebutolol." Br J Clin Pract 40 (1986): 33-4
  14. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  15. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  16. Frishman WH "Carvedilol." N Engl J Med 339 (1998): 1759-65
  17. "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  18. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
  19. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  20. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  21. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc, Fort Worth, TX.
  22. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  23. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
View all 23 references
Major

Beta-Blockers (Includes Coreg CR) ↔ Diabetes

Severe Potential Hazard, High plausibility

Applies to: Diabetes Mellitus

Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask symptoms of hypoglycemia such as tremors, tachycardia and blood pressure changes. In addition, the nonselective beta-blockers (e.g., propranolol, pindolol, timolol) may inhibit catecholamine-mediated glycogenolysis, thereby potentiating insulin-induced hypoglycemia and delaying the recovery of normal blood glucose levels. Since cardioselectivity is not absolute, larger doses of beta-1 selective agents may demonstrate these effects as well. Therapy with beta-blockers should be administered cautiously in patients with diabetes or predisposed to spontaneous hypoglycemia.

References

  1. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  2. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  3. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  4. "Product Information. Normodyne (labetalol)." Schering Laboratories, Kenilworth, NJ.
  5. Grimaldi A, Bennett P, Delas B, et al "Beta-blockers and hypoglycaemia: assessment of cardioselective and intrinsic sympathomimetic properties in relation to severity of hypoglycaemia." Curr Ther Res Clin Exp 36 (1984): 361-73
  6. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  7. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
  8. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  9. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  10. "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  11. Velde TM, Kaiser FE "Ophthalmic timolol treatment causing altered hypoglycemic response in a diabetic patient." Arch Intern Med 143 (1983): 1627
  12. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  13. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  14. Darga LL, Hakim MJ, Lucas CP, Franklin BA "Comparison of the effects of guanadrel sulfate and propranolol on blood pressure, functional capacity, serum lipoproteins and glucose in systemic hypertension." Am J Cardiol 67 (1991): 590-6
  15. Giugliano D, Acampora R, Marfella R, DeRosa N, Ziccardi P, Ragone R, DeAngelis L, DOnofrio F "Metabolic and cardiovascular effects of carvedilol and atenolol in non-insulin-dependent diabetes mellitus and hypertension - A randomized, controlled trial." Ann Intern Med 126 (1997): 955-9
  16. Uusitupa M, Aro A, Pietikainen M "Severe hypoglycaemia caused by physical strain and pindolol therapy." Ann Clin Res 12 (1980): 25-7
  17. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  18. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
  19. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  20. "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals, Wilmington, DE.
  21. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
View all 21 references
Major

Beta-Blockers (Includes Coreg CR) ↔ Hemodialysis

Severe Potential Hazard, High plausibility

Applies to: hemodialysis

Therapy with beta-adrenergic receptor blocking agents (aka beta-blockers) should be administered cautiously in patients requiring hemodialysis. When given after dialysis, hemodynamic stability should be established prior to drug administration to avoid marked falls in blood pressure. The hemodynamic status should be closely monitored before and after the dose.

References

  1. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  2. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  4. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  5. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  6. Miki S, Masumura H, Kaifu Y, Yuasa S "Pharmacokinetics and efficacy of carvedilol in chronic hemodialysis patients with hypertension." J Cardiovasc Pharmacol 18 Suppl 4 (1991): s62-8
  7. "Product Information. Normodyne (labetalol)." Schering Laboratories, Kenilworth, NJ.
  8. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
  9. Deetjen A, Heidland A, Pangerl A, Meyer-Sabellek W, Schaefer RM "Antihypertensive treatment with a vasodilating beta-blocker, carvedilol, in chronic hemodialysis patients." Clin Nephrol 43 (1995): 47-52
  10. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  11. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  12. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
  13. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  14. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
View all 14 references
Major

Beta-Blockers (Includes Coreg CR) ↔ Hypersensitivity

Severe Potential Hazard, High plausibility

Applies to: Allergies

The use of beta-adrenergic receptor blocking agents (aka beta-blockers) in patients with a history of allergic reactions or anaphylaxis may be associated with heightened reactivity to culprit allergens. The frequency and/or severity of attacks may be increased during beta-blocker therapy. In addition, these patients may be refractory to the usual doses of epinephrine used to treat acute hypersensitivity reactions and may require a beta-agonist such as isoproterenol.

