Carvedilol - Oral

Carvedilol helps to keep your blood pressure under control.

It is also used to treat angina pectoris (chest pain which occurs when the heart does not receive enough blood supply) and heart failure (weakness and inability of the heart to pump blood).

This medicine may also be used to improve heart function after a heart attack.

Take Carvedilol exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Take this medicine together with food or immediately after a meal. Try to take it at the same time each day.

Carvedilol is available as a tablet and extended-release capsule.

If you are taking the extended-release type of capsule (usually labelled as "ER"), swallow it whole. Do not divide, chew, or crush the capsule.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.

Carvedilol must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as this may worsen your condition.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following conditions:

• severe heart failure with fluid retention (swelling) and requiring intravenous medications
• sick sinus syndrome (abnormal heart rhythms due to problems with your heart's natural pacemaker)
• very slow heartbeat
• severe low blood pressure
• cardiogenic shock (a serious sudden condition when the heart cannot supply enough oxygen-rich blood to the brain and vital organs of the body)
• metabolic acidosis (a condition when there is too much acid in the blood)
• history of lung problems e.g. asthma, bronchospasm (breathing distress caused by narrowing of the airways)
• severe liver disease

as Carvedilol may not be suitable for you.

Inform your doctor if you have the following conditions:

• Prinzmetal's angina (a rare type of chest pain that occurs when a person is at rest)
• other heart diseases
• chronic obstructive pulmonary disease (a long-term lung disease that causes airflow obstruction making it hard to breathe)
• other lung diseases
• diabetes
• myasthenia gravis (muscle weakness disorder)
• peripheral vascular disease (narrowing or blockage of the blood vessels outside of the heart and brain causing poor blood circulation to the arms and legs)
• phaeochromocytoma (rare tumour of the adrenal gland causing high blood pressure)
• thyroid disease
• history of allergic reactions
• history of psoriasis (a type of skin disease that allows the skin cells to rapidly build up causing itchy patches of thick, red skin and silvery scales)

Let your doctor know if you are pregnant or breastfeeding.

If you are going for an operation, including minor surgery and dental work, always inform your doctor or dentist that you are taking Carvedilol.

Some genetic traits can affect this medicine’s efficacy. Individuals who are poor metabolisers of CYP2D6 may experience enhanced side effects of Carvedilol (e.g. drowsiness). Although not routinely done, your doctor may advise you to undergo genetic testing to check if this medicine is best suited for you. If you know you have this gene type, inform your doctor.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. liver or kidney function, blood sugar levels, eye examination) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
• Regular monitoring of signs and symptoms of breathing problems may also be needed.

What lifestyle changes can I make to improve my blood pressure?

Regular exercise and eating a healthy diet will help control your blood pressure and improve your overall health. Engage in physical activity like walking for at least 30 to 60 minutes on most days of the week. If you have not exercised for a long time, start with light exercises such as slow walks. Speak to your doctor about what type of exercise would be suitable for you. Follow a healthy diet plan by eating more fruits, vegetables, whole grains and low-fat dairy products and reduce your intake of foods high in saturated fat, cholesterol and sodium. Cutting down on deep-fried foods and using less salt when cooking can kick-start your healthy diet.

If you smoke, you should try to quit. Smoking is harmful to your blood pressure, heart and overall health. Speak to your doctor or pharmacist about ways to stop your smoking habit.

Carvedilol may cause dizziness. If affected, do not drive or take part in any activity in which you need to be alert.

Other side effects include any of the following: headache, nausea, vomiting, diarrhoea, abdominal pain, indigestion, dry eye, eye irritation, vision problems, generalised weakness or lack of energy, pain in the arms or legs, increased weight, and feeling depressed.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• severe dizziness or passing out
• fruity breath odour, fast breathing, fast heartbeat, feeling confused, feeling sleepy, feeling weak, flushing, unusual thirst or hunger, passing urine more often, shaking, or sweating
• chest pain, tightness or pressure, pain that may spread to the arms, jaw, neck, shoulder or back, shortness of breath, lightheadedness
• hair loss, brittle hair, weight loss, difficulty sleeping, increased sweating, hot flushes, irritability, tremors, bulging eyes
• pain or difficulty in passing urine, change in how much urine is passed, blood in the urine

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• rifampicin (medicine to treat TB [an infection known as tuberculosis])
• digoxin (medicine for heart disease)
• ciclosporin (medicine used in organ transplants or certain immune disorders)
• amiodarone (medicine for irregular heartbeat)
• other medicines for high blood pressure e.g. diltiazem, verapamil, clonidine, propranolol, doxazosin
• medicines for diabetes e.g. insulin
• medicines to treat depression e.g. fluoxetine, clomipramine
• NSAIDs (medicines for pain and inflammation)

This list does not include all medicines that may interact with Carvedilol.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Cut down on your salt intake. This may help lower your blood pressure and improve your overall health. Discuss with your doctor or dietitian about ways to cut down on your salt intake.

Avoid excessive consumption of alcohol. You may speak with your doctor if you have a drinking problem.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.