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Pharmacy and Medications

Carvidilol and weight gain

04/12/2006

Question:

Would a dose of 12.5mg twice a day contribute to weight gain since dose has been doubled have put on 2 stone would this be connected I have not ate much extra

Answer:

A stone is a measure of weight equivalent to 14 pounds. Two stone is 28 pounds.

Carvedilol is a newer medicine used to treat high blood pressure, angina and congestive heart failure. It acts as both a nonselective beta blocker and alpha receptor blocker. According to the package insert, weight gain has been reported in around 10% of patients taking carvedilol compared to 7% of patients taking placebo.

Beta Blocker medications have, in general, been associated with weight gain during their use. In one study about 23% of high blood pressure patients treated with non-selective beta blockers gained weight. Typical weight gains for these patients have been reported to average around 1.2 kg (2.6 pounds), but ranged up to about 3.5kg (7.7 pounds or about a half stone). Larger weight gains during betablocker use are possible, but less likely. For example, one patient treated for migraines with propranolol 80mg twice daily gained 9 kg (19.2 pounds, 1.41 stone) during 9 months of therapy. Weight gain generally occurs during the first year of therapy, and could possibly be attributed to reductions in energy metabolism, though other reasonable explanations exist.

Another study attempted to use this known side effect to document reversal of severe weight loss (cachexia) in patients with congestive heart failure. Study patients received either carvedilol (target dose 25mg twice daily) or sustained release metoprolol (target dose 200mg) and had an average weight gain of 5.2 ± 9.6kg over the six month study period. The maximum gain was 14.8kg (around 2 stone), but non-cachectic patients gained an average of 0.8kg and no more than around 6 kg. There was no difference in the weight gain between carvedilol and metoprolol groups.

Weight gain of 28 pounds is significant. It seems clear that carvedilol could contribute to this weight gain. However, a 28 pound gain is larger than would typically be expected from carvedilol alone. Some patients taking carvedilol can retain fluid, which manifests as rapid weight gain. Whether the weigh gain you describe is due entirely or in part to your carvedilol is worth further investigation. Ask your doctor. He may want to change your medicine, recommend a dietician to help you develop a diet plan to help you lose weight, or have other strategies to help you maintain a healthy weight.

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Response by:

Robert James Goetz, PharmD, DABAT
Assistant Professor of Pharmacy Practice
College of Medicine
University of Cincinnati