References

  1. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
  2. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  4. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  5. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  6. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  7. "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  8. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
  9. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  10. "Product Information. Normodyne (labetalol)." Schering Laboratories, Kenilworth, NJ.
  11. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  12. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  13. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  14. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
  15. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  16. "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals, Wilmington, DE.
View all 16 references
Major

Beta-Blockers (Includes Coreg CR) ↔ Pvd

Severe Potential Hazard, High plausibility

Applies to: Peripheral Arterial Disease

Due to their negative inotropic and chronotropic effects on the heart, beta-adrenergic receptor blocking agents (aka beta-blockers) reduce cardiac output and may precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. In addition, the nonselective beta-blockers (e.g., propranolol, pindolol, timolol) may attenuate catecholamine-mediated vasodilation during exercise by blocking beta-2 receptors in peripheral vessels. Therapy with beta-blockers should be administered cautiously in patients with peripheral vascular disease. Close monitoring for progression of arterial obstruction is advised.

References

  1. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  2. Coppeto JR "Transient ischemic attacks and amaurosis fugax from timolol." Ann Ophthalmol 17 (1985): 64-5
  3. "Product Information. Normodyne (labetalol)." Schering Laboratories, Kenilworth, NJ.
  4. Michelson EL, Frishman WH, Lewis JE, et al "Multicenter clinical evaluation of long-term efficacy and safety of labetalol in treatment of hypertension." Am J Med Oct 17 (1983): 68-80
  5. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. Broeder CE, Thomas EL, Martin NB, Hofman Z, Jesek JK, Scruggs KD, Wambsgans KC, Wilmore JH "Effects of propranolol and pindolol on cardiac output during extended periods of low-intensity physical activity." Am J Cardiol 72 (1993): 1188-95
  7. Breckenridge A, Roberts DH "Antihypertensive treatment in concomitant peripheral vascular disease: current experience and the potential of carvedilol." J Cardiovasc Pharmacol 18 Suppl 4 (1991): s78-81
  8. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  9. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
  10. "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  11. Holti G "A double-blind study of the peripheral vasoconstrictor effects of the beta-blocking drug penbutolol in patients with Raynaud's phenomenon." Curr Med Res Opin 6 (1979): 267-70
  12. Lepantalo M "Beta blockade and intermittent claudication." Acta Med Scand 700 (1985): 1-48
  13. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  14. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  15. Tcherdakoff P "Side-effects with long-term labetalol: an open study of 251 patients in a single centre." Pharmatherapeutica 3 (1983): 342-8
  16. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  17. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
  18. Myers J, Morgan T, Waga S, et al "Long-term experiences with labetalol." Med J Aust 1 (1980): 665-6
  19. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  20. Mashford ML, Coventry D, Hecker R, et al. "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust 1 (1982): 416-9
  21. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  22. Eliasson K, Lins L-E, Sundqvist K "Peripheral vasospasm during beta-receptor blockade: a comparison between metoprolol and pindolol." Acta Med Scand 665 (1982): 109-12
  23. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  24. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
  25. Eliasson K, Danielson M, Hylander B, Lindblad LE "Raynaud's phenomenon caused by beta-receptor blocking drugs." Acta Med Scand 215 (1984): 333-9
View all 25 references
Major

Carvedilol (Includes Coreg CR) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Carvedilol is extensively metabolized by the liver. Patients with cirrhosis have demonstrated significantly higher plasma concentrations (approximately 4 to 7-fold) of carvedilol compared to healthy individuals. The use of carvedilol is not recommended for patients with clinically impaired hepatic function.

References

  1. Neugebauer G, Akpan W, von Mollendorff E, Neubert P, Reiff K "Pharmacokinetics and disposition of carvedilol in humans." J Cardiovasc Pharmacol 10 Suppl 1 (1987): s85-8
  2. Neugebauer G, Neubert P "Metabolism of carvedilol in man." Eur J Drug Metab Pharmacokinet 16 (1991): 257-60
  3. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  4. Neugebauer G, Gabor M, Reiff K "Pharmacokinetics and bioavailability of carvedilol in patients with liver cirrhosis." Drugs 36 Suppl 6 (1988): 148-54
  5. Neugebauer G, Gabor M, Reiff K "Disposition of carvedilol enantiomers in patients with liver cirrhosis: evidence for disappearance of stereoselective first-pass extraction." J Cardiovasc Pharmacol 19 Suppl 1 (1992): s142-6
View all 5 references
Major

Carvedilol (Includes Coreg CR) ↔ Peripheral Vascular Disease

Severe Potential Hazard, High plausibility

Applies to: Peripheral Arterial Disease, Cerebrovascular Insufficiency

The beta-adrenergic receptor blocking effects of carvedilol may precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. Carvedilol may also attenuate catecholamine-mediated vasodilation during exercise by blocking beta-2 receptors in peripheral vessels. Therapy with carvedilol should be administered cautiously in patients with peripheral vascular disease. Close monitoring for progression of arterial obstruction is advised.

