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Coreg Disease Interactions

There are 20 disease interactions with Coreg (carvedilol).

Major

Beta-blockers (applies to Coreg) bradyarrhythmia/AV block

Major Potential Hazard, High plausibility. Applicable conditions: 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. Crean PA, Williams DO (1986) "Effect of intravenous and oral acebutolol in patients with bundle branch block." Int J Cardiol, 10, p. 119-26
  2. Mashford ML, Coventry D, Hecker R, et al. (1982) "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust, 1, p. 416-9
  3. Treseder AS, Thomas TP (1986) "Sinus arrest due to timolol eye drops." Br J Clin Pract, 40, p. 256-8
  4. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  5. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  6. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  7. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  8. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  9. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  10. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  11. (2001) "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals
  12. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  13. (2001) "Product Information. Kerlone (betaxolol)." Searle
  14. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  15. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  16. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  17. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  18. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  19. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
  20. Frishman WH (1998) "Carvedilol." N Engl J Med, 339, p. 1759-65
  21. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD (1998) "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division
  22. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 22 references
Major

Beta-blockers (applies to Coreg) cardiogenic shock/hypotension

Major Potential Hazard, High plausibility.

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. Kholeif M, Isles C (1989) "Profound hypotension after atenolol in severe hypertension." Br Med J, 298, p. 161-2
  2. Tirlapur VG, Evans PJ, Jones MK (1986) "Shock syndrome after acebutolol." Br J Clin Pract, 40, p. 33-4
  3. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  4. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  5. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  6. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  7. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  8. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  9. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  10. (2001) "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals
  11. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  12. (2001) "Product Information. Kerlone (betaxolol)." Searle
  13. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  14. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  15. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  16. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  17. (2022) "Product Information. OptiPranolol (metipranolol ophthalmic)." Bausch and Lomb Americas, Inc.
  18. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  19. (2022) "Product Information. Betagan (levobunolol ophthalmic)." Allergan Inc
  20. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
  21. "Product Information. Acupress (carteolol ophthalmic)." Otsuka American Pharmaceuticals Inc, Rockville, MD.
  22. (2001) "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc
  23. Frishman WH (1998) "Carvedilol." N Engl J Med, 339, p. 1759-65
  24. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 24 references
Major

Beta-blockers (applies to Coreg) hemodialysis

Major Potential Hazard, High plausibility.

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. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  2. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  3. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  4. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  5. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  6. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  7. (2001) "Product Information. Kerlone (betaxolol)." Searle
  8. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  9. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  10. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  11. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  12. Deetjen A, Heidland A, Pangerl A, Meyer-Sabellek W, Schaefer RM (1995) "Antihypertensive treatment with a vasodilating beta-blocker, carvedilol, in chronic hemodialysis patients." Clin Nephrol, 43, p. 47-52
  13. Miki S, Masumura H, Kaifu Y, Yuasa S (1991) "Pharmacokinetics and efficacy of carvedilol in chronic hemodialysis patients with hypertension." J Cardiovasc Pharmacol, 18 Suppl 4, s62-8
  14. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
  15. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 15 references
Major

Beta-blockers (applies to Coreg) hypersensitivity

Major Potential Hazard, High plausibility. Applicable conditions: 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. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  2. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  3. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  4. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  5. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  6. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  7. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  8. (2001) "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals
  9. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  10. (2001) "Product Information. Kerlone (betaxolol)." Searle
  11. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  12. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  13. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  14. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  15. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  16. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
  17. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 17 references
Major

Beta-blockers (applies to Coreg) ischemic heart disease

Major Potential Hazard, High plausibility.

