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Carvedilol Disease Interactions

There are 21 disease interactions with carvedilol.

Major

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

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

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

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

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

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

Carvedilol (applies to carvedilol) CHF

Major Potential Hazard, High plausibility. Applicable conditions: 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. Kelly DT "Carvedilol in heart failure." Cardiology 82 Suppl 3 (1993): 45-9
  2. "Product Information. Coreg (carvedilol)." SmithKline Beecham (2001):
  3. Bristow MR, Renlund DG, Gilbert EM, Olsen SL, Taylor DO, Yanowitz FD "Carvedilol improves left ventricular function and symptoms in chronic heart failure: a double-blind randomized study." J Am Coll Cardiol 25 (1995): 1225-31
  4. 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
  5. 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
  6. Bristow MR, Fowler MB, Shusterman NH, Cohn JN, Colucci WS, Gilbert EM, Packer M "The effect of carvedilol on morbidity and mortality in patients with chronic heart failure." N Engl J Med 334 (1996): 1349-55
  7. Cleland JGF, Swedberg K "Carvedilol for heart failure, with care." Lancet 347 (1996): 1199-201
  8. Abernethy D, Moye LA "Carvedilol in patients with chronic heart failure." N Engl J Med 335 (1996): 1318
  9. Pop T, Berger J, Von Olshausen K "Carvedilol in patients with chronic heart failure." N Engl J Med 335 (1996): 1318-20
  10. Cohn JN, Colucci WS, Packer M "Carvedilol in patients with chronic heart failure." N Engl J Med 335 (1996): 1310-20
  11. Bristow MR, Bowers JA, Fowler MB, Krueger SK, Sackne, Cohn JN, Colucci WS, Gilbert EM, Hershberger R, Packer M, Uretsky BF "Carvedilol inhibits clinical progression in patients with mild symptoms of heart failure." Circulation 94 (1996): 2800-6
  12. Lane G, Garrett J, Tonkin A, Krum H, Macmahon S, Owensby D, Burton R, Doughty R, Ryan J, Shepherd J, Sing, Trotter A, Sharpe N "Randomised, placebo-controlled trial of carvedilol in patients with congestive heart failure due to ischaemic heart disease." Lancet 349 (1997): 375-80
  13. Abraham WT, Bristow MR, Gilbert EM, 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
  14. Gottlieb SS, Klapholz M, Liang CS, Sackner-Bernstein JD, Colucci WS, Freeman I, Goldscher DA, Kukin ML, Packer M, Pearle D, Kinhal V, Udelson JE "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
  15. Doughty RN, Whalley GA, MacMahon S, Gamble G, 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
  16. Frishman WH "Carvedilol." N Engl J Med 339 (1998): 1759-65
  17. Aboyoun CL, Amor R, Keogh AM, Macdonald PS, McCaffrey DJ, Lund M "Tolerability and efficacy of carvedilol in patients with New York Heart Association class IV heart failure." J Am Coll Cardiol 33 (1999): 924-31
View all 17 references
Major

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

Carvedilol (applies to carvedilol) 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. Danielson M, Eliasson K, Hylander B, Lindblad LE "Raynaud's phenomenon caused by beta-receptor blocking drugs." Acta Med Scand 215 (1984): 333-9
  2. Eliasson K, Sundqvist K, Lins L-E "Peripheral vasospasm during beta-receptor blockade: a comparison between metoprolol and pindolol." Acta Med Scand 665 (1982): 109-12
  3. Lepantalo M "Beta blockade and intermittent claudication." Acta Med Scand 700 (1985): 1-48
  4. Coventry D, Mashford ML, Hecker R, et al. "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust 1 (1982): 416-9
  5. Agrawal B, Meyer-Sabellek W "Antihypertensive profile of carvedilol." Clin Investig 70 Suppl 1 (1992): s43-52
  6. 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
  7. "Product Information. Coreg (carvedilol)." SmithKline Beecham (2001):
View all 7 references
Major