References

  1. Eliasson K, Lins L-E, Sundqvist K "Peripheral vasospasm during beta-receptor blockade: a comparison between metoprolol and pindolol." Acta Med Scand 665 (1982): 109-12
  2. Eliasson K, Danielson M, Hylander B, Lindblad LE "Raynaud's phenomenon caused by beta-receptor blocking drugs." Acta Med Scand 215 (1984): 333-9
  3. Meyer-Sabellek W, Agrawal B "Antihypertensive profile of carvedilol." Clin Investig 70 Suppl 1 (1992): s43-52
  4. Mashford ML, Coventry D, Hecker R, et al. "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust 1 (1982): 416-9
  5. Lepantalo M "Beta blockade and intermittent claudication." Acta Med Scand 700 (1985): 1-48
  6. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  7. Breckenridge A, Roberts DH "Antihypertensive treatment in concomitant peripheral vascular disease: current experience and the potential of carvedilol." J Cardiovasc Pharmacol 18 Suppl 4 (1991): s78-81
View all 7 references
Major

Carvedilol (Includes Coreg CR) ↔ Severe Hepatic Impairment

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

The use of carvedilol is contraindicated in patients with severe hepatic impairment. Compared to healthy subjects, patients with severe liver impairment (cirrhosis) exhibit a 4- to 7-fold increase in carvedilol levels.

Moderate

Beta-Blockers (Includes Coreg CR) ↔ Cerebrovascular Insufficiency

Moderate Potential Hazard, Moderate plausibility

Applies to: Cerebrovascular Insufficiency

Beta-adrenergic blocking agents (beta-blockers), should be used with caution in patients with cerebrovascular insufficiency because of their potential effects relative to blood pressure and pulse. If signs or symptoms suggesting reduced cerebral blood flow are observed, consideration should be given to discontinuing these agents.

Moderate

Beta-Blockers (Includes Coreg CR) ↔ Glaucoma

Moderate Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension

Systemic beta-adrenergic receptor blocking agents (aka beta-blockers) may lower intraocular pressure. Therefore, patients with glaucoma or intraocular hypertension may require adjustments in their ophthalmic regimen following a dosing change or discontinuation of beta-blocker therapy.

References

  1. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
  3. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  5. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
  6. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  7. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  8. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  9. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  10. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  11. "Product Information. Normodyne (labetalol)." Schering Laboratories, Kenilworth, NJ.
  12. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  13. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  14. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  15. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
View all 15 references
Moderate

Beta-Blockers (Includes Coreg CR) ↔ Hyperlipidemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperlipidemia

Beta-adrenergic receptor blocking agents (aka beta-blockers) may alter serum lipid profiles. Increases in serum VLDL and LDL cholesterol and triglycerides, as well as decreases in HDL cholesterol, have been reported with some beta-blockers. Patients with preexisting hyperlipidemia may require closer monitoring during beta-blocker therapy, and adjustments made accordingly in their lipid-lowering regimen.

