Carvedilol interactions

Should not be used in combination with other alpha adrenergic antagonists ( 5.4 , 7.2 ) (Alfuzosin label, Warnings and precautions)

Use CLOZARIL cautiously in patients with cardiovascular or cerebrovascular disease or conditions predisposing to hypotension (e.g., dehydration, use of antihypertensive medications) [see Dosage and Administration ( 2.2 , 2.6 ), Warnings and Precautions ( 5.2 )]. (Clozapine label, Boxed warning)

• Concomitant administration with IV beta-blockers. (Diltiazem label, Contraindications)

Do not use JALYN with other alpha-adrenergic antagonists, as this may increase the risk of hypotension. (Dutasteride and tamsulosin label, Warnings and precautions)

Concomitant negative chronotropic therapy such as digoxin or beta-blockers may lower the risk of this complication. (Flecainide label, Boxed warning)

Avoid coadministration of FANAPT with alpha-adrenergic blocking agents and adjust medications that affect blood pressure as needed [see Warnings and Precautions (5.7) ] . (Iloperidone label, Drug interactions)

…that Affect Concomitant Drug Concentrations Concomitant Drug Within Class Prevention or Management Drug Interactions with TOLSURA that Increase Concomitant Drug Concentrations and May Increase Risk of Adverse Reactions Associated with the Concomitant Drug Alpha Blockers Alfuzosin Silodosin Tamsulosin Not recommended during and 2 weeks after TOLSURA treatment. (Itraconazole label, Drug interactions)

Other Antihypertensive Drugs When metolazone tablets, USP, are used with other antihypertensive drugs, particular care must be taken to avoid excessive reduction of blood pressure, especially during initial therapy. (Metolazone label, Warnings)

Minoxidil should be reserved for hypertensive patients who do not respond adequately to maximum therapeutic doses of a diuretic and two other antihypertensive agents. (Minoxidil label, Boxed warning)

Hypotensive Agents Do not use BYSTOLIC with other β-blockers. (Nebivolol label, Drug interactions)

Examples: beta-blockers, clonidine, guanethidine, and reserpine Clopidogrel : Avoid concomitant use; if used concomitantly initiate at 0.5 mg before each meal and limit total daily dose to 4 mg ( 7 ) (Repaglinide label, Drug interactions)

Concomitant use with metoclopramide, beta-blockers, or cholinomimetic and anticholinergic drugs is not recommended ( 7.1 , 7.2 , 7.3 ) (Rivastigmine label, Drug interactions)

…coadministration of an alpha-blocker and CIALIS for the treatment of BPH has not been adequately studied, and due to the potential vasodilatory effects of combined use resulting in blood pressure lowering, the combination of CIALIS and alpha-blockers is not recommended for the treatment of BPH. [see Dosage and Administration ( 2.7 ), Drug Interactions ( 7.1 ),… (Tadalafil label, Warnings and precautions)

• Should not be used in combination with other alpha adrenergic blocking agents ( 5.2 , 7.2 , 12.3 ) (Tamsulosin label, Warnings and precautions)

…Syndrome (SS) c ] Agents with blood pressure-reducing effects Use with caution d Hypotension e Non-selective H1 receptor antagonists Contraindicated a Increased anticholinergic effects Beta-adrenergic blockers (see also agents or procedures with blood pressure-reducing effects) Use with the caution d More pronounced bradycardia, postural hypotension e Blood glucose-lowering… (Tranylcypromine label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Beta-blockers: Use with caution. (Albuterol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Amiodarone may increase carvedilol levels resulting in further slowing of the heart rate or cardiac conduction. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Antihypertensive Drugs Due to its alpha-adrenergic antagonism, aripiprazole has the potential to enhance the effect of certain antihypertensive agents. (Aripiprazole label, Drug interactions)

There was also a slightly greater proportion of patients on NUVIGIL requiring new or increased use of antihypertensive medications (2.9%) compared to patients on placebo (1.8%). (Armodafinil label, Warnings and precautions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medications, patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Asenapine label, Warnings and precautions)

Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Antihypertensive Drugs Prevention or Management Increase the frequency of monitoring blood pressure and adjust atomoxetine oral solution dosage as clinically appropriate. (Atomoxetine label, Drug interactions)

• Use of avanafil with alpha-blockers, other antihypertensives, or substantial amounts of alcohol (greater than 3 units) may lead to hypotension ( 2.3 , 5.6 , 5.7 ) (Avanafil label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medication), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Brexpiprazole label, Warnings and precautions)

Antihypertensives/Cardiac Glycosides Because brimonidine tartrate ophthalmic solution 0.1% and 0.15% may reduce blood pressure, caution in using drugs such as antihypertensives and/or cardiac glycosides with brimonidine tartrate ophthalmic solution 0.1% and 0.15% is advised. (Brimonidine label, Drug interactions)

Beta-blockers: Use with caution. (Budesonide and formoterol label, Drug interactions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Antihypertensive drugs: May cause symptomatic postural hypotension. (Carbidopa and levodopa label, Drug interactions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Cariprazine label, Warnings and precautions)

Intervention: • During concomitant use of VYSCOXA and ACE inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Celecoxib label, Drug interactions)

DRUG INTERACTIONS Cevimeline should be administered with caution to patients taking beta adrenergic antagonists, because of the possibility of conduction disturbances. (Cevimeline label, Drug interactions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Cimetidine increased AUC by about 30% but caused no change in C max [see Clinical Pharmacology (12.5) ] . (Carvedilol label, Drug interactions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

Hypotensive agents (e.g., reserpine, MAO inhibitors, clonidine) may increase the risk of hypotension and/or severe bradycardia. (Carvedilol label, Drug interactions)

…concomitant use of TONMYA with: MAO inhibitors may be life-threatening [see Contraindications (4) ] , Alcohol, barbiturates, and other CNS depressants may increase the risk of adverse reactions associated with these drugs, Tramadol may increase the seizure risk, Guanethidine or other similar acting drugs may block the antihypertensive action of these drugs. (Cyclobenzaprine label, Drug interactions)

Cyclosporine or digoxin levels may increase. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

Hypotensive agents (e.g., reserpine, MAO inhibitors, clonidine) may increase the risk of hypotension and/or severe bradycardia. (Carvedilol label, Drug interactions)

• Antihypertensive Drugs: Monitor blood pressure. (Dexmethylphenidate label, Drug interactions)

Intervention: During concomitant use of Diclofenac Potassium and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Diclofenac label, Drug interactions)

Cyclosporine or digoxin levels may increase. (Carvedilol label, Drug interactions)

Beta Blockers Although the results of a clinical study did not indicate a safety problem associated with the administration of Dihydroergotamine Mesylate Injection, USP to subjects already receiving propranolol, there have been reports that propranolol may potentiate the vasoconstrictive action of ergotamine by blocking the vasodilating property of epinephrine. (Dihydroergotamine label, Drug interactions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

Concomitant medications were grouped as ACE inhibitors, oral anticoagulants, calcium channel blockers, beta blockers, cardiac glycosides, inducers of CYP3A4, substrates and inhibitors of CYP3A4, substrates and inhibitors of P-glycoprotein, nitrates, sulphonylureas, loop diuretics, potassium sparing diuretics, thiazide diuretics, substrates and inhibitors of tubular… (Dofetilide label, Drug interactions)

As with other β-blockers, if COREG is administered with calcium channel blockers of the verapamil or diltiazem type, it is recommended that ECG and blood pressure be monitored. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Give a low dose of beta-blockers initially, and increase only after ECG verification of good tolerability [see Drug Interactions (7.3) , Clinical Pharmacology (12.3) ] . (Dronedarone label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reaction. (Carvedilol label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Following initiation and titration of Epogen, approximately 25% of patients on dialysis required initiation of or increases in antihypertensive therapy; hypertensive encephalopathy and seizures have been reported in patients with CKD receiving Epogen. (Epoetin alfa label, Warnings and precautions)

