Efficacy and safety of carvedilol in patients with chronic heart failure receiving concomitant amiodarone therapy. Australia/New Zealand Heart Failure Research Collaborative Group

J Card Fail. 1998 Dec;4(4):281-8. doi: 10.1016/s1071-9164(98)90233-0.


Background: The beta-blocker/vasodilator carvedilol is found to have beneficial effects in patients with chronic heart failure. However, the safety and efficacy of this agent in the presence of concomitant amiodarone therapy has not been previously determined.

Methods and results: We retrospectively analyzed the Australia/New Zealand Carvedilol Heart Failure Research Collaborative Group study of 415 patients with mild to moderate ischemic heart failure where amiodarone was administered as part of the treatment therapy (in 52 patients). After the open-label carvedilol run-in, patients received carvedilol (target dose 25 mg twice daily) or placebo for an average of 19 months. The main adverse events during this double-blind period were worsened heart failure, hypotension/dizziness, bradycardia/atrioventricular block, and aggravation of angina. By Chi square analysis, carvedilol and amiodarone together were not associated with a greater overall incidence of adverse effects than either drug alone. The beneficial effects of carvedilol on left ventricular ejection that were observed in the main trial were preserved in the presence of amiodarone.

Conclusions: Carvedilol is a useful additional therapy for patients with chronic heart failure already receiving amiodarone. Carvedilol can be added to amiodarone in these patients without expectation of increased adverse effects or loss of clinical efficacy.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Aged
  • Amiodarone / therapeutic use*
  • Carbazoles / therapeutic use*
  • Carvedilol
  • Double-Blind Method
  • Drug Interactions
  • Drug Therapy, Combination
  • Female
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Hemodynamics / drug effects
  • Humans
  • Male
  • Propanolamines / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Vasodilator Agents / therapeutic use*
  • Ventricular Function, Left / drug effects


  • Adrenergic beta-Antagonists
  • Carbazoles
  • Propanolamines
  • Vasodilator Agents
  • Carvedilol
  • Amiodarone