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. Miller RR, Olson HG, Amsterdam EA, Mason DT (1975) "Propranolol-withdrawal rebound phenomenon: exacerbation of coronary events after abrupt cessation of antianginal therapy." N Engl J Med, 293, p. 416-8
  2. Rangno RE, Langlois S (1982) "Comparison of withdrawal phenomena after propranolol, metoprolol, and pindolol." Am Heart J, 104, p. 473-8
  3. Szecsi E, Kohlschutter S, Schiess W, Lang E (1982) "Abrupt withdrawal of pindolol or metoprolol after chronic therapy." Br J Clin Pharmacol, 13, s353-7
  4. Walden RJ, Hernandez J, Yu Y, et al. (1982) "Withdrawal of beta-blocking drugs." Am Heart J, 104, p. 515-20
  5. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  6. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  7. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  8. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  9. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  10. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  11. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  12. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  13. (2001) "Product Information. Kerlone (betaxolol)." Searle
  14. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  15. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  16. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  17. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  18. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  19. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
  20. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 20 references
Major

Beta-blockers (applies to Coreg) PVD

Major Potential Hazard, High plausibility. Applicable conditions: 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. Michelson EL, Frishman WH, Lewis JE, et al. (1983) "Multicenter clinical evaluation of long-term efficacy and safety of labetalol in treatment of hypertension." Am J Med, Oct 17, p. 68-80
  2. Eliasson K, Danielson M, Hylander B, Lindblad LE (1984) "Raynaud's phenomenon caused by beta-receptor blocking drugs." Acta Med Scand, 215, p. 333-9
  3. Myers J, Morgan T, Waga S, et al. (1980) "Long-term experiences with labetalol." Med J Aust, 1, p. 665-6
  4. Tcherdakoff P (1983) "Side-effects with long-term labetalol: an open study of 251 patients in a single centre." Pharmatherapeutica, 3, p. 342-8
  5. Eliasson K, Lins L-E, Sundqvist K (1982) "Peripheral vasospasm during beta-receptor blockade: a comparison between metoprolol and pindolol." Acta Med Scand, 665, p. 109-12
  6. Lepantalo M (1985) "Beta blockade and intermittent claudication." Acta Med Scand, 700, p. 1-48
  7. Mashford ML, Coventry D, Hecker R, et al. (1982) "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust, 1, p. 416-9
  8. Coppeto JR (1985) "Transient ischemic attacks and amaurosis fugax from timolol." Ann Ophthalmol, 17, p. 64-5
  9. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  10. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  11. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  12. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  13. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  14. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  15. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  16. (2001) "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals
  17. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  18. (2001) "Product Information. Kerlone (betaxolol)." Searle
  19. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  20. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  21. Broeder CE, Thomas EL, Martin NB, Hofman Z, Jesek JK, Scruggs KD, Wambsgans KC, Wilmore JH (1993) "Effects of propranolol and pindolol on cardiac output during extended periods of low-intensity physical activity." Am J Cardiol, 72, p. 1188-95
  22. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  23. Holti G (1979) "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, p. 267-70
  24. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  25. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  26. Breckenridge A, Roberts DH (1991) "Antihypertensive treatment in concomitant peripheral vascular disease: current experience and the potential of carvedilol." J Cardiovasc Pharmacol, 18 Suppl 4, s78-81
  27. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 27 references
Major

Carvedilol (applies to Coreg) liver disease

Major Potential Hazard, High plausibility.

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 contraindicated in patients with severe hepatic impairment.

References

  1. Neugebauer G, Neubert P (1991) "Metabolism of carvedilol in man." Eur J Drug Metab Pharmacokinet, 16, p. 257-60
  2. Neugebauer G, Gabor M, Reiff K (1992) "Disposition of carvedilol enantiomers in patients with liver cirrhosis: evidence for disappearance of stereoselective first-pass extraction." J Cardiovasc Pharmacol, 19 Suppl 1, s142-6
  3. Neugebauer G, Akpan W, von Mollendorff E, Neubert P, Reiff K (1987) "Pharmacokinetics and disposition of carvedilol in humans." J Cardiovasc Pharmacol, 10 Suppl 1, s85-8
  4. Neugebauer G, Gabor M, Reiff K (1988) "Pharmacokinetics and bioavailability of carvedilol in patients with liver cirrhosis." Drugs, 36 Suppl 6, p. 148-54
  5. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
View all 5 references
Major

