Carvedilol comes as both an oral tablet and extended-release capsule to be taken by mouth, typically twice daily with food. Carvedilol is available as both generic and brand-name versions; Coreg is the brand version.
Studies conducted on patients following MI revealed that carvedilol was equal to metoprolol in terms of improving survival rates; however, in patients with an LVEF less than 40% it proved more effective.
Carvedilol vs Metoprolol
Effectiveness
Carvedilol and metoprolol are two drugs frequently prescribed to treat heart failure. Both reduce symptoms by slowing the rate at which blood leaves your heart and lowering blood pressure; both also help prevent dangerous rhythm problems like atrial fibrillation.
Your doctor may suggest either medicine depending on other health considerations – for instance carvedilol may be preferred over metoprolol in treating those living with diabetes or prediabetes, while asthmatics might opt for one over the other.
Both drugs block beta-1 receptors in the heart, but carvedilol stands out by having additional properties that make it more effective than metoprolol. It has a more profound impact on alpha-1 receptors – these respond to chemicals produced in your body which increase heart rate and blood pressure during times of stress – making its use even more powerful.
As such, its control of sympathetic nervous system was improved. A study with healthy volunteers confirmed this finding, finding stronger effects of resting heart rate and blood pressure than metoprolol as well as more efficacy than other beta-1 selective drugs such as atenolol or bisoprolol.
Researchers conducted a comprehensive, long-term clinical trial comparing carvedilol and metoprolol for use in treating chronic heart failure with ejection fraction (HFrEF). Patients were randomly assigned either carvedilol or metoprolol tartrate treatment.
After four months and then five years follow-up, both drugs proved equally effective at slowing progression and mortality rates while simultaneously lowering HR and SBP; with the former showing more benefit.
Carvedilol has not only proven beneficial in treating heart failure but has also shown to lower cardiovascular mortality across other groups of patients, such as nonischemic HFrEF patients or those living with diabetes mellitus and hypertension.
This effect may be attributable to its vascular smoothing action which reduces systemic vascular resistance while simultaneously decreasing blood flow to the heart and afterload, leading to reduced cardiac oxygen consumption and ultimately afterload reduction.
Side effects
Carvedilol and metoprolol both work to block beta receptors in your body, acting similarly as medications used to treat heart failure; however, they affect different areas of the heart, so can cause different side effects.
Metoprolol may affect lung tissue more than carvedilol; thus you might experience wheezing or shortness of breath when taking metoprolol compared with taking carvedilol; therefore if you suffer from asthma, chronic bronchitis, or emphysema it would be wiser to consult your physician prior to starting metoprolol treatment.
Metoprolol and carvedilol both can slow your heart rate, though which one you choose depends on other health concerns and personal preferences. Metoprolol may be better for heart valve problems since it does not affect the heart as significantly.
Metoprolol may also be beneficial in cases of kidney disease since its impact is likely to be lessened on liver cells.
Both medications reduce your risk of another heart attack or mortality from cardiovascular issues while simultaneously controlling blood pressure, triglycerides levels, and preventing ventricular tachycardia (fast heart rhythm).
Metoprolol significantly decreases SBP, DBP and HR, and these changes persist over time with continued treatment. Conversely, initial dose of carvedilol decreases SBP but does not lead to significant decreases in systemic or femoral artery resistance reductions.
Be mindful that carvedilol may mask early warning symptoms of low blood sugar, such as tremors and an increased heart rate, potentially increasing hypoglycemia unawareness and becoming dangerous if you have diabetes.
Therefore it is critical to monitor your blood sugar closely when taking this medicine and consult your physician on this matter.
This medication may interact with various other drugs, including diuretics, ACE inhibitors, monoamine oxidase inhibitors and calcium channel blockers such as diltiazem (Cardizem) or verapamil (Calan). Interaction may increase your blood pressure or slow your heartbeat significantly which could be harmful. In addition, pregnancy mothers should not take this medicine as it could harm their fetus.
Dosage
Carvedilol is an alpha-1 receptor blocker, meaning it works by targeting both types of receptors found in the body: those activated by chemicals like adrenaline that raise heart rate and blood pressure – an essential target for this medication.
Carvedilol may target this particular set of receptors more effectively than other beta blockers; perhaps this explains its effectiveness against heart failure caused by weak heart muscle or congestive heart failure with reduced ejection fraction (HFrEF).
Carvedillol may interact with several medications used to lower blood sugar, making it harder to identify early warning signs of hypoglycemia – such as tremors and increased heart rate – which may indicate low blood sugar. People taking carvedilol should monitor their blood sugar more frequently.
This includes those living with diabetes who take this medicine.
It can also interact with some diuretics, ACE inhibitors like Lisinopril (Zestril) and Enalapril (Vasotec), and ARBs like losartan and Olmesartan (Benicar) to increase the risk of low blood pressure when taken together, especially among people with kidney issues; furthermore it increases their chances of cardiovascular or other vascular disease while taking this drug; those taking kidney dialysis drugs face even higher risks; therefore if prescribed this medicine they should lower dose accordingly; additionally it may increase risk further than usual as well as increase wheezing episodes among asthmatics patients taking this combination medication.
People should avoid abruptly discontinuing carvedilol without consulting with their physician first as this can increase the risk of chest pain and heart attack. Instead, discuss slowly decreasing dosage over time with their healthcare provider.
People taking antihypertensive medication must avoid alcohol, as this increases their chances of experiencing dangerously low blood pressure reactions. Furthermore, certain herbal and supplement medicines, including cod liver oil, hawthorn extract and garlic tablets may cause low blood pressure too.
It is advisable that prescriptions for all drugs taken such as paracetamol or aspirin be filled at one pharmacy so that pharmacists can check for potential interactions between medications.
Indications
Carvedilol is a beta blocker medication used to treat high blood pressure, coronary heart disease, congestive heart failure and reduce the chance of dangerous heart rhythm issues such as ventricular tachycardia. Carvedilol comes as both a tablet and extended-release (long-acting) capsule to take orally, usually twice daily with food; or once daily in the morning before breakfast with food for maximum effectiveness.
Please follow your doctor’s directions when taking this medicine. Read your prescription label carefully, asking your physician or pharmacist for clarity if any part is unclear.
Carvedilol may interact with certain medicines such as diuretics and medicines used to treat diabetes; use with caution if you have this condition as it could impede how quickly blood sugar returns to normal after exercise and may mask symptoms of low blood sugar.
Metoprolol and carvedilol are both effective at treating cardiovascular conditions, yet differ slightly in terms of application.
Carvedilol may be better for individuals suffering from weak heart muscles or with other medical issues like diabetes or asthma; on the other hand, taking metoprolol might lead to abnormal heart rhythms or history of blood clotting disorders requiring different medication altogether.
Both medications may reduce your risk of another heart attack after experiencing one, as well as developing atrial fibrillation – an extremely dangerous heart rhythm problem that is potentially life-threatening.
No evidence suggests carvedilol is more effective than metoprolol at preventing cardiovascular deaths in those who have recently had a heart attack or angina. Both drugs can help mitigate other potential risk factors that lead to deaths from cardiovascular causes, including slow or irregular heartbeats that cause fainting episodes.
An earlier study demonstrated that carvedilol had a more favorable hemodynamic profile than metoprolol at rest and during sustained oral administration for hypertensive patients who initially responded adequately to monotherapy with adequate BP reduction.
While Metoprolol significantly reduced cardiac output, while Carvedilol had no impact on cardiac output and reduced both systemic and femoral artery resistances compared with baseline.
