Coreg (Carvedilol) is a beta-blocker, a class of drugs used to treat various heart conditions including Congestive Heart Failure, Heart Damage (usually from a heart attack), and high blood pressure. While not all of its effects are completely understood, it primarily works by blocking the heart's response to adrenaline. This slows the heart, allowing it to pump more efficiently, preventing it from becoming overworked and possibly providing an opportunity for a damaged heart to heal, ultimately leading to an increased Ejection Fraction. Common side effects include (see http://www.rxlist.com/cgi/generic/carvedilol_ad.htm): Fatigue, Bradycardia (slow heart rate), Hypotension (low blood pressure), Syncope (fainting), Dizziness, Weight Gain, Diahrrea, Nausea, and Edema (swelling of feet and hands). The following steps are intended to help deal with the reduced heart rate and blood pressure, which are the underlying cause of many of the negative side effects.


Steps

1. Get regular exercise. During exercise, heart rate increases and blood pressure rises, directly counteracting the Coreg side effects. Exercise also strengthens the heart and improves cardiovascular function, making it easier for the body to deal with the reduced output caused by Coreg, even when not exercising.
2. Get plenty of sleep. Coreg causes fatigue and lethargy. In order to counteract this it is extremely important to get adequate sleep (at least 8 hours every night). Ideally, you should sleep on a regular schedule every night.
3. Time your dosage correctly. Coreg is usually administered twice daily. It remains in the system about 8 to 10 hours. Therefore it is best taken regularly about every 12 hours. Ideally the evening dosage should be taken at least 10 hours prior to the time you wish to wake up the following morning, otherwise the drug may make rising difficult.
4. Monitor your blood pressure. Many of Coreg's side effects are directly related to low blood pressure. Therefore, it may be helpful to monitor your blood pressure daily (automatic blood pressure cuffs are available at most pharmacies). Excessively low blood pressure (e.g. <90/<60) or heart rate (<55 bpm) may indicate that the Coreg dosage is too high and should be reduced.
5. Monitor symptoms. For most people, the extent of Coreg's side effects vary significantly from day to day. It may be useful to keep a journal of your symptoms. Note what activities you participated in (exercise, sleep, sitting, walking, etc...) within the previous 24 hours whenever symptoms change. Also, record what you ate and any other medications taken. This may help you identify patterns that lead to worsening or improvement of your symptoms.

Tips

• Exercise intensity should correspond to your own physical condition and should provide at least 20 minutes of cardiovascular stimulation (elevated heart rate).
• Exercise need not be overly rigorous. Even walking provides significant benefit. The most important thing is to be consistent. It is also helpful to increase intensity (walking speed) as your physical conditioning improves.
• Fatigue caused by Coreg is a common reason for not exercising. However, because this fatigue is caused by reduced circulation due to Coreg, it will quickly disappear once you start exercising and your heart begins to beat more rapidly. You will definitely feel better within a few minutes of beginning to exercise.

Warnings

• Heart patients should talk to their doctor before beginning a rigorous exercise program.
• Coreg can cause rapid changes in heart rate and blood pressure during and immediately following exercise. For this reason it is extremely important to perform an adequate warm up and cool down before and after exercising. Abruptly stopping rigorous exercise without an adequate cool down can lead to a rapid drop in heart rate and blood pressure, resulting in dizziness and/or fainting.
• Talk to a doctor before changing your dosage of Coreg.
• Do not abruptly discontinue use of Coreg, since this can lead to dangerously irregular and erratic heart rates. If you do plan to discontinue Coreg, it is extremely important to wean yourself off of the drug in a gradual and controlled manner.