Carvedilol (applies to Coreg) peripheral vascular disease

Major Potential Hazard, High plausibility. Applicable conditions: 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, Danielson M, Hylander B, Lindblad LE (1984) "Raynaud's phenomenon caused by beta-receptor blocking drugs." Acta Med Scand, 215, p. 333-9
  2. Eliasson K, Lins L-E, Sundqvist K (1982) "Peripheral vasospasm during beta-receptor blockade: a comparison between metoprolol and pindolol." Acta Med Scand, 665, p. 109-12
  3. Lepantalo M (1985) "Beta blockade and intermittent claudication." Acta Med Scand, 700, p. 1-48
  4. Mashford ML, Coventry D, Hecker R, et al. (1982) "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust, 1, p. 416-9
  5. Meyer-Sabellek W, Agrawal B (1992) "Antihypertensive profile of carvedilol." Clin Investig, 70 Suppl 1, s43-52
  6. Breckenridge A, Roberts DH (1991) "Antihypertensive treatment in concomitant peripheral vascular disease: current experience and the potential of carvedilol." J Cardiovasc Pharmacol, 18 Suppl 4, s78-81
  7. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
View all 7 references
Major

Carvedilol (applies to Coreg) severe hepatic impairment

Major Potential Hazard, Moderate plausibility. Applicable conditions: 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.

Major

Non-cardioselective beta-blockers (applies to Coreg) asthma/COPD

Major Potential Hazard, High plausibility. Applicable conditions: Chronic Obstructive Pulmonary Disease

Some beta-adrenergic receptor blocking agents (i.e., non-cardioselective 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. van Zyl AI, Jennings AA, Bateman ED, Opie LH (1989) "Comparison of respiratory effects of two cardioselective beta-blockers, celiprolol and atenolol, in asthmatics with mild to moderate hypertension." Chest, 95, p. 209-13
  2. Adam WR, Meagher EJ, Barter CE (1982) "Labetalol, beta blockers, and acute deterioration of chronic airway obstruction." Clin Exp Hypertens A, A4, p. 1419-28
  3. Falliers CJ, Vincent ME, Medakovic M (1986) "Effect of single doses of labetalol, metoprolol, and placebo on ventilatory function in patients with bronchial asthma: interaction with isoproterenol." J Asthma, 23, p. 251-60
  4. Durant PA, Joucken K (1984) "Bronchospasm and hypotension during cardiopulmonary bypass after preoperative cimetidine and labetalol therapy." Br J Anaesth, 56, p. 917-20
  5. Raine JM, Palazzo MG, Kerr JH, Sleight P (1981) "Near-fatal bronchospasm after oral nadolol in a young asthmatic and response to ventilation with halothane." Br Med J, 282, p. 548-9
  6. Stephen SA (1966) "Unwanted effects of propranolol." Am J Cardiol, 18, p. 463-72
  7. Chodosh S, Tuck J, Blasucci DJ (1988) "The effects of dilevalol, metoprolol, and placebo on ventilatory function in asthmatics." J Cardiovasc Pharmacol, 11, s18-24
  8. Morris R, Bulteau P (1980) "Respiratory arrest after beta-blocker in an asthmatic patient." Med J Aust, 2, p. 576
  9. Mashford ML, Coventry D, Hecker R, et al. (1982) "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust, 1, p. 416-9
  10. Schoenberger JA, Croog SH, Sudilovsky A, et al. (1990) "Self-reported side effects from antihypertensive drugs: a clinical trial." Am J Hypertens, 3, p. 123-32
  11. Horvath JS, Woolcock AJ, Tiller DJ, Donnelly P, Armstrong J, Caterson R (1978) "A comparison of metoprolol and propranolol on blood pressure and respiratory function in patients with hypertension." Aust N Z J Med, 8, p. 1-6
  12. Benson MK, Berrill WT, Cruickshank JM, Sterling GS (1978) "A comparison of four B-adrenoceptor antagonists in patients with asthma." Br J Clin Pharmacol, 5, p. 415-9
  13. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  14. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  15. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  16. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  17. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  18. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  19. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  20. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  21. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  22. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
  23. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD (1998) "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division
View all 23 references
Moderate

