Carvedilol: veterinary dose and monograph

At a glance

Drug class

Cardiovascular

Also known as

Carvil, Carca, Coreg

Species with doses

Dogs

General dose range

0.1–0.4 mg/kg PO q12h (titrate up slowly) — check the species tables for the indication

Routes

PO

Last reviewed

1 October 2026

Indications

• Chronic, COMPENSATED heart failure (dilated cardiomyopathy) — long-term myocardial protection (specialist)
• Tachyarrhythmias / rate control as an adjunct
• Systemic hypertension (combined beta/alpha blockade)

Carvedilol dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Chronic compensated CHF / arrhythmia (slow up-titration): Papich 5e: start 0.2 mg/kg PO q24h, increasing gradually to a maximum of 0.4 mg/kg q12h (1.5 mg/kg q12h was more effective in one report, but some dogs are refractory). Plumb’s p.203: start 0.2 mg/kg q12h (or ¼–½ of a 3.125 mg tablet q12h) and titrate slowly toward 0.8 mg/kg q12h (Rush); many dogs with CHF will not tolerate up-titration. Watch for decompensation; do not stop abruptly. Papich: no cat dose established.

Contraindications

Decompensated/acute congestive heart failure (stabilise first), significant bradyarrhythmia / high-grade AV block, hypotension, and bronchospastic disease (non-selective). Abrupt withdrawal (rebound). Diabetes (masks hypoglycaemia). Known hypersensitivity.

Species-specific warnings

Dogs: Only introduce in compensated heart failure and titrate slowly under cardiology guidance — abrupt or high starting doses can precipitate decompensation.

Adverse effects

• Worsening heart failure if started too high / too fast (negative inotropy)
• Bradycardia, hypotension, lethargy
• Bronchoconstriction (non-selective)
• GI upset; masks hypoglycaemia

Drug interactions

• Calcium-channel blockers (diltiazem)/other negative chronotropes: additive bradycardia/AV block/myocardial depression
• Digoxin: carvedilol raises digoxin levels (additive AV slowing)
• Other antihypertensives: additive hypotension
• CYP2D6 inhibitors: increased carvedilol levels

Pregnancy and lactation

Beta-blockers may cause fetal bradycardia/growth effects; use only if maternal benefit outweighs risk.

Monitoring

• Heart rate, rhythm (ECG), blood pressure during up-titration
• Signs of worsening CHF (resting respiratory rate, effort) at each dose increase
• Echocardiographic function over time (specialist follow-up)
• Never discontinue abruptly (taper)

Toxicity and overdose

Overdose: profound bradycardia, AV block, hypotension, heart failure, bronchospasm and CNS depression. Crucially, even at therapeutic doses, starting too high or up-titrating too fast can acutely DECOMPENSATE a heart-failure patient — the reason for the slow, cautious dosing schedule.

Management: GLUCAGON is the key antidote for beta-blocker overdose; plus atropine, IV fluids, high-dose catecholamines, and consider high-dose insulin-euglycaemia therapy/IV lipid emulsion for refractory cases. Treat bronchospasm; continuous ECG. For decompensation, manage heart failure and reduce/withdraw the drug.

Clinical pearls

• A combined beta/alpha-blocker with antioxidant action used (cardiology-guided) for chronic DCM heart failure — the goal is long-term remodelling benefit, not acute relief
• START LOW, GO SLOW: introduce only in COMPENSATED patients and up-titrate over weeks; starting too high can tip a heart-failure dog into decompensation
• Glucagon is the overdose antidote (beta-blocker class)
• Avoid in asthma/bronchospastic disease (non-selective) and never stop abruptly

Mechanism of action

Non-selectively blocks β1 and β2 adrenoceptors AND blocks α1 receptors (causing vasodilation that offsets some beta-blocker afterload effects), and is an antioxidant/free-radical scavenger. In chronic heart failure, gradual beta-blockade reduces the harmful chronic sympathetic overdrive, lowers heart rate and myocardial oxygen demand, and over time improves ventricular remodelling/function — the same evidence-based rationale as in human cardiology.

Formulations and products

• 3.125 mg tablet
• 6.25 / 12.5 / 25 mg tablet
• Carca / Carvil — 3.125 / 6.25 / 12.5 / 25 mg tablet, Tablet (human-label)
• Coreg — 3.125 / 6.25 / 12.5 / 25 mg tablet, Tablet (human-label)

Storage

Tablets: 15–30 °C, dry, protect from light.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other cardiovascular drugs

• Amlodipine
• Atenolol
• Benazepril
• Captopril
• Digoxin
• Diltiazem
• Dobutamine
• Dopamine

Frequently asked questions