Cardipres Drug Interactions

Carvedilol can mask early warning symptoms of hypoglycemia (low blood sugar) such as tremors and increased heart rate. (These symptoms are caused by activation of the adrenergic nervous system, which is blocked by the carvedilol). Therefore, diabetics taking medications that lower blood sugar such as insulin or oral anti-diabetic medications may need to increase the frequency with which they monitor their blood sugar.
Carvedilol taken with calcium channel blockers such as diltiazem or verapamil may trigger an irregular heart rhythm or an increase in blood pressure.
Reserpine, monoamine oxidase inhibitors and clonidine, because they have similar mechanisms of action as carvedilol, may greatly accentuate the effects of carvedilol and cause a steep decline a blood pressure and/or heart rate. Close monitoring of blood pressure and heart rate may be needed.
Carvedilol may cause an increase in digoxin blood levels. Therefore, in patients receiving digoxin, the digoxin blood level should be monitored if carvedilol is started, adjusted or discontinued.
Rifampin can sharply decrease the carvedilol blood level. Therefore, in patients taking rifampin, the dose of carvedilol may need to be increased.
Carvedilol shares a common pathway for elimination by the liver with several other drugs such as quinidine, fluoxetine, paroxetine, or propafenone. Use of these drugs may block the elimination of carvedilol. No studies have been done to confirm these effects on the elimination of carvedilol, however, carvedilol blood levels may be increase (along with the risk for carvedilol's side effects) if patients are taking any of these drugs.
Carvedilol may increase the levels in the blood of cyclosporin, and the dose cyclosporin may need to be adjusted when the two drugs are used together.