Carvedilol

Overview

Non-selective beta-blocker with additional alpha-1 blocking (vasodilating) activity. A powerhouse medication with robust mortality benefits in heart failure.

Maximum Dose

Max 50 mg/day (given as 25 mg BD). Max 100 mg/day if > 85 kg.

Clinical Focus

Because of its alpha-1 blockade, it causes more initial hypotension than other beta-blockers. Up-titrate strictly every 2 weeks.

Bottom Line

Carvedilol is a dual alpha/beta blocker with mortality benefit in heart failure, but causes more dizziness and orthostatic hypotension than selective beta-blockers.

Brand Names

Dilatrend, Dicarz

Oral Routes

Tablets (3.125 mg, 6.25 mg, 12.5 mg, 25 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Primary

HFrEF, hypertension, post-MI.

Clinical Place

Core pillar of HFrEF management alongside ACEi/ARNI, MRA, and SGLT2i.