As with other β-blockers, if COREG is administered with calcium channel blockers of the verapamil or diltiazem type, it is recommended that ECG and blood pressure be monitored. (Carvedilol label, Drug interactions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

Propranolol and Other Beta-Blockers: Coadministration of fluvoxamine maleate 100 mg per day and propranolol 160 mg per day in normal volunteers resulted in a mean five-fold increase (range 2 to 17) in minimum propranolol plasma concentrations. (Fluvoxamine label, Drug interactions)

• Beta-blockers may decrease effectiveness. (Formoterol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Table 4: Clinically Significant Drug Interaction with GVOKE and GVOKE VialDx Beta-Blockers Clincial Impact: Patients taking beta-blockers may have a transient increase in pulse and blood pressure when given GVOKE or GVOKE VialDx. (Glucagon label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Orthostatic vital signs should be monitored in patients who are at risk for hypotension (e.g., geriatric patients, patients with dehydration, hypovolemia, and concomitantly treated with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Haloperidol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Intervention: During concomitant use of CALDOLOR and ACE-inhibitors, ARBs, or beta- blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Ibuprofen label, Drug interactions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Intervention: During concomitant use of INDOCIN and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Indomethacin label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Hypotensive agents (e.g., reserpine, MAO inhibitors, clonidine) may increase the risk of hypotension and/or severe bradycardia. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

The risk of bradycardia increases with concomitant administration of drugs that slow heart rate (e.g., digoxin, amiodarone, beta-blockers). (Ivabradine label, Drug interactions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

Anesthesia 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 (10) ]. (Carvedilol label, Drug interactions)

Alpha Blockers tamsulosin Analgesics methadone alfentanil, buprenorphine IV and sublingual, fentanyl, oxycodone, sufentanil Methadone: The potential increase in plasma concentrations of methadone when coadministered with ketoconazole tablets may increase the risk of serious cardiovascular events including QT prolongation and torsade de pointes, or respiratory… (Ketoconazole label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

VIMPAT should also be used with caution in patients on concomitant medications that affect cardiac conduction, including sodium channel blockers, beta-blockers, calcium channel blockers, potassium channel blockers, and medications that prolong the PR interval [see Drug Interactions (7.2) ] . (Lacosamide label, Warnings and precautions)

In this setting, cardioselective beta-blockers should be considered, although they should be administered with caution. (Levalbuterol label, Drug interactions)

Drug or Drug Class Effect Beta-adrenergic antagonists e.g., Propranolol > 160 mg/day) In patients treated with large doses of propranolol (> 160 mg/day), T 3 and T 4 levels change slightly, TSH levels remain normal, and patients are clinically euthyroid. (Levothyroxine label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Hypotensive agents (e.g., reserpine, MAO inhibitors, clonidine) may increase the risk of hypotension and/or severe bradycardia. (Carvedilol label, Drug interactions)

Drug or Drug Class Effect Beta-adrenergic antagonists (e.g., Propranolol >160 mg/day) In patients treated with large doses of propranolol (>160 mg/day), T3 and T4 levels change, TSH levels remain normal, and patients are clinically euthyroid. (Liothyronine label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive drugs), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Lumateperone label, Warnings and precautions)

Patients at increased risk of these adverse reactions or at increased risk of developing complications from hypotension include those with dehydration, hypovolemia, treatment with antihypertensive medication, history of cardiovascular disease (e.g., heart failure, myocardial infarction, ischemia, or conduction abnormalities), history of cerebrovascular disease,… (Lurasidone label, Warnings and precautions)

Intervention: During concomitant use of QAMZOVA and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Meloxicam label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

…(oral): Due to potential inhibition of vitamin K activity by methimazole, the activity of oral anticoagulants (e.g., warfarin) may be increased; additional monitoring of PT/INR should be considered, especially before surgical procedures. β-adrenergic blocking agents: Hyperthyroidism may cause an increased clearance of beta blockers with a high extraction ratio. (Methimazole label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Antihypertensive Drugs: Monitor blood pressure. (Methylphenidate label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

