Carvedilol and Miconazole: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Carvedilol
Miconazole
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased carvedilol concentrations and an increased risk of bradycardia or heart block
Interaction Deep Dive
Concomitant administration of carvedilol with CYP2C9 inhibitors may increase the beta-blocking activity and result in additional slowing of heart rate or cardiac conduction. Amiodarone and its metabolite (inhibitors of CYP2C9 and P-gp) increased concentrations of the S(-)-enantiomer of carvedilol by at least 2-fold. Observe patients for signs of bradycardia or heart block, especially when adding one agent to preexisting treatment with the other1.
Why it happens (mechanism)
Inhibition of CYP2C9-mediated metabolism of carvedilol
Literature reports
1 report — tap to read
a) In a pharmacokinetic study of Japanese patients with heart failure (n=106), coadministration of carvedilol with small loading and maintenance doses of amiodarone increased the steady-state trough concentrations of S(-)-carvedilol by at least 2-fold 1.
Common questions
Can I take Carvedilol and Miconazole together?
Increased carvedilol concentrations and an increased risk of bradycardia or heart block Always confirm with your pharmacist or prescriber before making any change.
How serious is the Carvedilol and Miconazole interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Carvedilol or Miconazole need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: COREG(TM) oral tablets, carvedilol oral tablets. GlaxoSmithKline (per FDA), Research Triangle Park, NC, 2017. DailyMed
Keep reading about Carvedilol
Keep reading about Miconazole
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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