What is the use of Carvedilol?

From the Guidelines

Carvedilol is primarily used to treat heart failure (HF) and hypertension.

Key Uses of Carvedilol

• Heart Failure: Carvedilol has been shown to reduce mortality and morbidity in patients with heart failure, particularly those with left ventricular systolic dysfunction 1.
• Hypertension: Carvedilol can be used to treat hypertension, especially in patients with hypertension-related left ventricular systolic dysfunction 1.

Dosage and Administration

• The recommended dose of carvedilol for heart failure is 25 mg twice daily, with a maximum dose of 50 mg twice daily 1.
• The dose of carvedilol for hypertension is typically lower, ranging from 6.25 to 25 mg twice daily 1.

Mechanism of Action

• Carvedilol is a beta-blocker with alpha-1 blocking properties, which helps to reduce blood pressure and alleviate symptoms of heart failure 1.
• Carvedilol has been shown to improve left ventricular function, reduce hospitalization, and decrease mortality in patients with heart failure 1.

Clinical Evidence

• The CarvedilOl ProspEctive RaNdomIzed CU-mulative Survival (COPERNICUS) trial demonstrated a 38% reduction in mortality and a 31% reduction in hospitalization for heart failure with carvedilol compared to placebo 1.
• The Multicenter Oral Carvedilol Heart failure Assessment (MOCHA) trial showed that carvedilol improved left ventricular function and reduced symptoms of heart failure in a dose-dependent manner 1.
• The 2013 ACCF/AHA guideline for the management of heart failure recommends the use of carvedilol, along with other beta-blockers, to reduce morbidity and mortality in patients with heart failure 1.

From the FDA Drug Label

Carvedilol Tablet is indicated to reduce cardiovascular mortality in clinically stable patients who have survived the acute phase of a myocardial infarction and have a left ventricular ejection fraction of less than or equal to 40% (with or without symptomatic heart failure) Carvedilol Tablet is indicated for the management of essential hypertension Carvedilol Tablet is used, often with other medicines, for the following conditions: To treat patients with high blood pressure (hypertension) To treat patients who had a heart attack that worsened how well the heart pumps

The use of Carvedilol is for:

• Reducing cardiovascular mortality in patients who have survived a myocardial infarction with left ventricular dysfunction
• Managing essential hypertension
• Treating patients with high blood pressure
• Treating patients who had a heart attack that worsened how well the heart pumps 2, 2

From the Research

Uses of Carvedilol

• Carvedilol is used in the treatment of hypertension, coronary artery disease, and congestive heart failure 3, 4, 5, 6.
• It is a beta-blocker and a vasodilator, which significantly decreases myocardial work by reducing heart rate, contractility, and wall tension 3, 7.
• The drug has antioxidant properties, which may account for its cardioprotective effects in animal models of acute myocardial ischemia 3.
• Carvedilol is also used to treat patients with non-insulin-dependent or insulin-dependent diabetes mellitus, as it does not appear to affect glucose tolerance or carbohydrate metabolism 5.
• It has been shown to be effective in patients with stable angina pectoris and has a beneficial hemodynamic effect in patients with congestive heart failure (NYHA class II or III) secondary to ischemic heart disease 5, 7.

Benefits of Carvedilol

• Carvedilol offers particular advantages in the treatment of comorbid conditions, including coronary artery disease, stroke, hypertension, renal failure, diabetes, and atrial fibrillation 6.
• The drug has been shown to reduce morbidity and mortality in patients with congestive heart failure 4.
• Carvedilol is generally well tolerated, with only 7% of patients withdrawing from treatment due to adverse events 5.

Mechanism of Action

• Carvedilol produces its antihypertensive effect partly by reducing total peripheral resistance by blocking alpha 1-adrenoceptors and by preventing beta-adrenoceptor-mediated compensatory mechanisms 3, 5, 7.
• The drug's vasodilatory effects reduce afterload, and the resulting decrease in impedance to left ventricular ejection offsets the negative inotropic effect that would normally result from beta-blockade 3, 7.