Side Effects Coreg

  Known side effects of Coreg include fatigue, sleep disorders, dizzyness,
  and GI pains.  (See for example SK Beecham site on Carvediolol).   My
  wife uses Coreg and suffers from all these side effects.  What are good
  counter measure drugs or non-drug therapies?
  What are most severve and cautionary drug interactions with Coreg?
  Thank you.
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Dear Keith,
Thank you for your question.  Coreg belongs to a class of medications called beta-blockers.  This class includes the following other medications: generic (brand name), - propranolol (Inderal), atenolol (Tenormin), Labetalol (Normodyne, Trandate), metoprolol (Lopressor), pindolol (Viskin), Nadolol (Corgard), and sotalol (Betapace).  These drugs work by binding to a receptor called the beta receptor.  Once this receptor is blocked the drug exerts its effect in various methods.  The heart rate is slowed, the blood pressure is lowered and heart rhythms are stabilized.  
Beta-blockers are used to treat high blood pressure, angina (chest pain), heart attacks, heart rhythm problems such as atrial fibrillation and more recently heart failure.  
Potential side effects include: >10 % mental depression, tiredness, weakness, dizziness
1-10% Bradycardia (slow heart rate), wheezing, irregular heart beat, reduced peripheral circulation, heartburn
<1% Rash, chest pain, constipation, decreased sexual activity, itching, nausea, vomiting, stomach discomfort, insomnia, heart failure, nightmares, confusion, headache, impotence, cold extremities.
Potential drug interactions include:
Increased effect of metoprolol - amiodarone, cimetidine, diltiazem, nifedipine, nicardipine, verapamil, flecainide, hydralazine, MAO inhibitors, quinidine, ciprofloxacin, propafenone, oral contraeptives, fluoxetine, sertraline.
Decreased effect of metoprolol - NSAIDS, salycylates, barbiturates, rifampin, clonidine.
The dosage and frequency depend upon the individuals metabolism and the drug being used.
There are no substitutes to beta-blockers. There are no drugs to counteract the side effects of beta blockers.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.