A 45-year-old man with dilated cardiomyopathy (LVEF 25%) is started on carvedolol. The initial dose is 3.125 mg twice daily. According to guideline-directed medical therapy protocols, what is the target evidence-based dose of carvedolol in HFrEF?

• A 100 mg once daily
• B 50 mg twice daily
• C 25 mg twice daily ✓
• D 12.5 mg twice daily

Explanation

The landmark trials (MOCHA, COPERNICUS) used carvedolol target dose of 25 mg twice daily in patients weighing >85 kg, or 25 mg twice daily for most patients. The dose is uptitrated every 2 weeks from the starting dose. Metoprolol succinate (not tartrate) targets 200 mg once daily. Carvedolol 50 mg twice daily exceeds the evidence-based target and is not standard.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.