Comprehensive Product Description Guide: Coreg CR (Carvedilol Phosphate Extended-Release)

Coreg CR (Carvedilol Extended-Release) is a beta-blocker used to treat high blood pressure, heart failure, and to improve survival after a heart attack. It works by blocking certain receptors in the heart and blood vessels, thereby reducing heart rate and blood pressure, and improving heart function.

Coreg CR (Carvedilol Phosphate Extended-Release Capsules)

Carvedilol Phosphate (extended-release formulation)

Brand Name Equivalent: Coreg CR

Generic Names: Carvedilol ER, Carvedilol CR

Therapeutic Class: Beta-blocker with alpha-blocking activity

Common Terms: Blood pressure medicine, Beta-blocker extended-release, Heart failure treatment

Pharmacological Class: Non-selective Beta-adrenergic Blocker with Alpha1-adrenergic Blocking Activity

Therapeutic Class: Antihypertensive, Cardioprotective Agent

Regulatory Schedule (Australia): Schedule 4 (S4) – Prescription Only Medicine

Carvedilol works by blocking beta1, beta2, and alpha1 receptors. The beta-blocking effects reduce heart rate and myocardial contractility, decreasing cardiac output. Alpha1 blockade leads to vasodilation, which reduces systemic vascular resistance and blood pressure. Together, these actions improve heart function and decrease the risk of adverse cardiac events in conditions like chronic heart failure, post-myocardial infarction, and hypertension.

Chronic Heart Failure (CHF), including patients with impaired left ventricular function

Hypertension (High Blood Pressure)

Left Ventricular Dysfunction Post-Myocardial Infarction (MI)

Angina (off-label in some countries)

Dosage and Administration:
Administration:

Take once daily in the morning with food to reduce the risk of orthostatic hypotension.

Typical Adult Doses:

Heart Failure: Start with 10 mg once daily, titrated to a maximum of 80 mg/day as tolerated

Hypertension: Initial dose 20 mg once daily, can be increased every 7–14 days

Post-MI with LV dysfunction: Start with 10–20 mg once daily

Elderly Patients: Start with lower dose (10 mg/day) and monitor blood pressure closely

Extended-release capsules (10 mg, 20 mg, 40 mg, 80 mg)

Formulation: Extended-release oral capsule

Packaging: Blister pack or bottle, typically 30 or 90 capsules

Storage: Store below 25°C, protect from moisture

Contraindications:
Bronchial asthma or related bronchospastic conditions

Severe hepatic impairment

Second- or third-degree AV block (without pacemaker)

Sick sinus syndrome

Cardiogenic shock

Bradycardia (<50 bpm)

Hypersensitivity to carvedilol or capsule components

Use with caution in diabetic patients (may mask hypoglycemia)

May exacerbate symptoms in peripheral vascular disease

Taper gradually when discontinuing to avoid rebound hypertension or ischemia

Avoid abrupt cessation, especially in patients with ischemic heart disease

Monitor liver enzymes in hepatic impairment

Common Side Effects:
Dizziness or lightheadedness

Fatigue

Hypotension

Bradycardia

Weight gain (heart failure patients)

Less Common:
Cold extremities

Visual disturbances

Erectile dysfunction

Depression

Rare but Serious:
Hepatic dysfunction

Bronchospasm in asthmatics

AV block

Anaphylaxis (rare)

Avoid concomitant use with:

Calcium channel blockers (e.g., verapamil, diltiazem) – risk of bradycardia

CYP2D6 inhibitors (e.g., fluoxetine) – may increase plasma levels

Digoxin – monitor levels (increased AUC of digoxin)

Insulin or oral hypoglycemics – can mask hypoglycemia symptoms

Clonidine – additive bradycardia and hypotension

COPERNICUS Study: Demonstrated significant mortality reduction in severe heart failure patients receiving carvedilol.

COMET Trial: Carvedilol showed superior survival benefits over metoprolol in chronic heart failure.

CAPRICORN Study: Reduced mortality and morbidity in post-MI patients with LV dysfunction.

Frequently Asked Questions (FAQs)
Q: What is Coreg CR used to treat?
A: Coreg CR is used to manage heart failure, high blood pressure, and improve survival after a heart attack with left ventricular dysfunction.

Q: How should I take Coreg CR?
A: It should be taken once daily with food in the morning to reduce side effects like dizziness.

Q: Can I stop taking Coreg CR suddenly?
A: No. Always taper down under medical supervision to avoid rebound cardiovascular events.

Q: Is Coreg CR different from regular Coreg?
A: Yes. Coreg CR is extended-release and taken once daily, while regular Coreg is immediate-release and usually taken twice daily.

Q: Can Coreg CR cause weight gain?
A: Yes, especially in patients with heart failure. Report rapid weight gain to your doctor.
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