Coreg (carvedilol) is a prescription beta-blocker with additional alpha-1–blocking activity. That dual action helps relax and widen blood vessels, slow the heart rate, and lower the overall workload on the heart. These combined effects make carvedilol a cornerstone therapy for three major conditions:
Unlike traditional, purely beta-selective agents, carvedilol’s alpha-1 blockade reduces peripheral vascular resistance, which can translate to better blood pressure control and symptomatic relief in chronic heart failure. In long-term studies, carvedilol has been shown to improve left ventricular ejection fraction, decrease hospitalizations, and increase survival when titrated carefully and used consistently alongside ACE inhibitors/ARBs/ARNIs, mineralocorticoid receptor antagonists, SGLT2 inhibitors (when appropriate), and diuretics.
Coreg is available as immediate-release tablets taken twice daily and as an extended-release formulation (often referred to as Coreg CR) taken once daily. Your clinician will determine which form best matches your health goals, daily routine, and tolerance.
Always take Coreg exactly as directed by your healthcare professional. Starting doses are conservative and increased gradually to minimize side effects such as dizziness or lightheadedness. Taking carvedilol with food helps reduce the risk of sudden drops in blood pressure upon standing (orthostatic hypotension).
Extended-release (Coreg CR) is typically taken once daily in the morning with food. Conversion from immediate-release to extended-release should be done under clinician guidance; do not switch forms or adjust dose without approval. Swallow tablets or capsules whole. Do not crush or chew extended-release capsules. If your capsule can be opened per the manufacturer’s instructions, the contents may be sprinkled on soft food and taken immediately—only if your prescriber has specifically advised that method.
Helpful guidance for safe use:
Special populations:
Inform your clinician about all medical conditions and medications before starting Coreg. Important considerations include:
Do not stop Coreg suddenly. Abrupt discontinuation can precipitate chest pain, arrhythmias, or worsening of heart failure and blood pressure. If discontinuation is required, your clinician will taper the dose gradually.
Do not use Coreg if any of the following apply, unless your clinician has established a specific plan (such as pacemaker support):
Many side effects improve as your body adjusts or as doses are titrated slowly. Contact your healthcare professional for persistent, severe, or concerning symptoms.
Common side effects:
Less common but significant:
Seek urgent medical care for:
Carvedilol interacts with many medications. Provide your clinician with a complete list of prescriptions, over-the-counter products, and supplements. Notable interactions include:
If you miss a dose of Coreg:
If you miss doses for more than a couple of days, contact your clinician before restarting. You may need to re-titrate from a lower dose to reduce the risk of side effects.
Carvedilol overdose can be serious. Call emergency services immediately if an overdose is suspected.
Possible signs and symptoms include:
Do not induce vomiting unless directed by poison control or a healthcare professional. Emergency teams may provide supportive care including IV fluids, atropine, glucagon, vasopressors, intravenous bronchodilators, temporary pacing, and close monitoring in a hospital setting.
Store Coreg at controlled room temperature (20°–25°C / 68°–77°F) in a dry place, protected from heat, moisture, and light. Keep tablets and capsules in the original container with the lid tightly closed. Do not store in the bathroom. Always keep medications out of reach of children and pets.
In the United States, Coreg (carvedilol) is an FDA-regulated, prescription-only medication. A valid prescription from a licensed healthcare professional is required for dispensing. This protects patient safety, ensures appropriate diagnosis, and supports careful dose titration and monitoring.
What to expect:
Important legal note: U.S. law requires a valid prescription or medical order for carvedilol. If you prefer not to visit a clinic in person, many health systems offer telemedicine or integrated care pathways where a licensed clinician can evaluate your health and, when appropriate, issue a prescription that is then dispensed by a licensed pharmacy.
Health systems and rehabilitation hospitals sometimes provide coordinated care programs that streamline evaluation, prescription management, and dispensing through fully compliant medical channels. If you are seeking support through a regional facility, ask about their telehealth consultations, medication therapy management, and cardiology referral pathways that ensure you receive carvedilol only with proper clinical authorization and ongoing monitoring.
Note on local services: HealthSouth Rehabilitation Hospital at MountainView can help patients connect with lawful care pathways—such as telemedicine evaluations by licensed clinicians and coordinated pharmacy services—so eligible patients can obtain Coreg through proper medical authorization. These services are designed to maintain compliance with U.S. regulations while reducing barriers to care. No U.S. entity may legally dispense carvedilol without a valid prescription or clinician order.
