Carvedilol Risks, Warnings, and Complications

Precautions Before Starting Carvedilol

Tell your healthcare provider if you have ever had an allergic reaction to carvedilol, any of the ingredients in carvedilol tablets or capsules, other beta-blockers, or other medicines. Your pharmacy can give you a list of ingredients.

Give your healthcare provider a complete medical history. Carvedilol may not be right for people with certain medical conditions such as slow or irregular heartbeat, asthma or breathing problems, kidney disease, and severe liver disease. 

Also, tell your doctor if you have blood flow problems in your legs, low blood sugar levels, diabetes, low blood pressure, hyperthyroidism (overactive thyroid), pheochromocytoma (a tumor of the adrenal glands that causes fast heartbeat and high blood pressure), sick sinus syndrome (a heart rhythm abnormality), or Prinzmetal’s angina (a type of chest pain that occurs at rest with no obvious cause).

Give your doctor a complete list of all your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid serious interactions between carvedilol and other drugs.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or breastfeeding (carvedilol passes into breast milk to a lesser degree than some other beta-blockers — talk to your doctor about the best medication choice if you are breastfeeding).

Precautions During Use of Carvedilol

Keep all your medical and lab appointments while on carvedilol. Your doctor may want to increase your dose gradually based on your response.

Carvedilol can cause dizziness and lightheadedness if you get up too quickly from a sitting or lying position, especially when you first start taking this medicine. To prevent this, get out of bed slowly and rest your feet on the ground for a few minutes before standing up. Call your doctor if the problem is severe or does not disappear in a few days.

Do not drink alcohol or take any alcohol-containing medicines for 2 hours before and 2 hours after extended-release carvedilol. Ask your doctor or pharmacist if you are not sure which of your medications might contain alcohol.

If you wear contact lenses, you may experience dry eyes during treatment with carvedilol. Tell your doctor if this is a problem.

Tell your healthcare professionals you are taking carvedilol before any surgery, including dental surgery.

Call your doctor if you become pregnant while taking carvedilol.

Carvedilol Drug Interactions

Taking carvedilol with other medicines can affect how each medication works. Interactions between medications can also increase the risk of serious side effects. Your physician may choose a different drug combination, change the dose or frequency of one or both medicines, and/or closely monitor you for side effects if there are known interactions between carvedilol and your other medications.

There can be possible drug interactions between carvedilol and the following medications:

• Antacids like cimetidine
• Blood pressure medications like clonidine (Catapres, Kapvay, in Clorpres) and reserpine
• Calcium channel blockers like verapamil (Calan, Verelan, Covera-HS, in Tarka)
• Heart medications like digoxin ( Lanoxin), propafenone (Rythmol), diltiazem (Cardizem, Cartia, Dilacor, Taztia, Tiazac), and quinidine
• Immunosuppressive agents like cyclosporine (Gengraf, Neoral, Sandimmune)
• Antidepressants like fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax) and paroxetine (Brisdelle, Paxil)
• Antidepressants called monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil), isocarboxazid (Marplan), tranylcypromine (Parnate), and selegiline (Eldepryl, Emsam, Zelapar)
• Insulin and oral medications for diabetes
• Epinephrine (Epipen)
• Tuberculosis medications such as rifampin (Rifadin, Rimactane, in Rifater, in Rifamate)

This list does not describe all possible carvedilol interactions. Give your healthcare professionals a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. Also, tell your health care provider if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription drugs.