coreg vs toprol xl

[motherofTrent]

Dr. Fett,

I am on 25 mg of Toprol XL. I keep hearing about the benefits and effects of Coreg, from this and a couple of other sites, and from friends who are on it for other diagnosis. What is the difference between the two and is coreg any better than toprol?

[JAMESFETT]

Both are very good, and I am satisfied when I learn that any PPCM patient is on one or the other from the earliest moments tolerated. They compose the best of the beta-blocker component. The other essential component is the ACE-Inhibitor group, of which there are several. There have been reports suggesting that Coreg (carvedilol) may have more effect in helping the heart return to its more normal shape, but that has not been evaluated extensively. Whichever is used, it is important to aim for the maximum recommended dosage as tolerated and needed for improving left ventricular function.

JD

[JAMESFETT]

P.S. Of course they are both beta blockers, but they are not the same chemically and carvedilol is more of a "new generation" beta blocker. While both are considered "non-selective," carvedilol has an additional alpha-blocker effect, and that may confer different benefits. For example, carvedilol has some effects against what are called "proinflammatory" cytokines, such as tumor necrosis factor, and it appears those are involved in the cardiomyopathic process in PPCM. So if one can combat those abnormal and pathological cytokines there is a potential benefit in addition to the purely hemodynamic effects on the pumping of blood.

JD