REMERON/REMERONSolTab should be used with caution in patients with known cardiovascular or cerebrovascular disease that could be exacerbated by hypotension (history of myocardial infarction, angina, or ischemic stroke) and conditions that would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medication). (Mirtazapine label, Warnings and precautions)

However, a retrospective analysis of the use of antihypertensive medication in these studies showed that a greater proportion of patients on PROVIGIL required new or increased use of antihypertensive medications (2.4%) compared to patients on placebo (0.7%). (Modafinil label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

( 5.3 Hepatotoxicity) Hypertension: Patients taking some antihypertensive medications may have impaired response to these therapies when taking NSAIDs. (Naproxen label, Warnings and precautions)

Antihypertensive Therapy Niacin may potentiate the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension. (Niacin label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Antihypertensives: Possible additive hypotensive effects. (Nitroglycerin label, Drug interactions)

…of myocardial infarction or ischemia, heart failure, or conduction abnormalities), cerebrovascular disease, and conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications) where the occurrence of syncope, or hypotension and/or bradycardia might put the patient at increased medical risk. (Olanzapine label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Use ERZOFRI with caution in patients with known cardiovascular disease (e.g., heart failure, history of myocardial infarction or ischemia, conduction abnormalities), cerebrovascular disease, or conditions that predispose the patient to hypotension (e.g., dehydration, hypovolemia, and treatment with antihypertensive medications). (Paliperidone label, Warnings and precautions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

Small decreases in blood pressure have been observed in some patients treated with pentoxifylline extended-release tablets; periodic systemic blood pressure monitoring is recommended for patients receiving concomitant antihypertensive therapy. (Pentoxifylline label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Hypotensive agents (e.g., reserpine, MAO inhibitors, clonidine) may increase the risk of hypotension and/or severe bradycardia. (Carvedilol label, Drug interactions)

Drug Interactions Pilocarpine should be administered with caution to patients taking beta-adrenergic antagonists because of the possibility of conduction disturbances. (Pilocarpine label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

Anesthesia 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 (10) ]. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Beta-adrenergic blocking agents: Hyperthyroidism may cause an increased clearance of beta blockers with a high extraction ratio. (Propylthiouracil label, Drug interactions)

Use with caution in persons with increased risk of anticholinergic reactions, such as persons with bronchial asthma, chronic obstructive pulmonary disease, bradycardia, cardiac arrhythmias, beta blocker treatment (increased risk of anticholinergic reactions). (Pyridostigmine label, Warnings and precautions)

Quetiapine should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Quetiapine label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

Hypotensive agents (e.g., reserpine, MAO inhibitors, clonidine) may increase the risk of hypotension and/or severe bradycardia. (Carvedilol label, Drug interactions)

CYP P450 2D6 enzyme inhibitors may increase and rifampin may decrease carvedilol levels. (Carvedilol label, Drug interactions)

Consider the potential for symptomatic hypotension or ischemia in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, or concomitant treatment with antihypertensives or strong CYP and P-gp/BCRP inhibitors [see Drug Interactions (7.2) and Clinical Pharmacology (12.3) ] . (Riociguat label, Warnings and precautions)

Clinically significant hypotension has been observed with concomitant use of oral RISPERDAL and antihypertensive medication. (Risperidone label, Warnings and precautions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

• Beta-blockers: Use with caution. (Salmeterol label, Drug interactions)

Hypotensive agents (e.g., reserpine, MAO inhibitors, clonidine) may increase the risk of hypotension and/or severe bradycardia. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Caution is advised when SILDENAFIL ORAL FILM is co-administered with alpha-blockers or antihypertensives. (Sildenafil label, Warnings and precautions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Sofosbuvir and velpatasvir label, Warnings and precautions)

As with other β-blockers, if COREG is administered with calcium channel blockers of the verapamil or diltiazem type, it is recommended that ECG and blood pressure be monitored. (Carvedilol label, Drug interactions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

Monitor patients to assure diuretic efficacy including antihypertensive effects. (Sumatriptan and naproxen label, Drug interactions)

