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Carvedilol ๐
Related Subjects: |Hypertension |Acute Heart Failure |Chronic Heart Failure
๐ Carvedilol was the first beta-blocker proven to improve survival in heart failure.
๐ About
Always check the BNF link here for updated guidance.
- Non-selective ฮฒ-blocker (blocks both ฮฒ1 and ฮฒ2 receptors).
- Also blocks ฮฑ1-receptors โ causes peripheral vasodilation, reducing afterload.
- Particularly useful in heart failure with reduced ejection fraction (HFrEF).
๐ฏ Indications & Dosing Carvedilol (Oral)
- ๐ฉธ Hypertension / Angina / Post-MI: Start 12.5 mg once daily โ increase gradually to 25 mg twice daily (max) as tolerated.
- โค๏ธ Heart Failure (HFrEF): Start 3.125 mg twice daily โ titrate slowly (every 2โ4 weeks) up to 25 mg twice daily (max). Always start low and go slow โ risk of initial decompensation.
โ Contraindications
- Asthma, COPD, or active bronchospasm ๐ซ.
- 2nd or 3rd-degree heart block.
- Bradycardia (<60 bpm) or systolic BP <100 mmHg.
- Uncontrolled / acute decompensated heart failure.
- Diabetes (especially with thiazide use โ may worsen glycaemic control).
- Sick sinus syndrome.
- Severe peripheral vascular disease ๐ฆต.
โ ๏ธ Side Effects
- Fatigue, lethargy, cold peripheries ๐ฅถ.
- Postural hypotension, dizziness, diarrhoea.
- Bradycardia, worsening heart failure (initially).
- Worsening diabetic control (masks hypoglycaemia).
- Claudication, impotence, insomnia.
- May exacerbate psoriasis.
๐ Interactions
- May increase ciclosporin toxicity (monitor levels closely).
- Caution with other negative chronotropes (e.g. digoxin, verapamil, diltiazem) โ risk of heart block.
๐ References
- Carvedilol โ BNF
- ESC Heart Failure Guidelines.
- Oxford Handbook of Clinical Medicine.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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