What to avoid while taking carvedilol

Nearly half of all U.S. adults have high blood pressure or hypertension. High blood pressure also puts you at risk for heart failure, which is the leading cause of death in the U.S. according to the Centers for Disease Control and Prevention (CDC). Beta blockers are commonly prescribed to lower blood pressure and reduce the risk of heart disease. Coreg and its generic version, carvedilol, are considered a first line of defense for people who have had congestive heart failure. Beta blockers work to block hormones like epinephrine (adrenaline), which stimulate your heart and increase your heart rate.

Carvedilol not only reduces blood pressure but also helps to prevent heart attacks. Although carvedilol is well-tolerated and effective, like most medications, there are some important considerations you and your healthcare provider should discuss before taking it. Here, we discuss what you should avoid when taking the beta blocker.

How carvedilol works

Carvedilol works in two ways to treat high blood pressure and prevent heart failure. Primarily, “carvedilol reduces the effects of hormones like adrenaline on the heart,” says Jacob Hascalovici, MD, chief medical officer of Bliss Healthcare. “This helps to slow down the heart rate and decrease the force with which the heart contracts.” Specifically, he says, “It works by blocking certain receptors in the body known as beta receptors. These receptors are found in various tissues, including the heart.” 

While carvedilol’s main action is as a beta-blocker, it also works as an alpha-blocker. 

“Alpha receptors are found in blood vessels, and their activation can cause those blood vessels to narrow, resulting in increased blood pressure,” Dr. Hascalovici says. By blocking these alpha receptors, he says, “carvedilol helps to relax and widen the blood vessels, promoting easier blood flow and reducing blood pressure.” 

Because of its dual activities, carvedilol is one of the primary medications used to prevent heart problems and has been shown to decrease the likelihood of dying from a heart attack because it treats left ventricular dysfunction. 

4 foods and beverages to avoid with carvedilol

“We usually recommend taking carvedilol with a meal, as food can help your body better absorb the medication,” says Kelvin Fernandez, MD, founder of Ace Med Boards and a resident physician at Newark Beth Israel Hospital in New Jersey. The medication can lose efficacy, however, when paired with certain foods and drinks. 

The following foods and drinks may reduce carvedilol’s ability to work effectively or increase the risk of side effects.

1. Grapefruit

Grapefruit often causes drug interactions, making the medication less effective or more likely to cause side effects—not just carvedilol. 

“Grapefruit and its juice may interact with carvedilol and affect its metabolism in the body,” Dr. Hascalovici says. However, if you cannot start your day without a grapefruit or glass of grapefruit juice, Dr. Fernandez recommends speaking with a healthcare professional for an individualized treatment plan. Finding the balance between what your lifestyle allows and what’s best for your health is important.

2. Bananas

Because potassium-rich foods like bananas have been shown to potentially interact with carvedilol, you may want to eat them only in moderation. For instance, if you put multiple bananas in your morning smoothie, your carvedilol may increase your risk of hyperkalemia, an elevated level of potassium in the bloodstream. This can be more of a problem for patients with kidney problems or taking other medications that increase potassium levels. Therefore, discuss your intake of bananas and your potassium levels with your healthcare provider before beginning to take carvedilol. 

3. Alcohol

“It is generally recommended to limit or avoid alcohol consumption while taking carvedilol,” Dr. Hascalovici says. Alcohol raises blood pressure, so drinking while taking carvedilol can be dangerous—this is especially true if you’ve just started taking the medication and are not sure how you react to it or how your blood pressure responds. You may feel dizzy or lightheaded when combining carvedilol and alcohol. If that’s the case, stop consuming alcohol and speak with your healthcare provider.    

4. Caffeine 

Many people report feeling jittery after consuming caffeinated beverages when taking carvedilol. Too much caffeine, like the other items on this list, can reduce the efficacy of the prescription drug. 

What else should you avoid while taking carvedilol?

There are a few other considerations you should make regarding your lifestyle if you need to take carvedilol. Some of them only apply when you first start taking the medication, as your body is getting used to it and you’re more likely to be prone to dizziness and lightheadedness. Some, however, depend on your condition and other medications.

Driving, if you feel dizzy

Some people feel dizzy when they first begin taking carvedilol. If this is the case for you, you should avoid driving or doing other activities that require being extremely alert and coordinated,  like biking, until you feel better or get assessed by your healthcare provider. 

Strenuous exercise

While moderate exercise is good for you in general to keep your heart healthy and blood pressure down, you may not want to exercise as strenuously, at least while your body is getting used to carvedilol. Carvedilol may cause shortness of breath and lightheadedness. Keep in mind that if you play sports at a competitive level, carvedilol may not be allowed. 

Birth control, potentially

While many medications can affect how well hormonal birth control works, carvedilol is not one of them. You can continue to take your usual contraception medication. However, if you have hypertension, many birth control medications are not recommended, so keep this in mind and discuss your complete history with your healthcare team. 

Certain medications

There are many medications that are not recommended when taking carvedilol. For instance, cold and allergy medicines, particularly those with a decongestant, can increase your blood pressure. 

“It’s important to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs, herbal supplements, and prescription medications,” Dr. Hascalovici says. “Some medications can interact with carvedilol, such as certain blood pressure medications, heart medications, or drugs that affect liver enzymes.”

Stopping your medication abruptly

It’s not safe to interrupt or discontinue using carvedilol without your healthcare provider’s consent. If you do, you could experience severe chest pain, a heart attack, or an irregular heartbeat. Instead, you’ll need to work with your provider to plan a gradual decrease of the dose of carvedilol over a one to two-week period. 

Gastrointestinal side effects of carvedilol

Like any medication, carvedilol has some side effects. The most commonly reported side effects of taking this medication are low blood pressure, dizziness, fatigue, and gastrointestinal issues. These include:

• Nausea 
• Vomiting 
• Diarrhea 
• Stomach discomfort

One serious side effect associated with carvedilol is internal bleeding. “Beta blockers like carvedilol causing gastrointestinal bleeding is quite rare,” Dr. Fernandez says. “Yet, if someone already has a history of stomach issues, the risk might increase.” 

It’s important to go over your complete health history with your healthcare provider before starting the medication so they can help prevent side effects and risks. Be sure to speak with your provider if you experience any adverse side effects. They can provide medical advice to help you decide if carvedilol is the right medication for you or if there’s a better fit.