Carvedilol vs. Propranolol for Varice Prophylaxis?

Beta Blocker Choice for Varices

Ascites status

Refractory = not controlled by sodium restriction + max diuretics OR recurs within 4 weeks post-LVP.

SBP (systolic blood pressure, mmHg)

Creatinine (mg/dL)

Recent spontaneous bacterial peritonitis (last 3 mo)

AKI/HRS currently

On vasopressors

History of NSBB intolerance

Awaiting input

Enter patient factors and click Decide.

Dosing: Carvedilol 6.25 mg daily → 12.5 mg if tolerated. Propranolol start 20 mg BID; target HR 55–60; in severe ascites keep ≤80 mg/day. Hold NSBB if SBP < 90, AKI/HRS, on pressors, or sepsis.