Coreg Cr Generic Name & Formulations
Legal Class
Rx
General Description
Carvedilol (as phosphate) 10mg, 20mg, 40mg, 80mg; ext-rel caps.
Pharmacological Class
Noncardioselective beta-blocker/alpha-1 blocker.
See Also
How Supplied
CR caps—30, 90; Tabs—100
Manufacturer
Mechanism of Action
Carvedilol phosphate is a non-selective β-adrenergic blocking agent with α1-blocking activity. It has no intrinsic sympathomimetic activity.
Coreg Cr Indications
Indications
Mild to severe heart failure (HF), to increase survival and reduce hospitalization risk. To reduce cardiovascular mortality post-MI with left ventricular ejection fraction ≤40%.
Coreg Cr Dosage and Administration
Adult
Take with food in the AM. Swallow whole or may open caps and sprinkle beads on a spoonful of applesauce and take immediately. ≥18yrs: HF: initally 10mg once daily for 2 weeks, may double dose every 2 weeks if tolerated; max 80mg once daily. Reduce dose if pulse<55. Post-MI: initially 20mg once daily; increase to 40mg once daily after 3–10 days if tolerated; then to target dose of 80mg once daily. Low BP or heart rate, or fluid retention: may start at 10mg once daily. Switching from immediate-release carvedilol: see literature. ≥65yrs: switching from highest dose of immediate-release carvedilol (25mg twice daily) to Coreg CR: initially Coreg CR 40mg; if tolerated for ≥2weeks, may increase to 80mg.
Children
<18yrs: not recommended.
Coreg Cr Contraindications
Contraindications
Cardiogenic shock or decompensated HF requiring intravenous inotropic therapy. Asthma, related bronchospastic conditions. 2nd or 3rd-degree AV block, sick sinus syndrome, or severe bradycardia, unless paced. Severe hepatic impairment.
Coreg Cr Boxed Warnings
Not Applicable
Coreg Cr Warnings/Precautions
Warnings/Precautions
Peripheral vascular disease. Nonallergic bronchospasm. Diabetes (monitor blood glucose). Hyperthyroidism. Monitor renal function in ischemic heart disease, diffuse vascular disease, underlying renal insufficiency, and/or if systolic BP <100 mmHg. Initiation of therapy may temporarily worsen signs and symptoms; benefits may be delayed for several weeks; may need increased diuretic dose at first. Avoid abrupt cessation. Prinzmetal's angina. Pheochromocytoma. Elderly. Pregnancy. Nursing mothers.
Coreg Cr Pharmacokinetics
Absorption
-
Rapidly and extensively absorbed. Absolute bioavailability: approximately 25–35%.
Distribution
-
>98% plasma protein bound.
-
Steady-state volume of distribution: approximately 115 L.
-
Plasma clearance ranges from 500-700 mL/min.
Elimination
Fecal. Half-life: ~7–10hrs.
Coreg Cr Interactions
Interactions
May be potentiated by CYP2D6 inhibitors (eg, quinidine, fluoxetine, paroxetine, propafenone), alcohol (separate by 2 hours). Bradycardia, hypotension with catecholamine depletors (eg, reserpine, MAOIs). Carvedilol levels reduced by rifampin. Increased absorption with cimetidine. Caution with drugs that affect cardiac conduction (esp. diltiazem, verapamil). May potentiate antidiabetic agents. Monitor digoxin, cyclosporine when changing carvedilol dose. Anesthesia.
Coreg Cr Adverse Reactions
Adverse Reactions
Dizziness, edema, hypotension, syncope, bradycardia, AV block, GI upset, hyperglycemia, weight gain, abnormal vision.
Coreg Cr Clinical Trials
Coreg Cr Note
Not Applicable
Coreg Cr Patient Counseling
See Literature
Coreg Cr Generic Name & Formulations
Legal Class
Rx
General Description
Carvedilol (as phosphate) 10mg, 20mg, 40mg, 80mg; ext-rel caps.
Pharmacological Class
Noncardioselective beta-blocker/alpha-1 blocker.
See Also
How Supplied
CR caps—30, 90; Tabs—100
Manufacturer
Mechanism of Action
Carvedilol phosphate is a non-selective β-adrenergic blocking agent with α1-blocking activity. It has no intrinsic sympathomimetic activity.
Coreg Cr Indications
Indications
Hypertension.
Coreg Cr Dosage and Administration
Adult
Take with food in the AM. Swallow whole or may open capsules and sprinkle beads on a spoonful of applesauce and take immediately. ≥18yrs: initially 20mg once daily, may double dose every 1–2 weeks if tolerated and needed. Max daily dose of 80mg. Switching from immediate-release carvedilol: see literature. ≥65yrs: switching from highest dose of immediate-release carvedilol (25mg twice daily) to Coreg CR: initially Coreg CR 40mg; if tolerated for ≥2weeks, may increase to 80mg.
Children
<18yrs: not recommended.
Coreg Cr Contraindications
Contraindications
Cardiogenic shock or decompensated HF requiring intravenous inotropic therapy. Asthma, related bronchospastic conditions. 2nd or 3rd-degree AV block, sick sinus syndrome, or severe bradycardia, unless paced. Severe hepatic impairment.
Coreg Cr Boxed Warnings
Not Applicable
Coreg Cr Warnings/Precautions
Warnings/Precautions
Peripheral vascular disease. Nonallergic bronchospasm. Diabetes (monitor blood glucose). Hyperthyroidism. Monitor renal function in ischemic heart disease, diffuse vascular disease, underlying renal insufficiency, and/or if systolic BP <100mmHg. Avoid abrupt cessation. Prinzmetal's angina. Pheochromocytoma. Elderly. Neonates. Pregnancy (monitor). Nursing mothers.
Coreg Cr Pharmacokinetics
Absorption
-
Rapidly and extensively absorbed. Absolute bioavailability: approximately 25–35%.
Distribution
-
>98% plasma protein bound.
-
Steady-state volume of distribution: approximately 115 L.
-
Plasma clearance ranges from 500-700 mL/min.
Elimination
Fecal. Half-life: ~7–10hrs.
Coreg Cr Interactions
Interactions
May be potentiated by CYP2D6 inhibitors (eg, quinidine, fluoxetine, paroxetine, propafenone), alcohol (separate by 2 hours). Bradycardia, hypotension with catecholamine depletors (eg, reserpine, MAOIs). Carvedilol levels reduced by rifampin. Increased absorption with cimetidine. Caution with drugs that affect cardiac conduction (esp. diltiazem, verapamil). May potentiate antidiabetic agents. Monitor digoxin, cyclosporine when changing carvedilol dose. Anesthesia.
Coreg Cr Adverse Reactions
Adverse Reactions
Bradycardia, orthostatic hypotension, dizziness, nasopharyngitis, GI upset, edema.
Coreg Cr Clinical Trials
Coreg Cr Note
Not Applicable
Coreg Cr Patient Counseling
See Literature
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