Carvedilol Beyond the Heart: Pleiotropic Mechanisms and Emerging Therapeutic Applications Across Organ Systems

Carvedilol (CVR) is a nonselective β1- and β2-adrenergic receptor antagonist with additional α1-adrenergic blocking activity, commonly used to treat heart failure, hypertension, and left ventricular dysfunction following myocardial infarction. Beyond its established cardiovascular indications, increasing evidence suggests that CVR exhibits diverse pleiotropic effects, including anticancer, neuroprotective, hepatoprotective, renoprotective, cardioprotective, anti-inflammatory, and anti-arthritic activities. A comprehensive literature search was conducted in Web of Science, PubMed, Scopus, and Google Scholar, including English-language full-text studies reporting preclinical or clinical evidence of CVR's non-cardiovascular therapeutic effects. This review synthesises findings from 167 experimental and clinical studies that evaluate the molecular mechanisms, translational relevance, and therapeutic potential of CVR beyond cardiovascular disease. Current evidence indicates that CVR modulates oxidative stress, inflammation, apoptosis, and multiple cell-survival signalling pathways across diverse organ systems. Although most evidence remains preclinical, the growing body of data highlights CVR as a promising candidate for therapeutic repurposing and warrants further clinical investigation.