References

  1. Samuel P, Chin B, Schoenfeld BH, et al "Comparison of the effect of pindolol versus propranolol on the lipid profile in patients treated for hypertension." Br J Clin Pharmacol 24 (1987): s63-4
  2. Rossner S, Weiner L "Atenolol and metoprolol: comparison of effects on blood pressure and serum lipoproteins, and side effects." Eur J Clin Pharmacol 24 (1983): 573-7
  3. Gordon NF, Scott CB, Duncan JJ "Effects of atenolol versus enalapril on cardiovascular fitness and serum lipids in physically active hypertensive men." Am J Cardiol 79 (1997): 1065-9
  4. Szollar LG, Meszaros I, Tornoci L, et al "Effect of metoprolol and pindolol monotherapy on plasma lipid- and lipoprotein-cholesterol levels (including the HDL subclasses) in mild hypertensive males and females." J Cardiovasc Pharmacol 15 (1990): 911-7
  5. Rossner S, Weiner L "Atenolol and metoprolol: comparison of effects on blood pressure and serum lipoproteins, and side effects." Eur J Clin Pharmacol 24 (1983): 573-7
  6. Lithell H, Andersson PE "Metabolic effects of carvedilol in hypertensive patients." Eur J Clin Pharmacol 52 (1997): 13-7
  7. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
  8. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  9. Terent A, Ribacke M, Carlson LA "Long-term effect of pindolol on lipids and lipoproteins in men with newly diagnosed hypertension." Eur J Clin Pharmacol 36 (1989): 347-50
  10. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
  11. Safran AB, Simona F, Sansonetti A, Pometta D, James R "Effects of ocular carteolol and timolol on plasma high-density lipoprotein cholesterol level." Am J Ophthalmol 117 (1994): 683
  12. Sasaki J, Saku K, Ideishi M, et al "Effects of pindolol on serum lipids, apolipoproteins, and lipoproteins in patients with mild to moderate essential hypertension." Clin Ther 11 (1989): 219-24
  13. Clucas A, Miller N "Effects of acebutolol on the serum lipid profile." Drugs 36 Suppl 2 (1988): 41-50
  14. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  15. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  16. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  17. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  18. Darga LL, Hakim MJ, Lucas CP, Franklin BA "Comparison of the effects of guanadrel sulfate and propranolol on blood pressure, functional capacity, serum lipoproteins and glucose in systemic hypertension." Am J Cardiol 67 (1991): 590-6
  19. Ferrara LA, Marotta T, Scilla A, et al "Effect of oxprenolol and metoprolol on serum lipid concentration." Eur J Clin Pharmacol 26 (1984): 331-4
  20. Disler LJ, Joffe BI, Seftel HC "Massive hypertriglyceridemia associated with atenolol." Am J Med 85 (1988): 586-7
  21. Pasotti C, Capra A, Fiorella G, et al "Effects of pindolol and metoprolol on plasma lipids and lipoproteins." Br J Clin Pharmacol 13 (1982): s435-9
  22. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  23. Harvengt C, Heller FR, Martiat P, Nieuwenhuyze YV "Short-term effects of beta blockers atenolol, nadolol, pindolol, and propranolol on lipoprotein metabolism in normolipemic subjects." J Clin Pharmacol 27 (1987): 475-80
  24. Lind L, Pollare T, Berne C, Lithell H "Long-term metabolic effects of antihypertensive drugs." Am Heart J 128 (1994): 1177-83
  25. Northcote RJ, Packard CJ, Ballantyne D "The effect of sotalol on plasma lipoproteins and apolipoproteins." Clin Chim Acta 158 (1986): 187-91
  26. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
  27. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  28. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  29. Leren P, Foss PO, Nordvik B, Fossbakk B "The effect of enalapril and timolol on blood lipids." Acta Med Scand 223 (1988): 321-6
  30. Carlson LA, Ribacke M, Terent A "A long-term study on the effect of pindolol on serum lipoproteins: a preliminary report." Br J Clin Pharmacol 24 (1987): s61-2
  31. Valimaki M, Maass L, Harno K, Nikkila EA "Lipoprotein lipids and apoproteins during beta-blocker administration: comparison of penbutolol and atenolol." Eur J Clin Pharmacol 30 (1986): 17-20
  32. "Product Information. Normodyne (labetalol)." Schering Laboratories, Kenilworth, NJ.
  33. Weiner L, Rossner S "Atenolol 50 mg or metoprolol 200 mg: a comparison of antihypertensive efficacy, side effects and lipoprotein changes." Acta Med Scand 677 (1983): 153-7
  34. Sasaki J, Kajiyama G, Kusukawa R, Mori H, Koga S, Takagi R, Tanaka N, Ogawa N, Arakawa K "Effect of bevantolol and propranolol on serum lipids in patients with essential hypertension." Int J Clin Pharmacol Ther 32 (1994): 660-4
  35. Kasiske BL, Ma JZ, Kalil RS, Louis TA "Effects of antihypertensive therapy on serum lipids." Ann Intern Med 122 (1995): 133-41
  36. "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  37. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  38. Lehtonen A, Hietanen E, Marniemi J, Peltonen P, Nikkila EA "Effect of sotalol withdrawal on serum lipids and lipoprotein lipase activity." Int J Clin Pharmacol Ther Toxicol 21 (1983): 73-6
  39. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
View all 39 references
Moderate

