### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
HI At my last appointment with my heart specialist the doctor increased my dose of Carvidilol (Coureg) to 12.5mg twice per day in the hope that this would decrease the chances of an AFIB event, in fact he said I can eat anything now. Unfortunately over Christmas I had two or three AFIB events each of which subsided after a few hours and where my pulse fortunately never reached over 124 ppm ( at least when I checked it ). The reason for the events was probably due to over indulgence in foods that may have had higher levels of sodium chloride at the same time as drinking a lot of wine and on one occasion brandy. On a normal day my pulse is 49 to 52 in the morning and seldom gets above 65 even after some fairly heavy physical activity. It does go up to mid to high 60 s if I have two or three glasses of wine. Normally of course I am on a very low salt diet as my wife and I make almost everything from scratch ourselves without adding sodium chloride. The reason I am writing is that early March we are traveling to Australia for a month followed by a month cruising back to the US. I don t know whether I will be able to get low or no salt food on board the ship. I m wondering whether an even higher dose of coureg might be advisable during the trip to counter the unknown levels of salt I will encounter on the voyage. Thanx Keith Jones

### output:

Hello, Your dosage or Carvedilol is optimum and increasing it at present is not justified as you already have low borderline pulse (50) at rest and increasing the dose may bring it more low which would cause fatigue and weakness on routine activity. Mostly you would be able to tolerate normal salt in cooking. Just avoid breads, bakery products and preserved food as they have higher salt content. Avoid Bing Chat Doctor.  If you have an Atrial fibrillation episode, taking a higher dose e.g. 25 mg max of carvedilol single dose, would be ok. But taking on routine basis is not a good idea. Also discuss the need for anticoagulation with your doctor on next visit. Regards 