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Thread: Carvedilol dosing: what's the maximum mg?

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    Default Carvedilol dosing: what's the maximum mg?

    I'm taking carvedilol to prevent me from having flare ups and to help keep the overall redness on my nose & cheeks down. I take 6,25 mg twice a day for about 4 years now. The first 3 years in combination with 100 mg minocycline and the past year in combination with 10 mg Isotretoine. (not only do I have redness, but also the acne)

    However, recently I've had a few flare-ups again, which was quite a shock since I haven't had them in a long time.
    So, I slowly upped the dose from 12,50 mg carvedilol a day, to 25 mg.
    I even tend to take another 6,25 in the late afternoon to really keep the redness to a minimum - so a total of 31,25 mg a day.
    I don't experience side effects as far as I know, but is this dose too dangerous?

    Is anyone else taking 25 mg or higher & is there a better improvement than with 12,50 mg?
    Last edited by Queensically; 8th June 2019 at 09:13 PM.

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    Quote Originally Posted by Queensically View Post
    I'm taking carvedilol to prevent me from having flare ups and to help keep the overall redness on my nose & cheeks down. I take 6,25 mg twice a day for about 4 years now. The first 3 years in combination with 100 mg minocycline and the past year in combination with 10 mg Isotretoine. (not only do I have redness, but also the acne)

    However, recently I've had a few flare-ups again, which was quite a shock since I haven't had them in a long time.
    So, I slowly upped the dose from 12,50 mg carvedilol a day, to 25 mg.
    I even tend to take another 6,25 in the late afternoon to really keep the redness to a minimum - so a total of 31,25 mg a day.
    I don't experience side effects as far as I know, but is this dose too dangerous?

    Is anyone else taking 25 mg or higher & is there a better improvement than with 12,50 mg?
    My doctor has prescribed Carvedilol for me to try but I've not taken it yet. There are some quite mixed opinions if you search the forum using the box on the top hand right corner. I'd say the majority of people say it increased their flushing, although a minority found it helped. A lot of medicines are very sensitive to how much you take, and can reduce flushing up to a certain point, and then increase it again above a certain amount - so I'd be cautious for that reason in increasing it. I don't think 25mg is a particularly high dose, though, as that is the initial dose my doctor prescribed, although often people start on a lower dose I agree.

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    In one of the studies on Carvedilol for Rosacea, one of doses used was 31.25mg per day so itís not unheard of https://www.jaad.org/article/S0190-9622(12)00440-9/pdf

    What effect has 10mg Isotretinoin had on your Rosacea, has it had any effect on your on your flushing / redness (either good or bad)?

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    Senior Member Brady Barrows's Avatar
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    I take 12.5 mg twice a day which is the recommended dosage but I do this for CHF. The study cited by Brooks states, "These results are encouraging, but further prospective controlled studies of carvedilol therapy for ETR are warranted to determine the optimal dosage, treatment duration, long-term therapeutic effects, and side effects.....Our study is a retrospective analysis and the number of patients is relatively small. More prospective studies, with larger series and comparative studies with a traditional b-blocker, such as propran- olol, are necessary to evaluate the effects of carvedilol therapy in ETR."

    Wouldn't that be nice if a group of rosaceans got together and sponsored their own study on this? Wouldn't it be nice if 10,000 rosaceans got together in one non profit organization and each one donated one dollar and all agreed that funding such a study that is recommended above is a good idea and sponsor such a study be done by reputable professionals in a double blind, placebo controlled, peer reviewed paper?

    This site states, "The recommended initial dosage is 12.5 mg twice a day for the first two days. Thereafter, the treatment is continued at the dose 25 mg twice a day. If necessary, the dose may be further increased gradually at intervals of two weeks or more rarely to the recommended maximum dose of 100 mg a day divided into two doses (twice daily)." Of course, this is not taking Carvedilol for rosacea. It would seem prudent to ask your physician if you should increase your carvedilol dosage for rosacea and be supervised and monitored while doing this.

    I rarely flush, or flush only as anyone else flushes in the normal population.

    I have been taking Carvedilol for over a couple of years and haven't ever noticed that it improves my ETR as the paper Brooks cites say it does.

    Here are some other papers:

    Carvedilol for the Treatment of Refractory Facial Flushing and Persistent Erythema of Rosacea
    Chia-Chi Hsu, MD; J. Yu-Yun Lee, MD; Department of Dermatology, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan
    Download pdf

    J Dermatolog Treat. 2017 Jul 27;:1-16
    Long term management of distinct facial flushing and persistent erythema of rosacea by treatment with carvedilol.

    Pietschke K, Schaller M
    Last edited by Brady Barrows; 10th June 2019 at 01:54 AM.
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    Quote Originally Posted by Queensically View Post
    I'm taking carvedilol to prevent me from having flare ups and to help keep the overall redness on my nose & cheeks down. I take 6,25 mg twice a day for about 4 years now. The first 3 years in combination with 100 mg minocycline and the past year in combination with 10 mg Isotretoine. (not only do I have redness, but also the acne)

    However, recently I've had a few flare-ups again, which was quite a shock since I haven't had them in a long time.
    So, I slowly upped the dose from 12,50 mg carvedilol a day, to 25 mg.
    I even tend to take another 6,25 in the late afternoon to really keep the redness to a minimum - so a total of 31,25 mg a day.
    I don't experience side effects as far as I know, but is this dose too dangerous?

    Is anyone else taking 25 mg or higher & is there a better improvement than with 12,50 mg?

    I used to take 50 mg per day and it did absolutely nothing for my neurogenic rosacea. I now take clonidine and propranolol with about 10% help but have added LDN ( low dose naltrexone) at 2 mg per night with much more benefit.

    Angela

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    Quote Originally Posted by Brooks View Post
    In one of the studies on Carvedilol for Rosacea, one of doses used was 31.25mg per day so itís not unheard of https://www.jaad.org/article/S0190-9622(12)00440-9/pdf

    What effect has 10mg Isotretinoin had on your Rosacea, has it had any effect on your on your flushing / redness (either good or bad)?
    Thanks for your reply - I wasn't able to find any articles describing a higher dose than 25 mg.

    10mg isotretinoin has been good for keeping my cysts away. I'm scared to come off it because after taking it every other day for a few months, I got a big cyst that left a scar...
    The thing is, I've noticed more flushing the past month & a half.
    I'm usually not a flusher since taking carvedilol but now it seems like I get a flare up daily.
    Since 2 days, I also feel burning on my cheeks. Especially when applying products, even though I've been using them for a while.
    I'm afraid Isotretinoin has made my skin too sensitive & that it's the cause of this burning sensation.

    I'm very upset about it, because I don't want to get off isotretoin in fear of my acne coming back...

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    Quote Originally Posted by Ange4 View Post
    I used to take 50 mg per day and it did absolutely nothing for my neurogenic rosacea. I now take clonidine and propranolol with about 10% help but have added LDN ( low dose naltrexone) at 2 mg per night with much more benefit.

    Angela
    Hi Angela,

    Would you say the flushing & redness is pretty much gone after taking a combination of propranolol, clonidine & LDN ?
    My dermatologist had no clue about LDN but I'm thinking of taking this along with carvedilol.

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