Carvedilol, sold under the brand name Coreg among others, is a medication used to treat high blood pressure, congestive heart failure (CHF), and left ventricular dysfunction in people who are otherwise stable. For high blood pressure, it is generally a second-line treatment. It is taken by mouth. Common side effects include dizziness, tiredness, joint pain, low blood pressure, nausea, and shortness of breath. Severe side effects may include bronchospasm. Safety during pregnancy or breastfeeding is unclear. Use is not recommended in those with liver problems. Carvedilol is a nonselective beta blocker and alpha-1 blocker. How it improves outcomes is not entirely clear but may involve dilation of blood vessels. Carvedilol was patented in 1978 and approved for medical use in the United States in 1995. It is on the World Health Organization's List of Essential Medicines. It is available as a generic medication. In 2020, it was the 26th most commonly prescribed medication in the United States, with more than 23million prescriptions. Medical uses Carvedilol is indicated in the management of congestive heart failure (CHF), commonly as an adjunct to angiotensin-converting-enzyme inhibitor (ACE inhibitors) and diuretics. It has been clinically shown to reduce mortality and hospitalizations in people with CHF. The mechanism behind its positive effect when used long-term in clinically stable CHF patients is not fully understood, but is thought to contribute to remodeling of the heart, improving upon its structure and function. Carvedilol reduces the risk of death, hospitalizations, and recurring heart attacks for patients with reduced heart function following a heart attack. Carvedilol has also been proven to reduce death and hospitalization in patients with severe heart failure. In practice, carvedilol has been used in the treatment of uncomplicated hypertension, yet studies suggest it has relatively ineffective blood pressure-lowering effects when compared with other blood pressure-lowering therapies or other beta blockers. Available forms Carvedilol is available in the following forms: Oral tablet Extended-release (24-hour) oral capsule (approved by the FDA in 2006) Contraindications Carvedilol should not be used in patients with bronchial asthma or bronchospastic conditions due to increased risk of bronchoconstriction. It should not be used in people with second- or third-degree atrioventricular block, sick sinus syndrome, severe bradycardia (unless a permanent pacemaker is in place), or a decompensated heart condition. People with severe hepatic impairment should use carvedilol with caution. Side effects The most common side effects (>10% incidence) of carvedilol include: Dizziness Fatigue Low