These highlights do not include all the information needed to use carvedilol safely and effectively. See full prescribing information for carvedilol tablets, USP.Carvedilol Tablets, USP Initial U.S. Approval: 1995

1 INDICATIONS AND USAGE

1.2 Left Ventricular Dysfunction Following Myocardial Infarction

1.3 Hypertension

2 DOSAGE AND ADMINISTRATION

2.2 Left Ventricular Dysfunction Following Myocardial Infarction

2.3 Hypertension

2.4 Hepatic Impairment

3 DOSAGE FORMS AND STRENGTHS

4 CONTRAINDICATIONS

• Bronchial asthma or related bronchospastic conditions. Deaths from status asthmaticus have been reported following single doses of carvedilol tablets.
• Second- or third-degree AV block
• Sick sinus syndrome
• Severe bradycardia (unless a permanent pacemaker is in place)
• Patients with cardiogenic shock or who have decompensated heart failure requiring the use of intravenous inotropic therapy. Such patients should first be weaned from intravenous therapy before initiating carvedilol tablets.
• Patients with severe hepatic impairment
• Patients with a history of a serious hypersensitivity reaction (e.g., Stevens-Johnson syndrome, anaphylactic reaction, angioedema) to any component of this medication or other medications containing carvedilol.

5 WARNINGS AND PRECAUTIONS

5.1 Cessation of Therapy

5.2 Bradycardia

5.3 Hypotension

5.4 Heart Failure/Fluid Retention

5.5 Non-allergic Bronchospasm

5.6 Glycemic Control in Type 2 Diabetes

5.7 Peripheral Vascular Disease

5.8 Deterioration of Renal Function

5.9 Major Surgery

5.10 Thyrotoxicosis

5.11 Pheochromocytoma

5.12 Prinzmetal’s Variant Angina

5.13 Risk of Anaphylactic Reaction

5.14 Intraoperative Floppy Iris Syndrome

6 ADVERSE REACTIONS

6.1 Clinical Studies Experience

6.2 Laboratory Abnormalities

6.3 Postmarketing Experience

7 DRUG INTERACTIONS

7.1 CYP2D6 Inhibitors and Poor Metabolizers

7.2 Hypotensive Agents

7.3 Cyclosporine

7.4 Digitalis Glycosides

7.5 Inducers/Inhibitors of Hepatic Metabolism

7.6 Amiodarone

7.7 Calcium Channel Blockers

7.8 Insulin or Oral Hypoglycemics

7.9 Anesthesia

8 USE IN SPECIFIC POPULATIONS

8.1 Pregnancy

8.3 Nursing Mothers

8.4 Pediatric Use

8.5 Geriatric Use

10 OVERDOSAGE

11 DESCRIPTION

12 CLINICAL PHARMACOLOGY

12.1 Mechanism of Action

12.2 Pharmacodynamics

12.3 Pharmacokinetics

12.4 Specific Populations

12.5 Drug-Drug Interactions

13 NONCLINICAL TOXICOLOGY

13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility

14 CLINICAL STUDIES

14.2 Left Ventricular Dysfunction Following Myocardial Infarction

14.3 Hypertension

14.4 Hypertension With Type 2 Diabetes Mellitus

In a double-blind study (GEMINI), carvedilol, added to an ACE inhibitor or angiotensin receptor blocker, was evaluated in a population with mild-to-moderate hypertension and well-controlled type 2 diabetes mellitus. The mean HbA1c at baseline was 7.2%. Carvedilol was titrated to a mean dose of 17.5 mg twice daily and maintained for 5 months. Carvedilol had no adverse effect on glycemic control, based on HbA1c measurements (mean change from baseline of 0.02%, 95% CI -0.06 to 0.1, p = NS) [see Warnings and Precautions (5.6)].

16 HOW SUPPLIED/STORAGE AND HANDLING

17 PATIENT COUNSELING INFORMATION

17.1 Patient Advice

• Patients should take carvedilol with food.
• Patients should not interrupt or discontinue using carvedilol without a physician’s advice.
• Patients should consult their physician if they experience signs or symptoms of worsening heart failure such as weight gain or increasing shortness of breath.
• Patients may experience a drop in blood pressure when standing, resulting in dizziness and, rarely, fainting. Patients should sit or lie down when these symptoms of lowered blood pressure occur.
• If experiencing dizziness or fatigue, patients should avoid driving or hazardous tasks.
• Patients should consult a physician if they experience dizziness or faintness, in case the dosage should be adjusted.
• Diabetic patients should report any changes in blood sugar levels to their physician.
• Contact lens wearers may experience decreased lacrimation.

17.2 FDA-Approved Patient Labeling

• To treat patients who had a heart attack that worsened how well the heart pumps
• To treat patients with high blood pressure (hypertension)