From the Guidelines
Coreg (carvedilol) can cause significant side effects, including dizziness, fatigue, weakness, headache, and low blood pressure, which are often most pronounced when starting the medication or increasing the dose 1. The side effects of Coreg are primarily due to its ability to block both beta and alpha adrenergic receptors, affecting heart rate, blood pressure, and blood vessel dilation.
- Common side effects include:
- Dizziness
- Fatigue
- Weakness
- Headache
- Low blood pressure
- Less common but more serious side effects include:
- Worsening heart failure
- Bradycardia (slow heart rate)
- Hypotension requiring medical attention
- Allergic reactions Patients with certain conditions, such as diabetes, should monitor their blood sugar levels closely as Coreg can mask symptoms of hypoglycemia 1. Additionally, Coreg may cause depression, sleep disturbances, and cold extremities. It is essential for patients to contact their healthcare provider if they experience severe or persistent side effects, rather than discontinuing the medication abruptly, as sudden stoppage can worsen underlying heart conditions 1. The dosage of Coreg should be individualized and uptitrated at 3- to 10-d intervals to a maximum of 25 mg twice daily, with the target resting heart rate being 50 to 60 beats per minute unless a limiting side effect is reached 1.
From the FDA Drug Label
ADVERSE REACTIONS SECTION 6. 1 Clinical Studies Experience Carvedilol Tablet has been evaluated for safety in patients with heart failure (mild, moderate and severe), in patients with left ventricular dysfunction following myocardial infarction and in hypertensive patients. The observed adverse event profile was consistent with the pharmacology of the drug and the health status of the patients in the clinical trials Adverse events reported for each of these patient populations are provided below. The following adverse events were reported with a frequency of greater than 1% but less than or equal to 3% and more frequently with Carvedilol Tablet: Flu syndrome, cerebrovascular accident, peripheral vascular disorder, hypotonia, depression, gastrointestinal pain, arthritis, and gout Table 1 shows adverse events in U. S. placebo-controlled clinical trials for hypertension that occurred with an incidence of greater than or equal to 1%, Regardless of Causality) * Carvedilol TabletPlacebo (n = 1,142)(n = 462) *Shown are events with rate greater than 1% rounded to nearest integer Cardiovascular Bradycardia 2- Postural hypotension2- Peripheral edema 1- Central Nervous System Dizziness65 Insomnia21 Gastrointestinal Diarrhea21 Hematologic Thrombocytopenia1 - Metabolic Hypertriglyceridemia1- Dyspnea and fatigue were also reported in these studies, but the rates were equal or greater in patients who received placebo The following adverse events not described above were reported as possibly or probably related to Carvedilol Tablet in worldwide open or controlled trials with Carvedilol Tablet in patients with hypertension or heart failure. Incidence greater than 0. 1% to less than or equal to 1% Cardiovascular: Peripheral ischemia, tachycardia. Central and Peripheral Nervous System: Hypokinesia. Gastrointestinal: Bilirubinemia, increased hepatic enzymes
The possible side effects of Coreg include:
- Cardiovascular:
- Bradycardia
- Postural hypotension
- Peripheral edema
- Peripheral ischemia
- Tachycardia
- Central Nervous System:
- Dizziness
- Insomnia
- Hypokinesia
- Gastrointestinal:
- Diarrhea
- Gastrointestinal pain
- Bilirubinemia
- Increased hepatic enzymes
- Hematologic:
- Thrombocytopenia
- Metabolic:
- Hypertriglyceridemia
- Other:
From the Research
Side Effects of Coreg
The provided studies do not directly mention the side effects of Coreg. However, they discuss the effects and usage of beta-blockers, a class of drugs that Coreg (carvedilol) belongs to.
- The studies compare the effectiveness of different beta-blockers, such as bisoprolol, metoprolol, and carvedilol, in treating heart failure and hypertension 3, 4, 5, 6, 7.
- They mention that beta-blockers can have various effects on the body, including influencing blood pressure, heart rate, and lipoprotein metabolism 4.
- Some beta-blockers, like carvedilol, may have pleiotropic effects, which are additional physiological properties that could impact their clinical use 6.
- The studies suggest that different beta-blockers may have similar effects on mortality and hospitalization risk in patients with heart failure, but there might be some variation in their effectiveness and safety profiles 5, 6, 7.
Beta-Blocker Comparison
The comparison of different beta-blockers is a key aspect of the provided studies.
- Bisoprolol, metoprolol, and carvedilol are often mentioned as evidence-based beta-blockers for treating heart failure 6.
- Carvedilol might have a slightly better effect on mortality compared to metoprolol or bisoprolol, but the evidence is not conclusive 6.
- Nebivolol is another beta-blocker that might be an alternative, but the certainty of the evidence is very low 6.
- A study published in 2023 found that bisoprolol improved the prognosis of chronic heart failure compared to carvedilol, while carvedilol had similar effects to metoprolol succinate and nebivolol 7.