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Key takeaways
Carvedilol is a beta-blocker used to treat high blood pressure or heart failure, or to reduce the risk of death after a heart attack. For individuals looking for alternatives to carvedilol, some examples include Coreg CR, Toprol XL, or Zebeta.
Beta blockers, ACE inhibitors, diuretics, and calcium channel blockers are among the various classes of drugs that can serve as alternatives to carvedilol for managing blood pressure and heart conditions.
Coreg CR, Toprol XL, Zebeta, Entresto, and Zestril are highlighted as common substitutes, each with specific uses, dosages, and potential savings options.
Healthy lifestyle changes, including a heart-healthy diet, regular exercise, and potentially beneficial supplements like omega-3 fatty acids and CoQ10, are recommended alongside or as an alternative to medication, with consultation from a healthcare provider.
Compare carvedilol alternatives | Coreg CR | Toprol XL | Zebeta | Entresto | Prinivil and Zestril | Natural alternatives | How to switch meds
Carvedilol, known by the brand name Coreg, is part of a group of drugs called beta blockers. It is FDA approved to treat high blood pressure (hypertension) and heart failure. It may also be prescribed to reduce the risk of death after a heart attack (myocardial infarction).
Carvedilol is an effective drug for many people. However, a healthcare provider may recommend alternatives depending on the condition being treated. Some people may experience intolerable side effects of carvedilol, find that carvedilol isn’t working for them, or have trouble with the dosing schedule of carvedilol.
Choosing a carvedilol alternative is not a one-size-fits-all solution, and there are several drugs that can be used to replace carvedilol for hypertension or heart problems. Continue reading to learn more about carvedilol alternatives, how they’re used, and how to switch from carvedilol to a new drug.
What can I take in place of carvedilol?
Different treatment options are available that can be used as alternatives to carvedilol. For example, there are a few different beta blockers that are similarly effective to carvedilol for treating hypertension or heart failure. Only two other beta blockers are currently FDA-approved to treat heart failure: Toprol XL (metoprolol succinate) and Zebeta (bisoprolol).
Carvedilol is a non-selective beta blocker that blocks beta-1 and beta-2 receptors in the body. Beta-1 receptors primarily affect the heart rate and strength of the heart’s contraction, while beta-2 receptors mainly affect the smooth muscle of the blood vessels and airways. Carvedilol also blocks alpha 1-adrenergic receptors, which can help dilate the blood vessels and lower blood pressure. In addition to carvedilol, non-selective beta blockers include propranolol, nadolol, and labetalol.
Some beta blockers are cardioselective because they primarily block the beta-1 receptors in the heart. Cardioselective beta blockers include metoprolol, bisoprolol, and nebivolol. beta blockers that are selective for beta-1 receptors may cause fewer certain side effects, such as bronchoconstriction, than non-selective beta blockers.
Other examples of drugs for blood pressure or heart problems may include angiotensin-converting enzyme (ACE) inhibitors, diuretics, and calcium channel blockers. Some drugs, including Entresto (sacubitril/valsartan) and Corlanor (ivabradine), have unique mechanisms of action and may also be used for heart failure.
Compare carvedilol alternatives |
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|---|---|---|---|
| Drug name | Uses | Dosage | Savings options |
| Coreg (carvedilol) |
|
3.125 mg twice daily to 25 mg twice daily | Coreg coupons |
| Coreg CR (carvedilol extended-release) |
|
10 mg to 80 mg once daily | Coreg CR coupons |
| Toprol XL (metoprolol succinate) |
|
12.5 to 100 mg once daily | Toprol XL coupons |
| Zebeta (bisoprolol) |
|
2.5 to 20 mg once daily | Bisoprolol coupons |
| Entresto (sacubitril/valsartan) |
|
24 mg/26 mg to 97 mg/103 mg twice daily | Entresto coupons |
| Prinivil, Zestril (lisinopril) |
|
2.5 to 80 mg once daily | Zestril coupons |
| Calan SR (verapamil) |
|
120 mg once daily to 240 mg twice daily | Calan SR coupons |
| Aldactone (spironolactone) |
|
12.5 mg once daily to 25 mg twice daily | Aldactone coupons |
| Cozaar (losartan) |
|
50 to 100 mg once daily | Cozaar coupons |
| Corlanor (ivabradine) |
|
2.5 to 7.5 mg twice daily | Corlanor coupons |
| Bidil (hydralazine/isosorbide dinitrate) |
|
20 mg/37.5 to 40 mg/75 mg three times daily | Bidil coupons |
Other alternatives to carvedilol
- Tenormin (atenolol)
- Inderal (propranolol)
- Blocadren (timolol)
- Bystolic (nebivolol)
- Trandate (labetalol)
- Lopressor (metoprolol tartrate)
- Lanoxin (digoxin)
- Calan SR (verapamil)
- Cardizem (diltiazem)
- Lasix (furosemide)
Top 5 carvedilol alternatives
The following are some of the most common alternatives to carvedilol.
