Does carvedilol improve clinical efficacy, hemodynamic, and metabolic effects compared to traditional beta-blockers in patients with cardiovascular diseases?
Carvedilol offers hemodynamic and metabolic advantages over traditional beta-blockers for cardiovascular diseases, though its clinical utility is somewhat limited by low bioavailability.
IMPORTANCE OF THE FIELD: Carvedilol, a non-selective beta-blocker, has recently drawn attention because of its therapeutic benefits over other prescribed analogues for the treatment of cardiovascular diseases (CVDs). AREAS COVERED IN THIS REVIEW: The present review attempts to present the clinical efficacy of carvedilol in comparison to other available beta-blockers. The literature search was carried out in three electronic databases (Unbound Medline, Pubmed and Sciencedirect) and internet search engines (Scirus and Google Scholar) without time constraints to ensure maximum literature coverage. WHAT THE READER WILL GAIN: A relatively large number of comparative studies have revealed that carvedilol has advantage over traditional beta-blockers with respect to hemodynamic and metabolic effects, due to its unique non-selective alpha-/beta-adrenoceptor affinity. Such results indicate its safe and effective therapeutic application particularly in patients with complicated CVDs, even in pediatric and geriatric patients. TAKE HOME MESSAGE: The therapeutic profile of carvedilol indicates its suitability for treatment of complicated CVDs than other non-selective beta-blockers. However, there is a limitation in terms of its dose due to its low bioavailability (approximately 25%). Therefore, there is still need for bioavailability enhancement and dose reduction to further improve the therapeutic efficacy of the drug.
Chakraborty et al. (2010) studied this question.