I started with 12.5mg twice a day a couple weeks ago for high blood pressure. I’ve had some fatigue/lightheadedness and it seems to be causing some anxiety as that’s been the case recently and I’ve never had issues with anxiety before. Is this common? And should I look into getting switched to another medication or is there a chance it can improve the longer I take it?
Sasha Kovlikova glad it’s working for you, I just got switched off of carvedilol after 10 weeks. Fatigue was just getting worse and had a few other discomforting side effects. Anxiety was probably the worst. My cardiologist just prescribed Amlodipine so I’ll see how I do on that. Unfortunately I’m weaning off the carvedilol as it’s not recommend to just stop cold turkey.
I have had patients say they are easily upset or angered when taking carvedilol, for example, they will get upset when they drive up to a red light (why isn't this light green now?), or, their spouse notes them to be irritable all the time. I think carvedilol could cause anxiety, but I haven't had any patient specifically note that. The bottom line is if the symptom started after you started the medication, then there is a high chance that the medicine is causing it.
Regarding lightheadedness, these are very common and also likely to be caused by the medication. Most blood pressure medications cause lightheadedness, just lowering your blood pressure can cause that. The lightheadedness usually decreases over a couple months as your brain acclimates to the lower blood pressure. So I usually don't change medications when a patient has lightheadedness.
Fatigue is the most common side effect of Carvedilol. Some people get used to it, or it goes away over a couple months, others don't tolerate it and have to switch.
If your only blood pressure medication is Carvedilol, and you don't have some other reason Carvedilol was chosen (weak heart pumping function, racing heart beat, etc) there are many options for you to treat pressure. Standard examples would be amlodipine, lisinopril, chlorthalidone, hydrochlorothiazide. If I had a patient in your shoes I would say to give it two more weeks, see how the person felt, if there wasn't any improvement, I would switch the person to amlodipine 5 or 10 mg, depending on what the blood pressures are on the carvedilol.
Disclaimer: This is health education, not medical advice. Only your doctor can tell you what to do with your medications.
gc voon Yes it can do that, in my experience, however, it is not a common side effect. There are other medications which are commonly used along with Carvedilol which are more likely to cause low sodium. These are lisinopril or losartan, furosemide, hydrochlorothiazide.
Well, that explains my memory loss as well I guess. I take 25 mg twice daily , along with 40 mgs lisinopril and 20 mgs of fluorisimide ( spell ). Its mostly names of people and places that slip my mind. Eventually I remember, but after I stop trying to.
My meds were changed from coreg cr 80 mg to carvedilol 25mg twice a day. Side effects for caravedilol 25mg are unbearable: blurry eyes, rashes on knee and face and lips, left earache, very cold hands and feet. I was switched due to cost of meds but new meds don't agree with me. What is difference between these two meds that cause the above side effects. Corey Cr cost me 30.00 but carvedilol cost almost 10.00. Id rather pay 30.00 for Coreg cr 80mg than carvedilol 25mg twice a day due to side effects? Please advise.
The Carvedilol is just generic for Coreg. I just started the generic and i have no problem. Maybe a different drug store will carry a better brand of generic. I am going to be 55 and have high blood pressure for the first time in my life. My heart was pounding so fast. It helped the racing heart beat the very first pill. I am on the lowest dose for now. Good Luck!
I have other patients who have experienced the same type of problems you are having when attempting to switch from the Coreg CR to generic carvedilol. The medication is the same, but there are different fillers. The blurry vision, cold hands and feet are probably due to a higher peak effect of the medication, meaning the 25 mg is absorbed quickly and there is more carvedilol in your system than there ever was with the CR 80 mg dose. There are peaks and valleys with the regular carvedilol, whereas with the CR the absorption is steady and there aren't the peaks and valleys of effect. The rash would be more typical of an allergy to one of the fillers used in the medication. I can't advise you what to do because I am not your doctor, but I can say that if I had a patient in your shoes, I would change him or her back to Coreg CR 80 qday.
