Coreg and Synthroid Interactions Checker

Observe newborns for symptoms of hypotension, bradycardia, hypoglycemia, and respiratory depression and manage accordingly. Dyspnea and fatigue were also reported in these trials, but the rates were equal or greater in subjects who received placebo. Cardiac failure and dyspnea were also reported in these trials, but the rates were equal or greater in subjects who received placebo. Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice. The dose of COREG should be reduced if patients experience bradycardia (heart rate less than 55 beats per minute). Intraoperative Floppy Iris Syndrome (IFIS) has been observed during cataract surgery in some patients treated with alpha-1 blockers (COREG is an alpha/beta blocker).

Steady-state plasma concentrations of carvedilol and its enantiomers increased proportionally over the 6.25- to 50- mg dose range in subjects with heart failure. The mean apparent terminal elimination half-life for carvedilol was similar to that observed in healthy subjects. Do not abruptly stop taking COREG®, as it may lead to acute exacerbation of coronary artery disease upon cessation of therapy.Bradycardia, hypotension, worsening heart failure/fluid retention may occur. Discuss these symptoms with your doctor.Tell your doctor about all the medications you take. Do not abruptly stop taking COREG®, as it may lead to acute exacerbation of coronary artery disease upon cessation of therapy.

Following oral administration of radiolabeled carvedilol to healthy volunteers, carvedilol accounted for only about 7% of the total radioactivity in plasma as measured by area under the curve (AUC). Carvedilol is metabolized primarily by aromatic ring oxidation and glucuronidation. The synthroid 5mg oxidative metabolites are further metabolized by conjugation via glucuronidation and sulfation. The metabolites of carvedilol are excreted primarily via the bile into the feces. Demethylation and hydroxylation at the phenol ring produce 3 active metabolites with β-receptor blocking activity. Based on preclinical studies, the 4′-hydroxyphenyl metabolite is approximately 13 times more potent than carvedilol for β-blockade.

Before taking this medicine

Median trial medication exposure was 6.3 months for both carvedilol and placebo subjects in the trials of mild-to-moderate heart failure and 10.4 months in the trial of subjects with severe heart failure. Treatment with COREG may be started as an inpatient or outpatient and should be started after the patient is hemodynamically stable and fluid retention has been minimized. It is recommended that COREG be started at 6.25 mg twice daily and increased after 3 to 10 days, based on tolerability, to 12.5 mg twice daily, then again to the target dose of 25 mg twice daily. A lower starting dose may be used (3.125 mg twice daily) and/or the rate of up-titration may be slowed if clinically indicated (e.g., due to low blood pressure or heart rate, or fluid retention). Patients should be maintained on lower doses if higher doses are not tolerated. The recommended dosing regimen need not be altered in patients who received treatment with an IV or oral β-blocker during the acute phase of the myocardial infarction.

What are some medications that Coreg is compatible with?

In patients with these risk factors, it is recommended that renal function be monitored during up-titration of carvedilol and the drug discontinued or dosage reduced if worsening of renal function occurs. In patients with heart failure and diabetes, carvedilol therapy may lead to worsening hyperglycemia, which responds to intensification of hypoglycemic therapy. It is recommended that blood glucose be monitored when carvedilol dosing is initiated, adjusted, or discontinued. Trials designed to examine the effects of carvedilol on glycemic control in patients with diabetes and heart failure have not been conducted.

• The oxidative metabolites are further metabolized by conjugation via glucuronidation and sulfation.
• The mean apparent terminal elimination half-lives for R(+)-carvedilol range from 5 to 9 hours compared with 7 to 11 hours for the S(-)- enantiomer.
• A total of 6,975 subjects with mild-to-severe heart failure were evaluated in placebo- controlled trials of carvedilol.
• Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
• Coreg is used to treat heart failure and hypertension (high blood pressure).

Save Interactions List

It can be used alone or in combination with other antihypertensive agents, especially thiazide-type diuretics see Drug Interactions (7.2). Other side effects of COREG include shortness of breath, weight gain, diarrhea, and fewer tears or dry eyes that become bothersome if you wear contact lenses. Show this list to your doctor and pharmacist before you start a new medicine. Read the Patient Information that comes with COREG before you start taking it and each time you get a refill.

Patients taking a β-blocker and a drug that can deplete catecholamines (e.g., reserpine and monoamine oxidase inhibitors) should be observed closely for signs of hypotension and/or severe bradycardia. Lasix (furosemide) treats fluid retention in people with congestive heart failure, liver disease … You should not take Coreg if you have asthma, bronchitis, emphysema, severe liver disease, or a serious heart condition such as heart block, “sick sinus syndrome,” or slow heart rate (unless you have a pacemaker). Coreg is used to treat heart failure and hypertension (high blood pressure). It is important for you to take your medicine every day as directed by your doctor. If you stop taking Coreg suddenly, you could have chest pain and/or a heart attack.

Interactions between your drugs

Both digitalis glycosides and β-blockers slow atrioventricular conduction and decrease heart rate. Digoxin concentrations are increased by about 15% when digoxin and carvedilol are administered concomitantly. Therefore, increased monitoring of digoxin is recommended when initiating, adjusting, or discontinuing COREG see Clinical Pharmacology (12.5). In each trial, there was a primary end point, either progression of heart failure (1 U.S. trial) or exercise tolerance (2 U.S. trials meeting enrollment goals and the Australia-New Zealand trial).

Drug Interactions between Coreg and Synthroid

CYP2D6 is thought to be the major enzyme in the 4′- and 5′-hydroxylation of carvedilol, with a potential contribution from 3A4. CYP2C9 is thought to be of primary importance in the O-methylation pathway of S(-)-carvedilol. Effectiveness of COREG in patients younger than 18 years has not been established. If treatment with COREG is to be continued perioperatively, particular care should be taken when anesthetic agents that depress myocardial function, such as ether, cyclopropane, and trichloroethylene, are used see OVERDOSAGE. There are no adequate and well-controlled studies in pregnant or breastfeeding women; Coreg may be used during pregnancy or breastfeeding only if the potential benefit justifies the potential risk to the fetus or infant.

Dosage Forms and Strengths

Nonselective β-blockers may potentiate insulin-induced hypoglycemia and delay recovery of serum glucose levels. Patients subject to spontaneous hypoglycemia or diabetic patients receiving insulin or oral hypoglycemic agents should be cautioned about these possibilities. Concomitant administration of clonidine with a β-blocker may cause hypotension and bradycardia. When concomitant treatment with a β-blocker and clonidine is to be terminated, the β-blocker should be discontinued first. Clonidine therapy can then be discontinued several days later by gradually decreasing the dosage. Using multivitamin with minerals together with levothyroxine may decrease the effects of levothyroxine.