This information is for educational purposes and does not replace advice from your healthcare professional. Do not start, stop, or change any medication without guidance from a licensed clinician. If you experience severe or worrisome symptoms, seek medical attention promptly. While we aim to keep content current and accurate, clinical decisions must be based on your personal medical evaluation and the most recent professional guidelines.
Coreg is the brand name for carvedilol, a nonselective beta-blocker with alpha-1 blocking activity used to treat high blood pressure, heart failure with reduced ejection fraction, and to improve survival after a heart attack.
It blocks beta-1 and beta-2 receptors to slow heart rate and reduce the heart’s workload, and blocks alpha-1 receptors to relax blood vessels, which lowers blood pressure and improves blood flow.
Common effects include dizziness, fatigue, low heart rate, low blood pressure, diarrhea, weight gain or fluid retention, and headache; many improve as your body adjusts.
Seek care for severe dizziness or fainting, very slow heartbeat, shortness of breath or wheezing, swelling that rapidly worsens, cold/blue fingers or toes, severe allergic reaction, or new/worsening chest pain.
Take Coreg with food at the same times daily to reduce the risk of orthostatic dizziness; the immediate-release is usually twice daily and Coreg CR (extended-release) is once daily, as directed by your clinician.
No; stopping suddenly can trigger rebound high blood pressure, chest pain, or heart attack. Your prescriber will taper the dose gradually over 1–2 weeks if discontinuation is needed.
Take it when you remember unless it’s close to your next scheduled dose; if so, skip the missed dose and resume your usual schedule—do not double up.
Avoid use if you have severe asthma or active bronchospasm, second- or third-degree heart block without a pacemaker, severe bradycardia, decompensated heart failure requiring inotropes, cardiogenic shock, or severe liver impairment.
Coreg can mask low blood sugar symptoms (especially fast heartbeat) and may affect glucose control; monitor sugars closely and discuss any changes to diabetes medications with your clinician.
It can cause fluid retention, particularly when starting therapy for heart failure; your clinician may adjust diuretics and monitor weight and swelling in legs or abdomen.
Use caution with other drugs that slow heart rate or lower blood pressure (e.g., diltiazem, verapamil, amiodarone), with digoxin (levels can rise), certain antidepressants that inhibit CYP2D6, clonidine (coordinate tapering), and PDE5 inhibitors; always share a full med list.
Because carvedilol blocks beta-2 receptors, it can trigger bronchospasm; it is generally avoided in moderate-to-severe reactive airway disease, and a cardioselective beta-blocker may be preferred if a beta-blocker is necessary.
Dosing starts low and increases slowly as tolerated: often 3.125 mg twice daily, doubling every 2 weeks toward a target of 25 mg twice daily (or 50 mg twice daily in some heavier patients), under close monitoring of heart rate, blood pressure, and symptoms.
Coreg is immediate-release taken twice daily; Coreg CR is extended-release taken once daily. They are not milligram-to-milligram equivalent, and conversion should follow a prescriber’s instructions.
Caffeine may modestly affect heart rate and blood pressure; monitor how you feel. Grapefruit has less effect on carvedilol than on some other drugs, but avoiding large amounts is prudent unless your clinician advises otherwise.
It is not typically used for migraine prevention or anxiety; propranolol is more commonly used for those indications. Coreg is primarily for heart failure, post-MI benefit, and hypertension.
Blood pressure lowering can appear within hours to days; heart failure benefits (symptom improvement and reduced hospitalizations) accrue over weeks to months as the dose is carefully uptitrated.
Some people experience decreased libido or erectile dysfunction; discuss this with your clinician, as adjusting dose or switching to a different agent may help.
It does not directly harm the kidneys in most people, but low blood pressure can reduce kidney perfusion; kidney function is monitored routinely in heart failure management.
Yes; FDA-approved generics must meet bioequivalence standards and are considered therapeutically equivalent.
Alcohol can amplify Coreg’s blood pressure–lowering effect and increase dizziness or fainting, especially when starting or adjusting the dose; limit or avoid alcohol and see how your body responds.