Beta-Blockers (Includes Coreg CR) ↔ Hyperthyroidism

Moderate Potential Hazard, High plausibility

Applies to: Hyperthyroidism

When beta-adrenergic receptor blocking agents (aka beta-blockers) are used to alleviate symptoms of hyperthyroidism such as tachycardia, anxiety, tremor and heat intolerance, abrupt withdrawal can exacerbate thyrotoxicosis or precipitate a thyroid storm. To minimize this risk, cessation of beta-blocker therapy, when necessary, should occur gradually with incrementally reduced dosages over a period of 1 to 2 weeks. Patients should be advised not to discontinue treatment without first consulting with the physician. Close monitoring is recommended during and after therapy withdrawal.

References

  1. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  2. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  3. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  4. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  5. "Product Information. Normodyne (labetalol)." Schering Laboratories, Kenilworth, NJ.
  6. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  7. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  8. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
  9. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  10. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  11. "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  12. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  13. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  14. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
  15. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
View all 15 references
Moderate

Beta-Blockers (Includes Coreg CR) ↔ Ischemic Heart Disease

Moderate Potential Hazard, High plausibility

Applies to: Ischemic Heart Disease

Heightened sensitivity to catecholamines may occur after prolonged use of beta-adrenergic receptor blocking agents (aka beta-blockers). Exacerbation of angina, myocardial infarction and ventricular arrhythmias have been reported in patients with coronary artery disease following abrupt withdrawal of therapy. Cessation of beta-blocker therapy, whenever necessary, should occur gradually with incrementally reduced dosages over a period of 1 to 2 weeks in patients with coronary insufficiency. Patients should be advised not to discontinue treatment without first consulting with the physician. In patients who experience an exacerbation of angina following discontinuation of beta-blocker therapy, the medication should generally be reinstituted, at least temporarily, along with other clinically appropriate measures.

References

  1. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
  2. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  3. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  4. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  5. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  6. Miller RR, Olson HG, Amsterdam EA, Mason DT "Propranolol-withdrawal rebound phenomenon: exacerbation of coronary events after abrupt cessation of antianginal therapy." N Engl J Med 293 (1975): 416-8
  7. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  8. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  9. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  10. "Product Information. Normodyne (labetalol)." Schering Laboratories, Kenilworth, NJ.
  11. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
  12. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  13. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
  14. "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  15. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  16. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  17. Walden RJ, Hernandez J, Yu Y, et al "Withdrawal of beta-blocking drugs." Am Heart J 104 (1982): 515-20
  18. Rangno RE, Langlois S "Comparison of withdrawal phenomena after propranolol, metoprolol, and pindolol." Am Heart J 104 (1982): 473-8
  19. Szecsi E, Kohlschutter S, Schiess W, Lang E "Abrupt withdrawal of pindolol or metoprolol after chronic therapy." Br J Clin Pharmacol 13 (1982): s353-7
View all 19 references
Moderate

Beta-Blockers (Includes Coreg CR) ↔ Myasthenia Gravis

Moderate Potential Hazard, Low plausibility

Applies to: Myoneural Disorder

Beta-adrenergic receptor blocking agents (aka beta-blockers) may potentiate muscle weakness consistent with certain myasthenic symptoms such as diplopia, ptosis, and generalized weakness. Several beta-blockers have been associated rarely with aggravation of muscle weakness in patients with preexisting myasthenia gravis or myasthenic symptoms.

References

  1. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  2. Coppeto JR "Timolol-associated myasthenia gravis." Am J Ophthalmol 98 (1984): 244-5
  3. Confavreux C, Charles N, Aimard G "Fulminant myasthenia gravis soon after initiation of acebutolol therapy." Eur Neurol 30 (1990): 279-81
  4. Herishanu Y, Rosenberg P "Beta-blockers and myasthenia gravis." Ann Intern Med 83 (1975): 834-5
  5. Berstein LP, Henkind P "Additional information on adverse reactions to timolol." Am J Ophthalmol 92 (1981): 295-6
  6. Choi KL, Wat MS, Ip TP, Kung AWC, Lam KSL "Phaeochromocytoma associated with myasthenia gravis precipitated by propranolol treatment." Aust N Z J Med 25 (1995): 257
  7. Verkijk A "Worsening of myasthenia gravis with timolol maleate eyedrops." Ann Neurol 17 (1985): 211-2
View all 7 references
Moderate