Thanks for the video very informative. I have been diagnosed with HF July 2017 I just turned 55 and am a bodybuilder. My most recent diagnosis as of Dec 2017 is Non compaction cardiomyopathy and am currently on 25 mg 2x day of the Carvedilol, 49/51 mg Entresto, 12.5 mg spironolactone, 75 mg colpidogrel and 20 mg Lasix as needed. I train 5-6 days a week as well as doing 20 min fasted cardio and 30 min post workout cardio 6 days a week preparing for a competition. My question is about my training and is it too much to the point it will be detrimental to my health. BTY the cardiac MRI showed my EF at 28%
Thank you so much for taking the time to respond to my question. I have another MRI scheduled in June which will be 6 mo's from my last one. We will be able to better determine at that time if improvements have been made in heart function or if i have gone the other way. If the latter is the case then I have tough decisions to make and perhaps change in lifestyle. And yes, my Dr's don't see to many patients like me and my ability to function as well as i do considering my diagnosis.. if it wasn't for the diagnosis, would never think i was sick. Thanks again
Sorry, John, I don't have experience with any patients with Non Compaction who are highly active like you. The standard "doctor" thing to say would be to tone down your activity, but, if you feel well with all of the exertion you do, it's understandable that you would not want to do that. The recommendation to decrease your activity is based on Guidelines from the American Heart Association and American College of Cardiology:
see section on LV Non Compaction. In the guideline they admit that they don't know for sure what the recommendations should be, because of lack of sufficient study.
As a bodybuilder, you are straining against heavy weight, which makes your blood pressure go up quite high during the lifts, up to as high as 300 mmHg. Once the lift stops, the blood pressure goes down a lot, but exposing your heart to that high pressure repeatedly is a concern. For my patients with Dilated Cardiomyopathy (low EF, but without Non Compaction), I generally recommend against heavy weight lifting for this reason, and I ask my patients who do weight training to do high rep exercises, say 15 reps, without heavy straining on the last reps, to avoid those very high spikes in blood pressure.
For your question, I wonder about a Cleveland Clinic MyConsult second opinion, because they might have someone who could better address this. I have had some patients over the years who have found the consults useful. They cost a lot (745$), but your investment in your sport is tremendous, so it might be worth it.
Sorry I don't have a direct answer for your question. Best wishes.
Does this medication cause blurred vision? My vision changed shortly after taking this medication. Also, I hear a loud pulsating whooshing sound in my right ear. Does this mean my blood pressure is high?
yes, carvedilol can cause blurry vision. The pulsing wooshing sound does not necessarily mean you have high blood pressure. When my patients report this to me, I usually order a carotid ultrasound to check for narrowing of the arteries in the neck. There are other tests that can be done for the symptom depending on how long it has lasted. You should tell your doc.
i am taking carvedilol 12.5mg twice a day because of the ejection fraction 45,i feel weak and lightheaded,the problem is that i don't have high blood pressure usually and carvedilol reduces it even more.
Hello, that is a common situation. It can take a long time to get used to carvedilol. You are on a moderate dose. If you are having a hard time with your everyday activities, tell your doctor, and he or she might decrease your dose.
When my patients feel poorly like this, I usually decrease the dose. Then, I will very slowly increase the dose over 6 months or a year. However, I have lots of patients who can't tolerate more than 6.25 mg twice a day of carvedilol, no matter how slowly I try to increase it.
It is a good medication for low pumping function of the heart (yours is mildly decreased at 45%).
By saying no sex drive, perhaps you mean difficulty with getting an erection. This is a very common side effect of carvedilol and lisinopril (or other similar medication), and diuretic type medication (furosemide or spironolactone or other) used for treatment of cardiomyopathy. If by saying you have no sex drive you mean you have no interest at all in having sex, that is a bit of a different situation, although I think it could also be a side effect of the meds.
I have patients with cardiomyopathy, and erectile dysfunction from the treatment. I usually use sildenafil for them to help with the ED, because the medications are so important for treatment of the condition.
Alternatives to Carvedilol in this situation are usually bisoprolol and metoprolol, both of which have similar side effects, occasionally someone will do better with one as compared to the other.
Your symptom is important, affects your quality of life, and hopefully your doc can help you with it. Please let me know if you have any other questions.
I want off this stuff recovered CHF I can not take the side effects anymore .. severe fatigue .. ED and weakness.... there HAS to be an alternative to this, quality of life is not great on this stuff at all..
Teufelhund Odinic Rite was your Blood Pressure really high? I don’t know of T causing weak heart function, I have seen it cause high BP.
In some of my patients who normalize EF I will decrease dose of carvedilol, but I don’t have experience with T directly affecting heart. It’s often hard to know if the person got better because of med, or if just got better on their own.
I have had many patients who feel terrible on carvedilol, all the same stuff you describe. When my patients feel badly like that I switch them...
Hi, if you had low ejection fraction CHF (Ejection Fraction 40% or less), the alternatives to carvedilol are Metoprolol ER and Bisoprolol. Both are similar to Carvedilol, but I have had patients who feel better on one of these meds as compared to carvedilol.