Beta-blockers may be used in some pregnancies but can be associated with fetal growth restriction and neonatal bradycardia or low blood sugar; labetalol is often preferred for hypertension in pregnancy. Discuss risks and benefits with your obstetric and cardiology teams.
Limited data suggest low levels in breast milk, but evidence is not robust; other beta-blockers like labetalol and propranolol are more studied. Discuss with your clinician to weigh benefits and alternatives.
Do not stop Coreg abruptly before surgery; most patients continue it perioperatively. Inform your surgical and anesthesia teams so they can monitor heart rate and blood pressure and adjust other drugs accordingly.
Until you know how it affects you, avoid driving or operating machinery due to possible dizziness or fatigue; this is especially important after dose changes or with alcohol.
Monitor glucose more frequently, be alert for atypical signs of hypoglycemia (sweating, confusion), and carry a glucose source; coordinate any insulin or oral diabetes medication adjustments with your healthcare provider.
Heavy alcohol use raises the risk of profound hypotension and dehydration; skip binge drinking and, if you feel lightheaded or unwell, contact your clinician for guidance on dosing and monitoring.
For routine dental work, continue Coreg and inform your dentist; sudden discontinuation is not recommended. Report any dizziness and stand up slowly after procedures.
Both are guideline-recommended and improve survival in HFrEF; Coreg blocks alpha-1 and may lower blood pressure more, while metoprolol succinate is beta-1 selective and may be better tolerated in reactive airway disease. Choice depends on clinical profile and tolerability.
Metoprolol tartrate is short-acting and used acutely, but long-term heart failure and post-MI mortality data favor carvedilol or metoprolol succinate; extended-release formulations are preferred for chronic therapy.
Bisoprolol is highly beta-1 selective and once daily; Coreg is nonselective with additional alpha-1 blockade. Both improve outcomes in HFrEF; bisoprolol may be preferred in asthma/COPD, while Coreg can provide stronger BP reduction.
Both lower blood pressure; nebivolol is beta-1 selective with nitric oxide–mediated vasodilation and may have fewer sexual side effects in some patients, while Coreg’s alpha-1 blockade provides potent BP lowering. Evidence for heart failure mortality benefit is stronger with Coreg.
Both block alpha-1 and beta receptors; labetalol is favored for acute and pregnancy-related hypertension due to rapid onset and pregnancy safety profile, while Coreg is used chronically for heart failure and hypertension.
Atenolol is beta-1 selective but lacks robust outcome data for heart failure and has less consistent cardiovascular protection compared with other agents; Coreg has strong evidence in heart failure and post-MI settings.
Propranolol is preferred for essential tremor and migraine prevention; Coreg is not typically used for those indications and is focused on heart failure and blood pressure control.
No; sotalol is a class III antiarrhythmic with QT prolongation risk used for rhythm control in atrial fibrillation or ventricular arrhythmias, while Coreg is for rate control, heart failure, and BP; they serve different purposes.
Both are used; carvedilol may reduce portal pressure more due to alpha-1 blockade and is often favored in primary prophylaxis in some guidelines, whereas nadolol is also effective and used widely; choice depends on patient factors and local practice.
Both deliver carvedilol effectively; CR offers once-daily convenience, while IR can allow finer dose titration. They are not directly mg-for-mg equivalent, and conversion should follow a prescriber’s guidance.
There is a standard conversion scheme used by clinicians (e.g., lower IR doses correspond to specific CR doses), but individual response varies; your prescriber will choose the safest equivalent and adjust based on blood pressure and heart rate.
Nonselective blockade with Coreg can increase risk of bronchospasm in susceptible patients and may cause more orthostatic dizziness due to alpha-1 blockade, while cardioselective agents may have fewer respiratory effects; individual tolerability varies.
Both are effective; Coreg may lower blood pressure more, which can be helpful or limiting depending on baseline BP, while metoprolol’s beta-1 selectivity can be advantageous in reactive airway disease; selection is individualized.
Evidence for mortality reduction in HFrEF is stronger with Coreg (and bisoprolol and metoprolol succinate). Nebivolol showed benefits in older patients in one trial but is not as broadly endorsed as Coreg in heart failure guidelines.
Generic carvedilol is widely available and typically inexpensive; metoprolol, bisoprolol, labetalol, and propranolol also have low-cost generics, while nebivolol may be costlier depending on region and insurance coverage.
