Common questions about carvedilol

Carvedilol is a type of medicine called a beta blocker.

Like other beta blockers, carvedilol works by slowing down your heart rate and making it easier for your heart to pump blood around your body.

It also works like an alpha blocker to widen some of your blood vessels. This helps lower your blood pressure.

For angina, carvedilol works by improving the blood supply to your heart. Angina is chest pain that comes on when not enough blood gets to the muscles of the heart. It usually happens because the arteries to the heart become hardened and narrowed.

Carvedilol widens the arteries, so more oxygen gets to the heart and chest pain is prevented. It also slows your heart down and makes it beat more effectively. This reduces the amount of oxygen needed by your heart muscle and prevents angina.

Carvedilol usually starts to work after about 1 hour. But it will take days or weeks to work fully.

You may not feel any different when you take carvedilol for high blood pressure, but this does not mean it's not working. It's important to keep taking your medicine.

Most people take carvedilol for a long time with no problems. In fact, it works best when you take it long term.

Talk to your doctor if you want to stop taking carvedilol. Do not stop taking it suddenly without talking to your doctor, as this can make your condition worse, especially if you have heart disease.

If you're bothered by side effects, your doctor may be able to prescribe a different medicine instead.

Carvedilol works as well as other beta blockers to reduce blood pressure, but it's mainly used to prevent angina or heart failure because it also widens the blood vessels.

The main difference with carvedilol is that it can affect other parts of your body too, such as your lungs.

Other medicines used to lower blood pressure work in different ways to beta blockers. These include:

• ACE inhibitors such as ramipril and lisinopril
• angiotensin receptor blockers like losartan
• calcium channel blockers like amlodipine
• medicines that make you pee more (diuretics) like indapamide

The medicine your doctor prescribes first depends on your age and ethnicity. If you're under 55 years old, you'll usually be offered an ACE inhibitor or an angiotensin receptor blocker. If you're 55 years old or over, or of African Caribbean or Black African origin, you'll usually be offered a calcium channel blocker.

If you're bothered by side effects, you may have to try a different blood pressure medicine. Many people need to take more than 1 medicine for high blood pressure.

There are lots of other medicines to prevent angina attacks.

They include:

• calcium channel blockers such as diltiazem and amlodipine
• nitrates like isosorbide mononitrate
• medicines such as ranolazine, nicorandil or ivabradine

If carvedilol does not work for you, or you cannot take carvedilol or other beta blockers because of side effects, you may be able to switch to another medicine.

Your doctor will be able to advise you on which medicine is best for you. Some people need to take more than 1 medicine to control their angina symptoms.

Carvedilol is used with other medicines to treat heart failure and prevent complications. These can include ACE inhibitors (like ramipril and lisinopril) or angiotensin receptor blockers (like losartan).

Other beta blockers like bisoprolol and nebivolol can be used instead of carvedilol in a similar way.

Tell your doctor you're taking carvedilol if you're going to be put to sleep (using general anaesthetic) or have any kind of major operation.

Your doctor may advise you to stop taking carvedilol before surgery.

This is because carvedilol can lower your blood pressure too much when it's combined with some general anaesthetics.

Some people on carvedilol say their sex drive goes down and some men say they cannot get an erection.

There's not enough evidence to say that carvedilol causes this.

If you're having problems with your sex life, talk to your doctor.

You do not need to stop playing sports if you take carvedilol. But it's a good idea not to push yourself too much.

Regular exercise is good for you because it lowers blood pressure by keeping your heart and blood vessels in good condition.

However, in some sports carvedilol may not be allowed if you're competing at a very high level.

Carvedilol will not stop your contraception working.

But some types of combined hormonal methods of contraception, such as the combined pill and contraceptive patch, are not usually recommended if you have high blood pressure.

Talk to your doctor if you're taking a combined hormonal contraceptive.

If carvedilol makes you be sick or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Carvedilol can make you feel tired or dizzy, especially when you first start taking it or after increasing your dose.

If this happens to you, do not drive a car, ride a bike, or use tools or machinery until you feel OK again.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking carvedilol. GOV.UK has more information on the law on drugs and driving.

Drinking alcohol can increase the blood pressure-lowering effect of carvedilol. This can make you feel dizzy or lightheaded.

During the first few days of taking carvedilol, or after an increase in your dose, it's best to stop drinking alcohol until you see how the medicine affects you.

If you find carvedilol makes you feel dizzy it's best to stop drinking alcohol.

You can eat and drink normally while taking carvedilol.

Eating a healthy, balanced diet can help your heart condition.

If you have heart problems, you can boost the health of your heart by making some lifestyle changes.

• Quit smoking – smoking increases your heart rate and blood pressure. Quitting smoking will cut your risk of heart attack and stroke. Try to avoid second-hand smoke, too.
• Cut down on alcohol – drinking too much alcohol raises blood pressure over time and makes heart failure worse. Drinking alcohol while you're taking carvedilol can make you feel dizzy or lightheaded.
• Exercise – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic, walking every day is enough.
• Eat well and lower the salt in your diet – aim to eat a diet that includes plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products and lean proteins. Eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be.
• Manage stress – when you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse too. Finding ways to cope with stress will help to keep your blood pressure down.
• Vaccinations – if you have heart failure, it's recommended that you have the flu vaccine every year and the COVID-19 vaccine and pneumococcal vaccine as recommended by your GP. Ask your doctor about these vaccinations. You can have them free on the NHS.