Beta-blockers (applies to Coreg) cerebrovascular insufficiency

Moderate Potential Hazard, Moderate plausibility.

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.

References

  1. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  2. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  3. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  4. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  5. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  6. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  7. (2001) "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals
  8. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  9. (2001) "Product Information. Kerlone (betaxolol)." Searle
  10. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  11. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  12. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  13. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  14. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  15. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
  16. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 16 references
Moderate

Beta-blockers (applies to Coreg) glaucoma

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  2. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  3. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  4. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  5. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  6. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  7. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  8. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  9. (2001) "Product Information. Kerlone (betaxolol)." Searle
  10. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  11. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  12. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  13. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  14. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  15. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
  16. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 16 references
Moderate

Beta-blockers (applies to Coreg) hyperlipidemia

Moderate Potential Hazard, Moderate plausibility.

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. Rossner S, Weiner L (1983) "Atenolol and metoprolol: comparison of effects on blood pressure and serum lipoproteins, and side effects." Eur J Clin Pharmacol, 24, p. 573-7
  2. Valimaki M, Maass L, Harno K, Nikkila EA (1986) "Lipoprotein lipids and apoproteins during beta-blocker administration: comparison of penbutolol and atenolol." Eur J Clin Pharmacol, 30, p. 17-20
  3. Disler LJ, Joffe BI, Seftel HC (1988) "Massive hypertriglyceridemia associated with atenolol." Am J Med, 85, p. 586-7
  4. Harvengt C, Heller FR, Martiat P, Nieuwenhuyze YV (1987) "Short-term effects of beta blockers atenolol, nadolol, pindolol, and propranolol on lipoprotein metabolism in normolipemic subjects." J Clin Pharmacol, 27, p. 475-80
  5. Darga LL, Hakim MJ, Lucas CP, Franklin BA (1991) "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, p. 590-6
  6. Weiner L, Rossner S (1983) "Atenolol 50 mg or metoprolol 200 mg: a comparison of antihypertensive efficacy, side effects and lipoprotein changes." Acta Med Scand, 677, p. 153-7
  7. Ferrara LA, Marotta T, Scilla A, et al. (1984) "Effect of oxprenolol and metoprolol on serum lipid concentration." Eur J Clin Pharmacol, 26, p. 331-4
  8. Pasotti C, Capra A, Fiorella G, et al. (1982) "Effects of pindolol and metoprolol on plasma lipids and lipoproteins." Br J Clin Pharmacol, 13, s435-9
  9. Carlson LA, Ribacke M, Terent A (1987) "A long-term study on the effect of pindolol on serum lipoproteins: a preliminary report." Br J Clin Pharmacol, 24, s61-2
  10. Samuel P, Chin B, Schoenfeld BH, et al. (1987) "Comparison of the effect of pindolol versus propranolol on the lipid profile in patients treated for hypertension." Br J Clin Pharmacol, 24, s63-4
  11. Terent A, Ribacke M, Carlson LA (1989) "Long-term effect of pindolol on lipids and lipoproteins in men with newly diagnosed hypertension." Eur J Clin Pharmacol, 36, p. 347-50
  12. Sasaki J, Saku K, Ideishi M, et al. (1989) "Effects of pindolol on serum lipids, apolipoproteins, and lipoproteins in patients with mild to moderate essential hypertension." Clin Ther, 11, p. 219-24
  13. Szollar LG, Meszaros I, Tornoci L, et al. (1990) "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, p. 911-7
  14. Leren P, Foss PO, Nordvik B, Fossbakk B (1988) "The effect of enalapril and timolol on blood lipids." Acta Med Scand, 223, p. 321-6
  15. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  16. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  17. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  18. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  19. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  20. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  21. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  22. Northcote RJ, Packard CJ, Ballantyne D (1986) "The effect of sotalol on plasma lipoproteins and apolipoproteins." Clin Chim Acta, 158, p. 187-91
  23. Lehtonen A, Hietanen E, Marniemi J, Peltonen P, Nikkila EA (1983) "Effect of sotalol withdrawal on serum lipids and lipoprotein lipase activity." Int J Clin Pharmacol Ther Toxicol, 21, p. 73-6
  24. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  25. (2001) "Product Information. Kerlone (betaxolol)." Searle
  26. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  27. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  28. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  29. Safran AB, Simona F, Sansonetti A, Pometta D, James R (1994) "Effects of ocular carteolol and timolol on plasma high-density lipoprotein cholesterol level." Am J Ophthalmol, 117, p. 683
  30. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  31. Clucas A, Miller N (1988) "Effects of acebutolol on the serum lipid profile." Drugs, 36 Suppl 2, p. 41-50
  32. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  33. Kasiske BL, Ma JZ, Kalil RS, Louis TA (1995) "Effects of antihypertensive therapy on serum lipids." Ann Intern Med, 122, p. 133-41
  34. Lind L, Pollare T, Berne C, Lithell H (1994) "Long-term metabolic effects of antihypertensive drugs." Am Heart J, 128, p. 1177-83
  35. Sasaki J, Kajiyama G, Kusukawa R, Mori H, Koga S, Takagi R, Tanaka N, Ogawa N, Arakawa K (1994) "Effect of bevantolol and propranolol on serum lipids in patients with essential hypertension." Int J Clin Pharmacol Ther, 32, p. 660-4
  36. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
  37. Lithell H, Andersson PE (1997) "Metabolic effects of carvedilol in hypertensive patients." Eur J Clin Pharmacol, 52, p. 13-7
  38. Gordon NF, Scott CB, Duncan JJ (1997) "Effects of atenolol versus enalapril on cardiovascular fitness and serum lipids in physically active hypertensive men." Am J Cardiol, 79, p. 1065-9
  39. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 39 references
Moderate

