There are two different forms of carvedilol, immediate-release tablets and extended-release capsules.1,2 Both forms should be taken orally with food. They should be swallowed as a whole and should not be chewed or crushed.3
If a patient has trouble swallowing the pill whole and is on the extended-release capsule, they can open the capsule and sprinkle all the contents on a spoonful of applesauce. The whole spoonful should be swallowed immediately without chewing.
Carvedilol also comes in many doses. Dosages must be individualized to the patient and any up-titrations should be carefully monitored by a physician.1,2
Immediate-release tablets come in the following doses: 3.125 mg, 6.25 mg, 12.5 mg, or 25 mg.1 Immediate-release tablets of carvedilol should be taken twice a day with food.
Extended-release capsules come in the following doses: 10 mg, 20 mg, 40 mg, or 80 mg.2 Extended-release capsules of carvedilol should be taken once a day with food.
Immediate physiological effects of carvedilol occur in a very short time. Within a few hours, even a small dose of carvedilol can lower blood pressure.4 It reaches peak plasma drug concentration in one to two hours, but is delayed by one to two hours when taken with food. Average terminal elimination half-life of carvedilol is around seven to ten hours.1
Absorption of the extended-release capsule form of carvedilol (Coreg CR) takes longer.2 It reaches peak concentration about 3.5 hours later than immediate-release carvedilol does,4 about five hours after administration,2 but maintains a stable concentration for 24 hours.5
References
- COREG [package insert]. Ciales, PR: GK Pharmaceuticals Contract Manufacturing Operations; 2008.
- COREG CR [package insert]. Ciales, PR: GK Pharmaceuticals Contract Manufacturing Operations; 2008.
- APO-CARVEDILOL [package insert]. Toronto, Canada: Apotex Pharmaceutical Holdings Inc.; 2015.
- Stafylas PC, Sarafidis PA. Carvedilol in hypertension treatment. Vasc Health Risk Manag. 2008;4(1):23-30. 2008.
- Frishman WH, Henderson LS, Lukas MA. Controlled-release carvedilol in the management of systemic hypertension and myocardial dysfunction. Vasc Health Risk Manag. 2008;4(6):1387-1400.