• Hypertension: May require antihypertensive therapy; monitor relevant drug interactions. (Tacrolimus label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)

In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution. (Terbutaline label, Precautions)

In patients with hypertension on antihypertensive therapy, KYZATREX® increased the mean systolic/diastolic BP by 3.4/0.7 mm Hg from baseline after 4 months of treatment and 3.1/1.0 mm Hg from baseline after 6 months of treatment. [see Adverse Reactions (6.1) ]. (Testosterone label, Warnings and precautions)

Hypotensive agents (e.g., reserpine, MAO inhibitors, clonidine) may increase the risk of hypotension and/or severe bradycardia. (Carvedilol label, Drug interactions)

As with other β-blockers, if COREG is administered with calcium channel blockers of the verapamil or diltiazem type, it is recommended that ECG and blood pressure be monitored. (Carvedilol label, Drug interactions)

Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Concomitant use with an antihypertensive may require a reduction in the dose of the antihypertensive drug. (Trazodone label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

Use of BCRP and/or P-gp only inhibitors (e.g., quinidine, carvedilol, eltrombopag, curcumin) may increase the exposure of ubrogepant [ s ee Clinical Pharmacology ( 12.3 ) ] . (Ubrogepant label, Drug interactions)

• Beta-blockers: Use with caution. (Umeclidinium and vilanterol label, Drug interactions)

Hypotensive agents (e.g., reserpine, MAO inhibitors, clonidine) may increase the risk of hypotension and/or severe bradycardia. (Carvedilol label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Alpha-Blockers : Caution is advised when PDE5 inhibitors are co-administered with alpha-blockers. (Vardenafil label, Warnings and precautions)

Metoprolol: Possibly reduced blood-pressure lowering effect despite increased metoprolol plasma levels. (Venlafaxine label, Drug interactions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

Ziprasidone should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Ziprasidone label, Warnings and precautions)

In such cases, butorphanol should be discontinued and the hypertension treated with antihypertensive drugs. (Butorphanol label, Warnings)

CNS depressants include: alcohol, opioid analgesics, benzodiazepines, tricyclic antidepressants, sedative/hypnotics, anticonvulsants, antipsychotics, antihistamines, anticholinergics, alpha and beta blockers, general anesthetics, muscle relaxants, and illicit CNS depressants. (Carbamazepine label, Drug interactions)

Chlorpromazine may counteract the antihypertensive effect of guanethidine and related compounds. (Chlorpromazine label, Warnings)

Drug Interactions ACE-inhibitors Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. (Etodolac label, Drug interactions)

…PROSCAR was concomitantly used in clinical studies with acetaminophen, acetylsalicylic acid, α-blockers, angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines,… (Finasteride label, Drug interactions)

Drugs That Slow Heart Rate or Atrioventricular Conduction (e.g., beta blockers or diltiazem) Experience with GILENYA in patients receiving concurrent therapy with drugs that slow the heart rate or AV conduction (e.g., beta blockers, digoxin, or heart rate-slowing calcium channel blockers, such as diltiazem or verapamil) is limited. (Fingolimod label, Drug interactions)

Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE inhibitors and/or angiotensin II receptor antagonists. (Ketorolac label, Drug interactions)

Alpha-adrenergic blocking agents, such as prazosin, terazosin, and doxazosin, can antagonize the effects of midodrine hydrochloride tablets. (Midodrine label, Drug interactions)

Drug Interactions: ACE-inhibitors: Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. (Nabumetone label, Drug interactions)

The antihypertensive action of guanethidine and similar agents may be blocked. (Nortriptyline label, Warnings)

Antihypertensive effects of guanethidine and related compounds may be counteracted when phenothiazines are used concomitantly. (Prochlorperazine label, Precautions)

Alpha-adrenergic Antagonists The administration of dutasteride capsules in combination with tamsulosin or terazosin has no effect on the steady-state pharmacokinetics of either alpha-adrenergic antagonist. (Dutasteride label, Drug interactions)