Beta-Blockers (Includes Coreg CR) ↔ Pheochromocytoma

Moderate Potential Hazard, Moderate plausibility

Applies to: Pheochromocytoma

Administration of beta-blockers alone in the setting of pheochromocytoma has been associated with a paradoxical increase in blood pressure due to the attenuation of beta-mediated vasodilatation in skeletal muscle. In patients with pheochromocytoma, an alph-blocking agent should be initiated prior to the use of any beta-blocking agent. Caution should be taken in the administration of these agents to patients suspected of having pheochromocytoma.

Moderate

Beta-Blockers (Includes Coreg CR) ↔ Psoriasis

Moderate Potential Hazard, Moderate plausibility

Applies to: Psoriasis

The use of beta-blockers in psoriatic patients should be carefully weighed since the use of these agents may cause an aggravation in psoriasis.

Moderate

Beta-Blockers (Includes Coreg CR) ↔ Tachycardia

Moderate Potential Hazard, Moderate plausibility

Applies to: Tachyarrhythmia

Beta-adrenergic blockade in patients with Wolff-Parkinson-White syndrome and tachycardia has been associated with severe bradycardia requiring treatment with a pacemaker. In one case, this result was reported after an initial dose of 5 mg propranolol. The use of beta-adrenergic receptor blocking agents (aka beta-blockers) should be administered cautiously in these patients.

Moderate

Carvedilol (Includes Coreg CR) ↔ Chf

Moderate Potential Hazard, High plausibility

Applies to: Congestive Heart Failure

The use of carvedilol is contraindicated in patients with NYHA class IV decompensated heart failure. Sympathetic stimulation may be important in maintaining the hemodynamic function in these patients, thus beta-blockade can worsen the heart failure. Carvedilol may be used for the treatment of mild to moderate (NYHA class II or III) heart failure of ischemic or cardiomyopathic origin in patients receiving digitalis, diuretics, an ACE inhibitor, and/or nitrates.

References

  1. Packer M, Colucci WS, Sackner-Bernstein JD, Liang CS, Goldscher DA, Freeman I, Kukin ML, Kinhal V, Udelson JE, Klapholz M, Gottlieb SS, Pearle D "Double-blind, placebo-controlled study of the effects of carvedilol in patients with moderate to severe heart failure. The PRECISE Trial Prospective Randomized Evaluation of Carvedilol on Symptoms an Exercise." Circulation 94 (1996): 2793-9
  2. Kelly DT "Carvedilol in heart failure." Cardiology 82 Suppl 3 (1993): 45-9
  3. Packer M, Cohn JN, Colucci WS "Carvedilol in patients with chronic heart failure." N Engl J Med 335 (1996): 1310-20
  4. Macmahon S, Sharpe N, Doughty R, Krum H, Tonkin A, Trotter A, Burton R, Garrett J, Lane G, Owensby D, Ryan J, Shepherd J, Sing "Randomised, placebo-controlled trial of carvedilol in patients with congestive heart failure due to ischaemic heart disease." Lancet 349 (1997): 375-80
  5. Krum H, Sackner-Bernstein JD, Goldsmith RL, et al. "Double-blind, placebo-controlled study of the long-term efficacy of carvedilol in patients with severe chronic heart failure." Circulation 92 (1995): 1499-506
  6. Frishman WH "Carvedilol." N Engl J Med 339 (1998): 1759-65
  7. Bristow MR, Gilbert EM, Abraham WT, et al. "Carvedilol produces dose-related improvements in left ventricular function and survival in subjects with chronic heart failure. MOCHA Investigators." Circulation 94 (1996): 2807-16
  8. Moye LA, Abernethy D "Carvedilol in patients with chronic heart failure." N Engl J Med 335 (1996): 1318
  9. Packer M, Bristow MR, Cohn JN, Colucci WS, Fowler MB, Gilbert EM, Shusterman NH "The effect of carvedilol on morbidity and mortality in patients with chronic heart failure." N Engl J Med 334 (1996): 1349-55
  10. Cleland JGF, Swedberg K "Carvedilol for heart failure, with care." Lancet 347 (1996): 1199-201
  11. Doughty RN, Whalley GA, Gamble G, MacMahon S, Sharpe N "Left ventricular remodeling with carvedilol in patients with congestive heart failure due to ischemic heart disease. Australia-Ne Zealand Heart Failure Research Collaborative Group." J Am Coll Cardiol 29 (1997): 1060-6
  12. Colucci WS, Packer M, Bristow MR, Gilbert EM, Cohn JN, Fowler MB, Krueger SK, Hershberger R, Uretsky BF, Bowers JA, Sackne "Carvedilol inhibits clinical progression in patients with mild symptoms of heart failure." Circulation 94 (1996): 2800-6
  13. Olsen SL, Gilbert EM, Renlund DG, Taylor DO, Yanowitz FD, Bristow MR "Carvedilol improves left ventricular function and symptoms in chronic heart failure: a double-blind randomized study." J Am Coll Cardiol 25 (1995): 1225-31
  14. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  15. Macdonald PS, Keogh AM, Aboyoun CL, Lund M, Amor R, McCaffrey DJ "Tolerability and efficacy of carvedilol in patients with New York Heart Association class IV heart failure." J Am Coll Cardiol 33 (1999): 924-31
  16. Von Olshausen K, Pop T, Berger J "Carvedilol in patients with chronic heart failure." N Engl J Med 335 (1996): 1318-20
  17. Australia-New Zealand Heart Failure Research Collaborative Group. "Effects of carvedilol, a vasodilator-B-blocker, in patients with congestive heart failure due to ischemic heart disease." Circulation 92 (1995): 212-8
View all 17 references
Moderate