If you never had low ejection fraction with your heart failure, there are lots of alternatives.
There are no good herbal / supplement alternatives to carvedilol, unfortunately.
metoprolol is quite similar to atenolol. It might be better with regard to side effects. I say "might" because I don't think it is proven for a fact that metoprolol is better than atenolol.
So it would be reasonable for you to try metoprolol. There are two types, metoprolol tartrate which is usually twice a day, and metoprolol succinate, which is once a day. Atenolol 50 mg = metoprolol 100 mg.
Another option would be nadolol 80 mg once a day, nadolol is similar to propranolol. I don't think there are any interactions between nadolol and benzodiazepines.
If you find the beta blocker helpful for your anxiety, it is probably a good idea to continue, because it may decrease your need for the benzodiazepine.
+CardioGauge thank you for the answer....unfortunately i had an allergic reaction today to carvedilol....so i will go back to atenolol....i asked my doctor to switch from atenolol to another beta blocker because i ve read that atenolol raises blood sugar and cholesterol and tryglicerides....at the same time for anxiety i take bromazepam(benzodiazepine available only in europe:i write from italy)....unfortunately bromazepam doesnt mix very good with propanolol wich was suggested to me as an alternative to atenolol....what do you think of metoprolol? any suggestion of some good beta blocker for anxiety issues wich causes high blood pressure(i've hit quite high numbers during anxiety attacks) and fast heart rate? thank you
Carvedilol is non addictive, so you don't have to worry about that. It lasts for about 8 - 12 hours in the body, so it will wear off in the evening (presuming you take it in the morning. The most common side effect is fatigue. Happens in about 25% of people. Some people get used to the fatigue, others do not and find it unacceptable. The dose is pretty low at 6.25 mg (highest dose usually 25 mg), so hopefully you will tolerate it. Dangerous side effects are very rare at the low dose you are getting.
It would take you a couple weeks to know whether or not it was helping you.
If you find it helps, but it wears off in the evening, discuss with your doc, he or she might give you recommendation for twice a day dosing.
Good luck, hope this helps!
Disclaimer: Only your doctor can tell you what to do with your medications. This is health education, not medical advice.
I been on carvedilol since 2010 on 6.25mg 2 times a day and also on spironolactone 25mg once a dayhalf a tablet.. losartin potassium 100mg once a day and lasix 40mg once a day and aspirin also..i have CHF did an echocardiogram and my heart is at 50%..what can i do to make it better..
CardioGauge thanku for reply..my doctor try giving me a higher dose of carvedilol about 6 months ago she raised it to i belive 10 mg but right away i started with really strong palpitations specially at night when in bed just out control palpitations..i am trying my best to stay healthy and always on top of my meds..thanku for your comments really help ful
The standard medications for your situation are carvedilol, losartan, spironolactone.
There is a new medication called Entresto, but that is for folks with an ejection fraction that is 40% or less, so you don't need that one at this point. If your Ejection Fraction were to decrease to 40 or less, your doc might put you on it.
So no, there are no obvious meds to add to your list.
One thing I notice is you are on a low dose of carvedilol, sometimes higher dose can be better. However, your doc has probably already considered this. The maximum carvedilol dose I have used is 50 mg twice a day. Many people can't take high dose carvedilol because they get woozy / lightheaded / have low blood pressure / low heart rate with the higher dose.
Some docs think valsartan is better than losartan for patients with heart failure, but in my experience that doesn't make a difference.
Sounds like you are doing great with exercise and your weight!
CardioGauge thanku for replying back..i do exercise 5 days a week and started eating healthy also i was at 240bls now i am at 218-220..i haven had any swelling on my feey or legs since the first time i started feeling sick in 2010..my other question is..is there another pill that can work with carvedilol to help my heart pump mu h better or to make it work not as hard as it is right now..thanku for your time...
Hi Arturo. Is your Ejection Fraction 50% ? A normal Ejection Fraction is 51 - 65%, so if the 50% you are referring to is your ejection fraction, that is pretty good and quite close to normal. Based on your medications, you probably had low ejection fraction in the past. Unfortunately, there usually aren't any quick fixes for heart failure, but there are a few things you can do to decrease the chance you end up with out of breath and in the hospital.
You are on all the standard medications for heart failure. There aren't any other medications proven to help in your situation, so you have the medications covered. There are no supplements proven to be helpful so I don't recommend supplements to patients in your shoes. These are the things I look at to try to help my patients with heart failure.
1) Staying physically active is important for people with CHF, I recommend to my patients to exercise daily for half an hour if possible. It should be something the person enjoys, and can do without feeling sick or excessively exhausted afterwards.