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

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

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

Beta-blockers (applies to carvedilol) 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. Weiner L, Rossner S "Atenolol and metoprolol: comparison of effects on blood pressure and serum lipoproteins, and side effects." Eur J Clin Pharmacol 24 (1983): 573-7
  2. 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
  3. Disler LJ, Joffe BI, Seftel HC "Massive hypertriglyceridemia associated with atenolol." Am J Med 85 (1988): 586-7
  4. Heller FR, Martiat P, Harvengt C, 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
  5. Darga LL, Franklin BA, Hakim MJ, Lucas CP "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
  6. Weiner L, Rossner S "Atenolol and metoprolol: comparison of effects on blood pressure and serum lipoproteins, and side effects." Eur J Clin Pharmacol 24 (1983): 573-7
  7. 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
  8. Ferrara LA, Scilla A, Marotta T, et al. "Effect of oxprenolol and metoprolol on serum lipid concentration." Eur J Clin Pharmacol 26 (1984): 331-4
  9. Fiorella G, Pasotti C, Capra A, et al. "Effects of pindolol and metoprolol on plasma lipids and lipoproteins." Br J Clin Pharmacol 13 (1982): s435-9
  10. 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
  11. Chin B, Schoenfeld BH, Samuel P, 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
  12. Carlson LA, Ribacke M, Terent A "Long-term effect of pindolol on lipids and lipoproteins in men with newly diagnosed hypertension." Eur J Clin Pharmacol 36 (1989): 347-50
  13. Sasaki J, Ideishi M, Saku K, 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
  14. 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
  15. Foss PO, Fossbakk B, Leren P, Nordvik B "The effect of enalapril and timolol on blood lipids." Acta Med Scand 223 (1988): 321-6
  16. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories (2002):
  17. "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc (2002):
  18. "Product Information. Normodyne (labetalol)." Schering Corporation (2002):
  19. "Product Information. Trandate (labetalol)." Glaxo Wellcome (2002):
  20. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb (2002):
  21. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories (2001):
  22. "Product Information. Blocadren (timolol)." Merck & Company Inc (2001):
  23. Ballantyne D, Northcote RJ, Packard CJ "The effect of sotalol on plasma lipoproteins and apolipoproteins." Clin Chim Acta 158 (1986): 187-91
  24. Hietanen E, Lehtonen A, Peltonen P, Nikkila EA, Marniemi J "Effect of sotalol withdrawal on serum lipids and lipoprotein lipase activity." Int J Clin Pharmacol Ther Toxicol 21 (1983): 73-6
  25. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical (2001):
  26. "Product Information. Kerlone (betaxolol)." Searle (2001):
  27. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals (2001):
  28. "Product Information. Betapace (sotalol)." Berlex Laboratories (2001):
  29. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories (2001):
  30. Simona F, James R, Pometta D, Safran AB, Sansonetti A "Effects of ocular carteolol and timolol on plasma high-density lipoprotein cholesterol level." Am J Ophthalmol 117 (1994): 683
  31. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation (2001):
  32. Clucas A, Miller N "Effects of acebutolol on the serum lipid profile." Drugs 36 Suppl 2 (1988): 41-50
  33. "Product Information. Levatol (penbutolol)." Reed and Carnrick (2001):
  34. Kasiske BL, Louis TA, Ma JZ, Kalil RS "Effects of antihypertensive therapy on serum lipids." Ann Intern Med 122 (1995): 133-41
  35. Lind L, Pollare T, Lithell H, Berne C "Long-term metabolic effects of antihypertensive drugs." Am Heart J 128 (1994): 1177-83
  36. Arakawa K, Kajiyama G, Koga S, Ogawa N, Sasaki J, Tanaka N, Kusukawa R, Mori H, Takagi R "Effect of bevantolol and propranolol on serum lipids in patients with essential hypertension." Int J Clin Pharmacol Ther 32 (1994): 660-4
  37. "Product Information. Coreg (carvedilol)." SmithKline Beecham (2001):
  38. Andersson PE, Lithell H "Metabolic effects of carvedilol in hypertensive patients." Eur J Clin Pharmacol 52 (1997): 13-7
  39. Gordon NF, Duncan JJ, Scott CB "Effects of atenolol versus enalapril on cardiovascular fitness and serum lipids in physically active hypertensive men." Am J Cardiol 79 (1997): 1065-9
  40. "Product Information. Bystolic (nebivolol)." Forest Pharmaceuticals (2007):
View all 40 references
Moderate

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

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

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

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

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

Carvedilol (applies to carvedilol) renal dysfunction

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

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

Carvedilol drug interactions

There are 519 drug interactions with carvedilol.

Carvedilol alcohol/food interactions

There are 3 alcohol/food interactions with 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.