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Anesthetics: Hypotensive effects of carvedilol may be potentiated by general anesthetics, and anesthetic that cause myocardial depression such as ether, cyclopropane, and trichloroethylene should preferably be avoided.
Antiarrhythmics: Use of carvedilol with antiarrhythmic drugs and other drugs affecting cardiac conduction can precipitate bradycardia and heart block. Quinidine and carvedilol have negative inotropic action on the heart; bradycardia and hypotension have occurred in patients given with carvedilol.
Antibacterials: Plasma concentration of Carvedilol may be reduced by rifampicin.
Antidepressants: Bradycardia and heart block, occurring shortly after starting fluoxetine therapy have been reported. Use of fluoxetine increased the plasma concentration of Carvedilol in patients with heart failure but no clinical effects were noted.
Antihypertensive: An enhanced antihypertensive effect is seen when other antihypertensives are given with betablockers. Carvedilol can potentiate the severe orthostatic hypotension that may follow the initial dose of alpha blockers prazosin and can exacerbate rebound hypertension following withdrawal of clonidine treatment.
Calcium Channel Blockers: Use of calcium channel blockers with beta blockers (Carvedilol) has resulted in hypotension, bradycardia, conduction defect, and heart failure.
Cardiac Glycosides: Carvedilol has been reported to increase plasma concentrations of digoxin.
Cyclosporin: Cyclosporin plasma concentrations increased when carvedilol was added to treatment regimen. It is recommended that cyclosporin concentrations should be monitored carefully if cyclosporin and carvedilol are used together.