2) Keeping a healthy weight. If your weight is a good weight, the heart doesn't have to pump as much blood, this makes you less likely to get out of breath.
3) Eating a healthy diet. The Mediterranean Diet is a generally healthy diet that I recommend. Avoiding lots of salt is probably a good idea, although this is not a very well proven item.
4) Keeping track of weight. I tell my patients with CHF to weigh themselves every day and write it down. If the weight goes up 5 lb suddenly, this can mean there is fluid buildup and medications might need to be adjusted.
5) Avoid having more than one alcoholic drink per day, because alcohol can weaken heart pumping function.
6) Treat sleep apnea if it is present. People who snore heavily often have sleep apnea, which is stoppage of breathing while sleeping.
7) If the person has diabetes, treat it properly, because chronically high blood sugar is bad for the heart.
8) controlling blood pressure to 120/70 as possible.
Disclaimer: This information is health education, not medical advice. Only your doctor can tell you what to do to manage your medical conditions.
1) Inderal is is taken 2 or 3 times per day, carvedilol is 2 times per day, so the carvedilol doesnt wear off quite as fast as the inderal.
2) Inderal causes more side effects, in my experience, more fatigue, more erectile dysfunction, more strange dreams, more forgetfulness. However, many people do well on propranolol.
3) Carvedilol is typically used for weakened heart pumping function, Fast heart rhythms, palpitations, High Blood pressure, while inderal is used for preventing migraines, preventing panic attacks, preventing stage fright, treating tremors, treating palpitations. So they are used for different stuff.
4) both medications have long acting forms that are more expensive than the short acting forms. Inderal LA is $1.50 a pill, while Carvedilol CR is $10 a pill!!
hope that helps
I am one in five that gets too tired.
I recently got up'd to 50 mg twice a day.....
I am gonna stop, and see if my energy comes back....I would rather have the energy and drive to do sufficient cardio-vascular than be on this med.
Had CABG five years ago, and feel good. I remember, I rejected Lisinopril for same reason, made me way too tired.
Thanks for your comment. 50 mg of carvedilol twice a day is the maximum dose. That is a LOT of carvedilol. I have a few patients on that dose. My patients on this dose have either severe hypertension or severe heart weakening (heart failure). definitely talk to your doc before stopping, because while you may feel less tired after stopping, you could also have some of the withdrawal side effects, such as racing heart beat, very high blood pressure, etc.
I am having extreme anxiety with this medication. I am taking 3.125 twice daily presently trying to wean myself off of it. I have to take lorazepam just to get through the anxiety. My insides feel jittery. Is this common?
Carvedilol doesn't usually cause a jittery feeling. If anything, it would be expected to tone down anxiety a little bit (Propranolol is a closely related medication used for anxiety and stage fright). However, you are the judge of it, if you feel a symptom after taking the medication, and it occurs reliably, then it is certainly possible the medication is causing that symptom.
My fiancee was just prescribed 3.125 of carevediol once a day by her cardiologist. She has been struggling with going back to her normal weight and tiredness since her last PA band tightening (she's in the process of hopefully getting the artieralnswitch and currently has the mustard procedure.) How does this medication effect the metabolism, ability to stay active and weight? According to her research, it can dramatically slow down energy expenditure and effect weight even without a change in eating or exercise habits. I deeply appreciate any insight you can give her as right now she is very hesitant to start this medication given her past struggles with fatigue and weight loss. Thank you
I don't take care of people who have transposition of the great arteries, so I don't have experience using carvedilol in patients like your fiancée. I would guess that they are giving that to her because her right ventricle is becoming weakened, having to pump blood to the entire body, rather than just to the lungs like it normally would, however, there are other possibilities.
3.125 mg once a day is a tiny dosage. I have many patients on 25 mg twice a day, which is 16 times the dose they are giving your fiancée.
I would expect she wouldn't feel much fatigue. Weight gain occurs sometimes in people, but most of the time, it doesn't happen. Because it is a small dosage, I would be surprised if she gained weight at all as a result of the medicine. It's always an experiment with a new medication. It seems since her doc wants her to try it, she should.
I should mention that some people feel better when they take carvedilol, with less out of breath, and better energy level, and actually have increased ability to be active.
Hope this is of some use. Best wishes...
Disclaimer: this is health education, not medical advice.
I have been prescribed Carvedilol 25mg 2times a day since 2007. Since around 2012 I get very sick everyday at the same time, so sick it is debilitating. My cardiologist figured out that the reason I get so sick around the same time is because I have developed a tolerance and my body starts going through withdrawals. Carvedilol has also screwed up my fight or flight mechanism big time.
