The primary aim of preventing variceal bleeding in liver cirrhosis is to reduce portosystemic pressure gradient. Carvedilol is a non- selective beta blocker with selective inhibition of α- 1 receptor and blockage of calcium channel. This paper reviews the role of carvedilol in reducing hepatic venous pressure gradient and preventing variceal bleeding. Analysis has shown that carvedilol is superior to propranolol in reducing portosystemic pressure gradient. Carvedilol may be similar to propranolol or endoscopic ligation for the primary and secondary prevention of variceal bleeding. Further randomized controlled trials with a larger sample size are warranted to confirm these findings.
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