What is the drug interaction between Carvedilol (Coreg) and cat's press, also known as catapres (Clonidine)?

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Last updated: April 21, 2025View editorial policy

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From the Guidelines

There is a potential drug interaction between carvedilol and certain medications, but no specific interaction with "cats press" is known, however, it is crucial to consult healthcare providers before taking any medication or supplement with carvedilol. Carvedilol is a beta-blocker used to treat high blood pressure and heart failure, and it is essential to be aware of potential interactions with other substances. Theoretically, certain substances might affect blood pressure, potentially enhancing the blood pressure-lowering effects of carvedilol and causing hypotension in some patients. Additionally, both substances may affect heart rate and rhythm. Some medications, such as potent CYP3A4 inhibitors or inducers, may increase or decrease the efficacy or safety of carvedilol 1. For example, ibrutinib can increase the exposure of carvedilol, while potent CYP3A4 inhibitors may increase the plasma levels of ibrutinib and the risk of ibrutinib-related toxicity. Dose reductions are recommended when some medications are used concomitantly with strong inhibitors/inducers of CYP34A and P-gp 1. If you're taking carvedilol, consult your healthcare provider before starting any new medication or supplement. Do not adjust your carvedilol dosage without medical supervision, and monitor your blood pressure regularly if you use both substances. Report any unusual symptoms like dizziness, lightheadedness, or irregular heartbeat to your healthcare provider immediately. Some key points to consider when taking carvedilol include:

  • Carvedilol is preferred in patients with heart failure with reduced ejection fraction (HFrEF) 1.
  • Avoid abrupt cessation of carvedilol, as it may cause rebound hypertension 1.
  • Carvedilol may interact with other medications, such as potent CYP3A4 inhibitors or inducers, and dose reductions may be necessary 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Drug-Drug Interaction with Carvedilol

  • Carvedilol is a beta-blocker that competitively blocks beta 1, beta 2, and alpha 1 receptors, and has vasodilating properties 2
  • The concomitant use of calcium-channel blockers and macrolide antibiotics, such as clarithromycin, can cause vasodilatory hypotension due to increased levels of calcium-channel blockers in the blood 3
  • Carvedilol is metabolized by cytochrome P450 2D6 (CYP2D6), and genetic variation in CYP2D6 can affect the response to carvedilol, with potential impacts on pharmacokinetics and bioavailability 4, 5, 6

Interaction with Other Medications

  • Carvedilol can interact with other medications, such as calcium-channel blockers, and increase the risk of hypotension and bradycardia 3
  • The use of carvedilol with other beta-blockers or calcium-channel blockers requires monitoring due to the potential for increased risk of adverse effects 2

Pharmacogenetics

  • Genetic variation in CYP2D6 can affect the pharmacokinetics and pharmacodynamics of carvedilol, but the clinical significance of this variation is still being researched 4, 5, 6
  • The ADRB1 and ADRB2 genotypes may also affect the response to carvedilol, with potential impacts on heart rate and blood pressure 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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