Carvedilol (Includes Coreg CR) ↔ Renal Dysfunction

Moderate Potential Hazard, Low plausibility

Applies to: Renal Dysfunction, Congestive Heart Failure

The use of carvedilol has rarely resulted in deterioration of renal function in patients with congestive heart failure. Patients with low blood pressure (systolic BP < 100 mm Hg), ischemic heart disease and diffuse vascular disease, and/or underlying renal impairment may be at greater risk. In these patients, monitoring of renal function is recommended during dosage titration, and the dosing reduced or discontinued accordingly.

References

  1. Dupont AG "Effects of carvedilol on renal function." Eur J Clin Pharmacol 38 Suppl 2 (1990): s96-100
  2. Kohno M, Takeda T, Ishii M, Saruta T, Mizuno Y, Yoshimura M, Kubo S, Fukiyama K, Fujishima M "Therapeutic benefits and safety of carvedilol in the treatment of renal hypertension. An open, short term study. Carvedilol Renal Hypertension Study Group in Japan." Drugs 36 Suppl 6 (1988): 129-35
  3. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  4. Tomita K, Marumo F "Effect of long-term carvedilol therapy on renal function in essential hypertension." J Cardiovasc Pharmacol 19 Suppl 1 (1992): s97-101
  5. Masumura H, Miki S, Kaifu Y, Kitajima W, Abe Y "Pharmacokinetics and efficacy of carvedilol in hypertensive patients with chronic renal failure and hemodialysis patients." J Cardiovasc Pharmacol 19 Suppl 1 (1992): s102-7
  6. Takeda T, Kohno M, Ishii M, Kubo S, Saruta T, Mizuno Y, Fukiyama K, Fujishima M, Yoshimura M "Efficacy and safety of carvedilol in renal hypertension. A multicenter open trial." Eur J Clin Pharmacol 38 Suppl 2 (1990): s158-63
  7. Dupont AG "Carvedilol and the kidney." Clin Investig 70 Suppl 1 (1992): s127-31
  8. Kramer BK, Ress KM, Erley CM, Risler T "Pharmacokinetic and blood pressure effects of carvedilol in patients with chronic renal failure." Eur J Clin Pharmacol 43 (1992): 85-8
View all 8 references
Moderate

Non-Selective Beta-Blockers (Includes Coreg CR) ↔ Prinzmetal's Variant Angina

Moderate Potential Hazard, Moderate plausibility

Applies to: Prinzmetal's Angina

Agents with non-selective beta-blocking activity may provoke chest pain in patients with Prinzmetal's variant angina. the use of non-selective beta blockers is not recommended in these patients. Caution should be taken in the administration of these agents to patients suspected of having Prinzmetal's variant angina.

Coreg CR (carvedilol) drug Interactions

There are 1007 drug interactions with Coreg CR (carvedilol)

Coreg CR (carvedilol) alcohol/food Interactions

There are 3 alcohol/food interactions with Coreg CR (carvedilol)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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