1. Coreg CR (carvedilol extended-release)
Coreg CR is the brand-name version of carvedilol extended-release capsules. Some people may have trouble remembering to take regular immediate-release carvedilol, which needs to be taken twice daily. Taking carvedilol extended-release capsules provides the same benefits as immediate-release carvedilol tablets and can be taken once daily.
2. Toprol XL (metoprolol succinate)
Toprol XL is the brand name of metoprolol succinate, a cardioselective beta blocker approved to treat chronic heart failure. It can also be used to lower blood pressure and treat chest pain (angina). Metoprolol succinate is generally prescribed in people with heart failure with reduced ejection fraction to reduce the risk of hospital visits and improve survival. Metoprolol succinate may also be preferred over non-selective beta blockers for people with heart failure and chronic obstructive pulmonary disease (COPD). The most common side effects of metoprolol succinate include tiredness, dizziness, diarrhea, rash, and low blood pressure (hypotension).
3. Zebeta (bisoprolol)
For people with heart failure and hypertension, Zebeta (bisoprolol) is an effective treatment option that may be prescribed instead of carvedilol. Bisoprolol is a cardioselective beta blocker that has been shown by clinical trials to be similarly effective to carvedilol and metoprolol succinate for reducing the risk of death from heart failure. Like other cardioselective beta blockers, bisoprolol may be a preferred option for people with heart failure and COPD. Bisoprolol has a long half-life and can be taken once daily. The most common adverse effects of bisoprolol include dizziness, weakness, headache, and diarrhea. However, bisoprolol may also cause fewer side effects of fatigue than non-selective beta blockers like carvedilol.
4. Entresto (sacubitril/valsartan)
Entresto is a combination drug containing sacubitril and valsartan. It is part of a unique class of drugs called angiotensin receptor neprilysin inhibitors (ARNIs). Entresto is approved to reduce the risk of hospitalization and death in people with chronic heart failure with reduced or preserved ejection fraction. It is typically taken as an oral tablet twice daily. The most common side effects of sacubitril/valsartan are dizziness, hypotension, hyperkalemia, and cough.
5. Prinivil, Zestril (lisinopril)
Prinivil and Zestril are brand names for lisinopril, an ACE inhibitor approved to treat hypertension and congestive heart failure. Lisinopril can also be prescribed after a heart attack to improve survival. It works by relaxing and widening the blood vessels to lower blood pressure and reduce stress on the heart. ACE inhibitors are typically considered first-line agents for hypertension, and they’re often prescribed together with other drugs, such as beta blockers, for heart failure. The most common side effects of lisinopril include dizziness, headache, hypotension, and cough.
Natural alternatives to carvedilol
In addition to prescription medications, healthcare providers may recommend healthy lifestyle changes for heart conditions, including a heart-healthy diet and exercise plan. Although there are no FDA-approved supplements to treat heart disease, there is supporting research for the use of certain supplements. However, it’s important to consult a healthcare provider before using a supplement, as supplements should complement an overall treatment plan.
Diet
Diet is an essential part of maintaining good heart health. Certain diets, such as the Mediterranean and DASH diets, are considered optimal diets for keeping things like blood pressure and cholesterol levels in check. General ways to eat a healthy diet include eating a lot of fresh fruits and vegetables, eating lean sources of protein, and minimizing intake of processed foods, sugars, salt, and alcohol.
Exercise
Regular exercise can help promote cardiovascular health by strengthening the heart, improving circulation, and increasing overall muscle strength. Exercising can also help reduce chronic inflammation and protect against vascular stress. It is recommended to do at least 150 minutes of moderate-intensity or 75 minutes of high-intensity aerobic exercise each week. Starting small and spreading out the time spent exercising throughout the week (for example, exercising for 30 minutes five days each week) can be a good way to start the habit of exercising.
Supplements
Certain supplements may help improve heart health. For example, omega-3 fatty acids may help lower triglyceride levels. In addition, research suggests that omega-3 fatty acids may help reduce the risk of cardiac death in people with heart failure. Coenzyme Q10 (CoQ10) is a vitamin-like antioxidant that may also be useful for heart failure patients. Research has shown that CoQ10 may help reduce the risk of cardiovascular events in heart failure patients. Other heart-healthy supplements include garlic, magnesium, and vitamin D.
How to switch to a carvedilol alternative
The process for switching beta blockers will depend on a person’s overall condition and the dosage being taken, among other factors. It’s important to work with a healthcare provider to ensure maximum safety and effectiveness when switching drugs.
When switching to a different beta blocker, the dose of the new beta blocker should be equivalent to or lower than the prescribed dose of carvedilol. In some cases, a healthcare provider will recommend starting at a low dose of the new drug and gradually increasing the dose over a few weeks. Starting at a low dose of a new medication is a conservative way to prevent side effects and ensure the new drug is the right treatment option. A healthcare provider may also want to monitor the possibility of adverse effects on blood pressure, blood sugar, and other laboratory values when switching between beta blockers.
Always work with a healthcare provider when switching medications. Abruptly stopping a beta blocker like carvedilol may lead to severe problems, including changes in heart rhythm, serious chest pain, or a heart attack.