I have an occasional patient who takes carvedilol 3 times a day to keep from getting the withdrawal symptoms you mention. Also, some patients do better on the once a day form of carvedilol, which prevents some of the up and down medication levels. Unfortunately though it is quite expensive.
Thanks for your comment.
HI DR. Ritter. I have been prescribed by my doctor this medicine. At first, he gave me a 1/4 (of 25mg) dose but my blood pressure didn't drop to normal pressure so he added another 1/4 of the 25 mg, still my BP didn't drop to normal so he added another 1/4 of 25mg until it became 25mg (Intake everyday). My question is, will I take this drug for the rest of my life? or can I lessen the dosage if my BP is getting normal?
It sounds like your doctor did a good job gently increasing the medication to the point where your blood pressure was low enough. Unfortunately with blood pressure, the medications do not cure the problem. For example generally you cannot take the medication for a couple of months, get normal blood pressure, then stop or decrease the medication, and expect your blood pressure to remain normal. It will go back up to where it was before you started the medication. So usually, when people go on blood pressure medications, it's forever.
Some people are able to decrease how much blood pressure medication they need, or get off the medication by making changes in their lifestyle. People who are overweight who lose a lot of weight can see significant decreases in the blood pressure. Also, people who have an unhealthy diet can make major improvements in the blood pressure by eating healthy. For example, eating a vegan diet could result in significant improvements.
High salt intake effects some people, and cutting out salt can result in improvements of a few points on the blood pressure.
Being sedentary and out of shape makes the blood pressure worse. Getting routine exercise on a daily basis can drop the pressure a few points as well.
Some people have elevated blood pressure because they snore heavily at night. They have sleep apnea. This makes their sleep poor. It ends up resulting in high blood pressure. I have had patients who are able to come off of one of their blood pressure medications when they are treated for sleep apnea with a CPAP machine.
So basically the answer is most people end up remaining on their blood pressure medications for life after starting them, but not everyone. Good luck.
Yes it can make a person feel tired, like they need to sleep more, and also, it can make a person unable to exercise as intensely as they can without the medication. Often, people get used to these side effects and are able to continue the Med, especially if it is helping them a lot with some other issue.
Feeling tired more easily during exercise is usually due to the slower heart rate a person has with metoprolol.
This is health education, not medical advice (sorry for the disclaimer)
Thank you for the info Dr. Ritter.
I was wondering...
My father suffers from Diabetes Mellitus and chronic renal disease. He’s doing hemodialysis, four days a week and suffers almost every day a lot of headache and fatigue due to the low blood pressure (his blood pressure measures are commonly at 9/6, 8/4…). His heart was affected by the CRD and has its left and right chambers both a little bit dilated. Last year he even had a severe bradycardia incident because of high potassium level in blood.
Usually he takes 6.25 of Carvedilol twice a day. Yesterday, his doctor recommended him to raise each dosis to 12.50... After some questions made remotely by text message to the doctor, regarding the low blood pressure issue, he changed the prescription to maintain the first dosis at 6.25, raising the second to 12.50.
My question is… What's the advantage in raise the dosis of Carvedilol in his particular case, considering that his blood pressure is being excessively low recurrently?
Thanks in advance for your time and attention.
+Christiano Medeiros If the left ventricle of his heart is enlarged and not pumping properly (low "ejection fraction"), Doctors often try to increase the dose of carvedilol up to 25 mg twice a day. In studies done to see if carvedilol helped patients with heart failure (which I don't know if your father has or not), doctors used a carvedilol dose of 25 mg twice a day. You can look at brief article http://www.ncbi.nlm.nih.gov/pubmed/12853193
This link above will take you to a description of an important Carvedilol study.
So, i would guess your father has a low ejection fraction (the percentage of blood pumped out with each heart beat), and the doc is trying to get him to a higher dose, closer to what is considered the best dose, 25 mg twice a day.
Because he has low BP at dialysis, the doc is leaving the daytime dose lower, so his blood pressure wont be lower. It sounds like a reasonable adjustment to me...
Besides treating a low ejection fraction, carvedilol decreases the heart rate, so, if he often has high heart rate, a higher dose could be used. I consider this a less likely scenario, however.
Cold most times, tired, bouts with light headedness and sometimes feel faint, BUT this med helped my cardiomyopathy! EJFR rate was so low after threatened a stroke p, fluid gain and CHF diagnosis. EJFR back to normal levels with this med.
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