Beta-blockers (applies to Coreg) hyperthyroidism

Moderate Potential Hazard, High plausibility.

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. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  2. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  3. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  4. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  5. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  6. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  7. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  8. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  9. (2001) "Product Information. Kerlone (betaxolol)." Searle
  10. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  11. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  12. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  13. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  14. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  15. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
  16. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 16 references
Moderate

Beta-blockers (applies to Coreg) myasthenia gravis

Moderate Potential Hazard, Low plausibility. Applicable conditions: 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. Use cautiously in patients with myasthenia gravis.

References

  1. Confavreux C, Charles N, Aimard G (1990) "Fulminant myasthenia gravis soon after initiation of acebutolol therapy." Eur Neurol, 30, p. 279-81
  2. Berstein LP, Henkind P (1981) "Additional information on adverse reactions to timolol." Am J Ophthalmol, 92, p. 295-6
  3. Coppeto JR (1984) "Timolol-associated myasthenia gravis." Am J Ophthalmol, 98, p. 244-5
  4. Verkijk A (1985) "Worsening of myasthenia gravis with timolol maleate eyedrops." Ann Neurol, 17, p. 211-2
  5. Herishanu Y, Rosenberg P (1975) "Beta-blockers and myasthenia gravis." Ann Intern Med, 83, p. 834-5
  6. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  7. Choi KL, Wat MS, Ip TP, Kung AWC, Lam KSL (1995) "Phaeochromocytoma associated with myasthenia gravis precipitated by propranolol treatment." Aust N Z J Med, 25, p. 257
View all 7 references
Moderate

Beta-blockers (applies to Coreg) pheochromocytoma

Moderate Potential Hazard, Moderate plausibility.

