Carvedilol โ€” NZ Medication Guide

What is Carvedilol?

Carvedilol is a non-selective beta-blocker with additional alpha-1 adrenergic blocking activity, used in heart failure and hypertension. This medication is commonly prescribed in New Zealand and is funded by Pharmac for heart failure.

What is Carvedilol Used For?

Carvedilol is used for the treatment of chronic heart failure (stable, mild-to-severe), left ventricular dysfunction following myocardial infarction, and hypertension. It reduces mortality in patients with heart failure with reduced ejection fraction.

How Does Carvedilol Work?

Carvedilol blocks both beta-1 and beta-2 adrenergic receptors as well as alpha-1 receptors, resulting in vasodilation (via alpha-1 blockade) and reduced heart rate and contractility. This combination reduces cardiac workload and improves symptoms and survival in heart failure.

How to Take Carvedilol

Taken twice daily with food to reduce the risk of orthostatic hypotension. Heart failure dosing begins at 3.125 mg twice daily and is titrated upward over weeks to a target dose of 25โ€“50 mg twice daily. Do not stop suddenly.

Common Side Effects of Carvedilol

  • Dizziness or light-headedness (especially on standing)
  • Fatigue
  • Slow heart rate (bradycardia)
  • Weight gain and fluid retention
  • Blurred vision
  • Nausea or diarrhoea

Serious Side Effects โ€” Seek Medical Attention

Contact your doctor or call 111 immediately if you experience any of the following:

  • Severe hypotension (very low blood pressure)
  • Worsening heart failure or breathlessness
  • Liver problems (rare โ€” yellowing of skin or eyes)
  • Severe bradycardia or heart block
  • Severe allergic reaction

Drug Interactions

Carvedilol may interact with other medicines. Always inform your doctor and pharmacist of all medications, supplements, and herbal products you are taking. Key interactions include:

  • Digoxin (increased risk of bradycardia)
  • Verapamil and diltiazem (severe bradycardia risk)
  • Clonidine
  • Rifampicin (reduces carvedilol levels)
  • Ciclosporin (increased cyclosporine levels)
  • Insulin and antidiabetics

New Zealand Prescribing Information

Carvedilol is funded by Pharmac for heart failure and is available as 3.125 mg, 6.25 mg, 12.5 mg, and 25 mg tablets. It is typically initiated by a cardiologist or specialist and managed in primary care once stable.

Frequently Asked Questions

Why do I need to take carvedilol with food?

Taking carvedilol with food slows its absorption and reduces the risk of a sudden drop in blood pressure (orthostatic hypotension), which can cause dizziness or fainting โ€” particularly when you stand up.

How is carvedilol different from bisoprolol?

Both are beta-blockers used for heart failure, but carvedilol also blocks alpha-1 receptors, providing additional vasodilation. The choice between them depends on individual patient factors and is made by your cardiologist or doctor.

Reviewed by a Registered Pharmacist NZ

References & Further Information

The following New Zealand and international resources were used to inform this page:

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