Carvedilol not working for flushing - what else can help?
Carvedilol helps many people with severe flushing, but not all. Before deciding it has not worked, it is worth checking that the dose is right and that the flushing is the type that carvedilol treats. If it still does not help, there are other options, including medicines that work in a different way and laser to reduce the background redness. In some cases, if there has been a partial response, there is the possibility of increasing the dose.
Is it the right kind of flushing?
Beta-blockers such as carvedilol block the effect of adrenaline on the blood vessels of the face, so they work best for flushing triggered by stress, anxiety and emotion. Flushing triggered mainly by heat, alcohol or spicy food may respond less well.
Alternatives
- Propranolol: another beta-blocker - occasionally patients may respond to this even if carvedilol has not worked, but in general I find carvedilol to be more effective.
- Clonidine: works on the nervous system to stabilise the blood vessel response to thermal triggers, and is an option where beta-blockers are not tolerated or not effective. It is taken daily and the dose is built up over a few weeks.
- Vascular laser: where flushing happens on a background of permanent redness, treating that redness often makes the flushes less noticeable. Treating the vessels with laser can also reduce flushing over time.
- Trigger management: recognising and avoiding your own triggers remains important alongside any medicine.
Carvedilol not helping?
I can review your flushing, your triggers and your response to carvedilol, and advise on alternatives. Consultations can be in person or remote.
Related Articles
- Carvedilol for facial flushing
- Medications for facial flushing
- Stress and emotional flushing
- Side effects of flushing medications