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 alpha-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.

References

  1. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  2. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  3. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  4. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  5. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  6. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  7. (2001) "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals
  8. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  9. (2001) "Product Information. Kerlone (betaxolol)." Searle
  10. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  11. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  12. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  13. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  14. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  15. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
  16. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 16 references
Moderate

Beta-blockers (applies to Coreg) psoriasis

Moderate Potential Hazard, Moderate plausibility.

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

References

  1. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  2. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  3. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  4. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  5. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  6. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  7. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  8. (2001) "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals
  9. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  10. (2001) "Product Information. Kerlone (betaxolol)." Searle
  11. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  12. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  13. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  14. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  15. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  16. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 16 references
Moderate

Beta-blockers (applies to Coreg) tachycardia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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.

References

  1. (2002) "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories
  2. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  3. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  4. (2002) "Product Information. Trandate (labetalol)." Glaxo Wellcome
  5. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  6. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  7. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  8. (2001) "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals
  9. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  10. (2001) "Product Information. Kerlone (betaxolol)." Searle
  11. (2001) "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals
  12. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  13. (2001) "Product Information. Zebeta (bisoprolol)." Lederle Laboratories
  14. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  15. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  16. (2007) "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals
View all 16 references
Moderate

Carvedilol (applies to Coreg) renal dysfunction

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hypotension

The use of carvedilol has rarely resulted in deterioration of renal function. 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 (1992) "Carvedilol and the kidney." Clin Investig, 70 Suppl 1, s127-31
  2. Kohno M, Takeda T, Ishii M, Saruta T, Mizuno Y, Yoshimura M, Kubo S, Fukiyama K, Fujishima M (1988) "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, p. 129-35
  3. Kramer BK, Ress KM, Erley CM, Risler T (1992) "Pharmacokinetic and blood pressure effects of carvedilol in patients with chronic renal failure." Eur J Clin Pharmacol, 43, p. 85-8
  4. Dupont AG (1990) "Effects of carvedilol on renal function." Eur J Clin Pharmacol, 38 Suppl 2, s96-100
  5. Takeda T, Kohno M, Ishii M, Kubo S, Saruta T, Mizuno Y, Fukiyama K, Fujishima M, Yoshimura M (1990) "Efficacy and safety of carvedilol in renal hypertension. A multicenter open trial." Eur J Clin Pharmacol, 38 Suppl 2, s158-63
  6. Tomita K, Marumo F (1992) "Effect of long-term carvedilol therapy on renal function in essential hypertension." J Cardiovasc Pharmacol, 19 Suppl 1, s97-101
  7. Masumura H, Miki S, Kaifu Y, Kitajima W, Abe Y (1992) "Pharmacokinetics and efficacy of carvedilol in hypertensive patients with chronic renal failure and hemodialysis patients." J Cardiovasc Pharmacol, 19 Suppl 1, s102-7
  8. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
View all 8 references
Moderate

Non-selective beta-blockers (applies to Coreg) Prinzmetal's variant angina

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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.

References

  1. (2002) "Product Information. Normodyne (labetalol)." Schering Corporation
  2. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  3. (2001) "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories
  4. (2001) "Product Information. Blocadren (timolol)." Merck & Co., Inc
  5. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  6. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  7. (2001) "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation
  8. (2001) "Product Information. Levatol (penbutolol)." Reed and Carnrick
  9. (2001) "Product Information. Coreg (carvedilol)." SmithKline Beecham
View all 9 references

Coreg drug interactions

There are 546 drug interactions with Coreg (carvedilol).

Coreg alcohol/food interactions

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


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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 interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.