Drug Name
Coreg (Carvedilol)

Drug Uses
This medication is an alpha- and beta-blocker, used to treat high blood pressure and heart failure. It is also used after an acute heart attack to improve survival. Lowering high blood pressure helps prevent strokes, heart attacks and kidney problems. This drug works by blocking the action of certain natural chemicals in your body (such as epinephrine) that affect the heart and blood vessels. This results in lowering of heart rate, blood pressure, and strain on the heart.

How to use
Take this medication by mouth with food, usually twice daily, or as directed by your doctor. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day. Take this drug exactly as prescribed. Do not increase or decrease the dose on your own. The dosage is based on your medical condition and response to therapy. If you are being treated for high blood pressure, it may take 1 or 2 weeks before the full benefit of this drug takes effect. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick. Do not suddenly stop taking this medication without consulting your doctor. Your condition may become worse when the drug is suddenly stopped.

Drug Class and Mechanism
Coreg is used for treating high blood pressure and congestive heart failure. It is related to labetalol (Normodyne, Trandate). Coreg blocks receptors of the adrenergic nervous system, the system of nerves in which epinephrine (adrenalin) is active. Nerves from the adrenergic system enter the heart and release an adrenergic chemical (norepinephrine) that attaches to receptors on the heart's muscle and stimulates the muscle to beat more rapidly and forcefully. By blocking the receptors, coreg reduces the heart's rate and force of contraction and, thereby, reduces the work of the heart. Coreg also blocks adrenergic receptors on arteries and causes the arteries to relax and the blood pressure to fall. The drop in blood pressure further reduces the work of the heart since it is easier to pump blood against a lower pressure.

Missed Dose
Take the missed dose as soon as you remember. If your next dose is less than 4 hours away, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

Storage
Store at room temperature below 86 degrees F (30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Warnings/Precautions
Do not stop using this drug without first consulting your doctor. Your condition may become worse when the drug is suddenly stopped, especially if you have chest pain (angina) or heart disease (e.g., coronary artery disease, ischemic heart disease, heart failure, high blood pressure). If your doctor decides you should no longer use this drug, you must gradually decrease your dose according to your doctor's instructions. When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Seek immediate medical attention if you develop: worsening chest pain, tightness or pressure in the chest, chest pain spreading to the jaw/neck/arm, sweating, trouble breathing or fast/irregular heartbeat. Before taking coreg, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: asthma, certain types of irregular heartbeats (e.g., sinus bradycardia, second or third degree atrioventricular block), cardiogenic shock, severe heart failure (overt or decompensated type), liver disease. Before using this medication, tell your doctor or pharmacist your medical history, especially of: other breathing problems (e.g., chronic obstructive lung disease), other heart problems (e.g., Prinzmetal's variant angina), diabetes, overactive thyroid disease (hyperthyroidism), kidney disease, blood circulation problems (e.g., Raynaud's disease), skin conditions (e.g., psoriasis), mental/mood disorders (e.g., depression), a certain type of tumor (pheochromocytoma), certain muscle disease (myasthenia gravis). Before having surgery, tell your doctor or dentist that you are taking this medication. If you have diabetes, this medication may mask the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of a low blood sugar level such as dizziness or sweating are unaffected by this drug. This drug may make you dizzy, drowsy, or faint, especially when you first start using this drug or if your doctor increases your dose. Use caution engaging in activities requiring alertness such as driving or using machinery. The manufacturer recommends avoiding these activities during periods of adjustment in your dose. Limit alcoholic beverages. To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position. Taking this medication with food will also help decrease these effects. Caution is advised when using this drug in the elderly because they may be more sensitive to its effects, especially dizziness and lightheadedness. This medication should be used only when clearly needed during pregnancy. Discuss the risks (e.g., low birth weight) and benefits with your doctor. Based on information from related drugs, this medication may pass into breast milk. Therefore, consult your doctor before breast-feeding.

Possible Side Effects
You may experience dizziness, lightheadedness, drowsiness, tiredness, diarrhea, unusual dreams, trouble sleeping, dry eyes, or vision problems as your body adjusts to the medication. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use. Remember that your doctor has prescribed this medication because the benefit to you is greater than the risk of side effects. Many people, using this medication, do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur: symptoms of a very slow heartbeat (e.g., persistent dizziness, fainting, unusual fatigue), fainting, bluish discoloration of the fingers and toes, numbness/tingling/swelling of the hands or feet, decreased sexual ability, reversible hair loss, mental/mood changes, worsening of heart failure symptoms (e.g., cough, trouble breathing, sudden weight gain), change in the amount of urine, increased thirst, increased urination. Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: easy bruising or bleeding, persistent sore throat or fever, yellowing skin or eyes, stomach pain, dark urine, persistent nausea. In the unlikely event you have a serious allergic reaction to this drug, seek medical attention immediately. Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

More Information
Do not share this medication with others. Lifestyle changes such as stress reduction programs, exercise and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you. Have your blood pressure and pulse checked regularly while taking this medication. It may be best to learn how to monitor your own blood pressure and pulse. Discuss this with your doctor. Laboratory and/or medical tests may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.