Carvedilol is a racemic mixture in which nonselective β-adrenoreceptor blocking activity is present in the S(-) enantiomer and α1-adrenergic blocking activity is present in both R(+) and S(-) enantiomers at equal potency. Carvedilol has no intrinsic sympathomimetic activity.

Carvedilol is an alpha-/beta-adrenergic blocking agent indicated for the treatment of: mild to severe chronic heart failure, left ventricular dysfunction following myocardial infarction in clinically stable patients, hypertension

Take with food. Individualize dosage and monitor during up-titration. Heart failure: Start at 3.125 mg twice daily and increase to 6.25, 12.5, and then 25 mg twice daily over intervals of at least 2 weeks. Maintain lower doses if higher doses are not tolerated. Left ventricular dysfunction following myocardial infarction: Start at 6.25 mg twice daily and increase to 12.5 mg then 25 mg twice daily after intervals of 3 to 10 days. A lower starting dose or slower titration may be used. Hypertension: Start at 6.25 mg twice daily and increase if needed for blood pressure control to 12.5 mg then 25 mg twice daily over intervals of 1 to 2 weeks.

Heart failure and left ventricular dysfunction following myocardial infarction (≥10%): Dizziness, fatigue, hypotension, diarrhea, hyperglycemia, asthenia, bradycardia, weight increase. Hypertension (≥5%): Dizziness.

Bronchial asthma or related bronchospastic conditions. Second- or third-degree AV block. Sick sinus syndrome. Severe bradycardia (unless permanent pacemaker in place). Patients in cardiogenic shock or decompensated heart failure requiring the use of IV inotropic therapy. Severe hepatic impairment. History of serious hypersensitivity reaction (e.g., Stevens-Johnson syndrome, anaphylactic reaction, angioedema) to any component of this medication or other medications containing carvedilol.

Acute exacerbation of coronary artery disease upon cessation of therapy: Do not abruptly discontinue. Bradycardia, hypotension, worsening heart failure/fluid retention may occur. Reduce the dose as needed. Non-allergic bronchospasm (e.g., chronic bronchitis and emphysema): Avoid β-blockers. However, if deemed necessary, use with caution and at lowest effective dose. Diabetes: Monitor glucose as β-blockers may mask symptoms of hypoglycemia or worsen hyperglycemia.