Carvedilol: Price, Dosage & Where to Buy

Carvedilol is an alpha- and beta-adrenergic blocking medicine, also known as a beta-blocker with additional alpha-blocking activity. It is most commonly prescribed to manage high blood pressure, and is also used for chronic heart failure and stable left ventricular dysfunction after myocardial infarction. It requires a prescription in the United Kingdom and generic versions have been available since 2007-09-05.

Carvedilol blocks beta-adrenergic receptors and also blocks alpha-adrenergic receptors. Beta-blockade slows the heart rate and reduces the force with which the heart contracts, lowering the heart's demand for oxygen and reducing some of the effects of stress hormones. Alpha-blockade relaxes blood vessel walls, which lowers resistance to blood flow.

Together, these actions can reduce blood pressure and the workload on the heart. In chronic heart failure, carefully monitored treatment can support the heart by reducing harmful over-stimulation of the cardiovascular system. Because the medicine can also slow electrical conduction through the heart and lower blood pressure, treatment is usually individualised and adjusted gradually by a clinician.

Carvedilol is used to manage essential hypertension, meaning high blood pressure without a separately identified cause. It is also indicated for mild to severe chronic heart failure of ischaemic or cardiomyopathic origin, usually alongside other heart-failure medicines such as diuretics, ACE inhibitors and digitalis. In this setting, treatment can increase survival and reduce the risk of hospitalisation.

Carvedilol is additionally used for left ventricular dysfunction after myocardial infarction in clinically stable people who have survived the acute phase. This indication applies when the left ventricular ejection fraction is less than or equal to 40%, with or without symptomatic heart failure, and aims to reduce cardiovascular mortality.

The label lists 3.125 mg, 6.25 mg, 12.5 mg, and 25 mg film-coated oral tablets, plus 10 mg, 20 mg, 40 mg, and 80 mg extended-release oral capsules. The label lists heart-failure treatment beginning at 3.125 mg twice daily, with increases to 6.25 mg, 12.5 mg, and 25 mg twice daily over intervals of at least 2 weeks if tolerated. The label lists treatment after myocardial infarction beginning at 6.25 mg twice daily, increasing to 12.5 mg and then 25 mg twice daily after intervals of 3 to 10 days.

The usual starting dose is 6.25 mg twice daily for hypertension, with possible increases to 12.5 mg and then 25 mg twice daily over intervals of 1 to 2 weeks. The label states that treatment should be individualised, monitored during increases, and taken with food.

Store below 30°C (86°F) and protect from moisture. Dispense in a tight, light-resistant container to maintain quality. Keep the medicine in its original container and as directed on the label.

A missed dose should not be replaced by taking extra medicine. General pharmacy guidance is to take the missed dose when remembered unless it is nearly time for the next scheduled dose, in which case it is usually omitted and the regular schedule resumed.

Carvedilol should not be stopped suddenly, because abrupt cessation can worsen coronary artery disease and may lead to serious heart complications. A pharmacist or prescriber can advise about the specific situation.

Available pregnancy data are insufficient to determine whether carvedilol is associated with developmental risks. Beta-blocker use during the third trimester may increase the risk of hypotension, bradycardia, hypoglycaemia, and respiratory depression in the newborn.

There are no data on carvedilol in human milk, breastfed infants, or milk production, although it is present in the milk of lactating rats. Pregnancy or breastfeeding should be discussed with a doctor or pharmacist.