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Ivabradine (cardiovascular agent)

Uses|Precautions & warnings|Side effects|Interactions|Dosage

Ivabradine is a generic drug for treating certain types of heart failure and cardiac conditions. It works by slowing down heart muscle contractions and prolonging diastolic time.

ivabradine

Uses

What is Ivabradine used for?

This drug is used for:

  • Stable angina pectoris
  • Chronic heart failure with reduced ejection fraction
  • Coronary artery disease (CAD)

How should I take Ivabradine?

Read the directions on the packaging for complete information. Check the label and expiration date.

Take the tablets by mouth, swallowing it whole. Do not crush, chew, or dissolve it in liquid. It is best to take it with meals.

How do I store Ivabradine?

This product is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer.

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Ivabradine?

Before using this drug, tell your doctor if you are/have:

  • Pregnant or breastfeeding.
  • Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
  • An allergy to any of the ingredients of this product.
  • Any other illnesses, disorders, or medical conditions.

Is it safe during pregnancy or breast-feeding?

Please always consult with your doctor to weigh the potential benefits and risks before taking Ivabradine. Ivabradine is pregnancy risk category D according to the US Food and Drug Administration (FDA).

This drug may cause fetal toxicity in pregnant women who are taking it, based on positive findings in animal studies. Women are advised to avoid pregnancy while taking this drug by using one or more methods of contraception, like condoms and/or oral contraceptive pills.

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from Ivabradine?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

  • Blurred vision
  • Bradycardia (slow heart rate)
  • Cardiac arrhythmias
  • Syncope (fainting)
  • Hypotension (low blood pressure)
  • Asthenia
  • Fatigue
  • Headache
  • Dizziness
  • Nausea
  • Constipation, diarrhea
  • Difficulty breathing
  • Muscle cramps
  • Skin reactions or rash
  • Angioedema
  • Hyperuricemia
  • Elevated creatinine levels

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Ivabradine?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects.

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

Drugs with known interactions:

  • Quinidine
  • Pimozide
  • Disopyramide
  • Rifampicin
  • Barbiturates
  • Phenytoin

Potentially fatal drug interactions may occur with:

  • Azole antifungals
  • Macrolides
  • HIV protease inhibitors
  • Verapamil
  • Diltiazem

If you experience an adverse drug interaction, stop taking this drug and continue taking your other medication. Inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with Ivabradine?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Avoid eating or drinking grapefruit products. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Ivabradine?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Bradycardia
  • Hypovolemia
  • Hypotension
  • Decompensated heart failure
  • Liver impairment
  • Have a pacemaker

Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Chronic heart failure

  • Start taking 5 mg twice a day. If after 2 weeks heart rate is consistently above 60 beats per minute (bpm), increase the dose to 7.5 mg twice a day. If the heart rate goes below 50 bpm, reduce the dose to 2.5 mg twice a day.
  • For elderly patients (75 years and older), start with 2.5mg twice a day. Increase dose if necessary.

Chronic stable angina pectoris in CAD patients (with normal sinus rhythm)

  • Start with 5 mg twice a day or less, two times a day. If necessary, increase the dose to 7.5 mg twice a day after 3 to 4 weeks. Decrease the dose to 2.5 mg if patient’s heart rate goes below 50 bpm.
  • For elderly patients (75 years and older), start with 2.5mg twice a day. Increase dose if necessary.

What is the dose for a child?

There is no established pediatric dose. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Ivabradine available?

Ivabradine is available in the following brand(s), dosage forms, and strengths:

  • Coralan FC (film-coated) tablets: 5 mg, 7.5 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Ivabradine https://www.mims.com/philippines/drug/info/ivabradine?mtype=generic Accessed June 22, 2021

Coralan https://www.mims.com/philippines/drug/info/coralan Accessed June 22, 2021

Ivabradine (Oral Route) https://www.mayoclinic.org/drugs-supplements/ivabradine-oral-route/side-effects/drg-20138533?p=1 Accessed June 22, 2021

Ivabradine https://www.ncbi.nlm.nih.gov/books/NBK507783/ Accessed June 22, 2021

Ivabradine. Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed June 22, 2021. http://online.lexi.com

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Written by Stephanie Nicole Nera, RPh, PharmD Updated Jun 22
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