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carvedilol (coreg)to prevent esophageal varices

I just went through and completed 12 weeks of harvoni to cure hep c.
I had to have 3 bands put on non-bleeding varices in esophagus.

How to slowly decrease dosage of carvedilol used to stop/prevent more  esophageal varices? I took 6.25 tablet  twice a day for 10 days and heart bpm was really low at 39. My uppuer cheekbones swollen (eyes appear sunken), so I then reduced dosage to 5 mg twice a day for 8 days BUT HEART RATE is STILL 39 bpm. Yesterday I again reduced dosage to 3.125 mg twice a day. They want my heart rate to be around 60 bpm as the goal. QUESTION: 1. Is my dosage decrease plan safe enough (slow enough) to prevent danger from too quick of a withdrawl? 2. If this were you , would you do somthing differently? 3. Do you have any other ideas or hypothetical suggestion?
Thank you so much for your time :)
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Avatar universal
I have been prescribed carvedilol 3.125 mg twice a day, but I have ITP which is a low platelet disorder which I tend to bruise easily and do not clot, but this medication will be used for the vercies veins I have .  I have had surgery twice to put the band for the bleeding. My question is this medication carvedilol used for that
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2 Comments
thank you everyone for your comments, my major concern at this point is my platelets cause they are not at a normal range and have not been for awhile.  My platelets run in a 2 digit right now they are 47 so they are pretty low. My blood pressure is never high either, the blood pressure meds that I take at the moment are to help with my kidneys. I am going to call the doctor and get a better explanation .
You may want to post a new question of your own as this is an older thread from 2015

Do you have liver cirrhosis? This is the liver cirrhosis community.

But in any event we here are not medical professionals only patients. You should as you said discuss this with your doctor.

Best of luck
Avatar universal
It's my understanding that the goal is to keep the heart rate at 60 beats per minute. That means the pulse needs to be monitored. Every morning you check the heart rate and if it's below 60 bpm you would skip the dose. If it's above 60 bpm you take the dose. 60 bpm is still very low and can make you feel weak. I too was on nadalol beta blocker and had to lower the dosage by half but no longer take it.  That seems to be the way to take the Carvedilol too so check with your doc. The 39 bpm is very low. You could take a break from the meds altogether. 39 bpm is dangerous. Check with your doc asap.
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446474 tn?1446347682
COMMUNITY LEADER
Thank you for adding your own personal experience with Carvedilol (Coreg).
I hope dearjoanie finds it helpful.

As you said - our medical providers are always the best source for information when it comes to managing our own unique case of cirrhosis and its complications and symptoms.

Cheers,
Hector
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Avatar universal
I've been on Coreg for 2 years and it needs to be dialed in with your doctor. My BP would drift as low as 70's / 50's at times. But other than that, my bleeding has stopped. As Hector mentioned, this disease process is very individualized, so keep in touch with your medical team.
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446474 tn?1446347682
COMMUNITY LEADER
Hi. Thank you for writing.

Note that a beta-blocker treatment will not stop or prevent varices. Varices are a complication of cirrhosis and can only be "cured" when a person no longer has cirrhosis. The good news is that varices and the portal hypertension can usually be controlled (reducing the blood flow and pressure) with use of a beta-blocker.

Only your doctor who knows the extent of your cirrhosis and portal hypertension can advise you on how your should titrate your meds to the proper dosage for you. Each of us is different and each person's liver disease should be treated on an individual basis.

Typical treatment as recommended by the AASLD is the use of the nonselective beta-blockers propranolol or nadolol which do have dosage guidelines for the reduction of portal blood flow. I myself used nadolol for 6 years before my liver transplant and am only experienced in its use. I haven't seen any guidelines for the use of carvedilol.

I would suggest calling your doctor's office and asking how you should be titrating the dose for the most effective preventative effect.

Beta-blocker treatment has been shown to reduce the risk of a bleed (as well as Endoscopic variceal ligation (EVL) "banding") so it is definitely something worth using to help you manage your portal hypertension. Hopefully now you are cured of your hep C and your liver disease will start to improve and you will have a reduction of your portal hypertension.

Best to you.
Hector
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