Carvedilol as a protector against the cardiotoxicity induced by anthracyclines (doxorubicin)

The myocardium is a tissue rich in mitochondria, which are of great importance in the maintenance of cardiac function. Carvedilol is a non-selective beta-blocker which, besides its neuroprotective and vasculoprotective properties, has cardioprotective and antioxidant effects. The number of patients undergoing chemotherapy is increasing, and doxorubicin is one of the most potent antineoplastics. However, its use is frequently associated with cardiotoxicity, which results from the interaction between doxorubicin and the reduced form of exogenous nicotinamide adenine dinucleotide dehydrogenase (NADH-D), found in cardiac mitochondria, resulting in the production of reactive oxygen species (ROS). The aim of this review article is to revisit the available evidence on the cardioprotection of carvedilol when associated with doxorubicin and to explain the mechanisms underlying the benefits of their co-administration.