Ivabradine

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Update Date 11/05/2020 . 7 mins read
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Uses

What is Ivabradine used for?

Ivabradine is used by people with a certain heart problem (chronic heart failure), to help prevent it from getting worse and needing treatment in a hospital. Heart failure is a condition where your heart does not pump blood as well as it should. Ivabradine works by making your heart beat more slowly. It should not be used if you have a slow resting heartbeat (less than 60 beats per minute) before starting ivabradine, low blood pressure, or if your heart failure symptoms have recently gotten worse. It is also given to patients who have stable angina pectoris (chest pain) and coronary artery disease.

How should I take Ivabradine?

Take this medication by mouth with a meal as directed by your doctor, usually twice daily. The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Other medications are usually used along with ivabradine to treat heart failure. Carefully follow your doctor’s directions for taking all your medications.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

Tell your doctor if your condition does not improve or if it worsens.

How do I store Ivabradine?

Ivabradine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Ivabradine in the bathroom or the freezer. There may be different brands of Ivabradine that may have different storage needs. 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 Ivabradine down the toilet or pour them into a drain unless instructed to do so. 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 taking ivabradine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver problems, other heart problems (such as sick sinus syndrome, heart block, irregular heartbeat, pacemaker use).

This drug may make you dizzy or cause vision changes. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Be especially careful when driving at night because sudden changes in light brightness can happen, which may set off vision changes. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Discuss the use of reliable forms of birth control (such as condoms, birth control pills) with your doctor. If you become pregnant or think you may be pregnant, tell your doctor right away. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Because of the possible risk to the infant, breastfeeding while using this drug is not recommended. Consult your doctor before breast-feeding.

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).

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

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.

Side effects

What side effects can occur from Ivabradine?

Dizziness or tiredness may occur. If either of these effects persists or worsens, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Ivabradine may rarely cause vision changes such as brief increased brightness, or seeing halos or colored bright lights. Sudden changes in light brightness may set off this effect. If vision changes happen, they usually start within the first 2 months and may go away during treatment or after stopping this medication.

Tell your doctor right away if you have any serious side effects, including: slow/fast/irregular heartbeat, fainting.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Ivabradine?

Other medications can affect the removal of ivabradine from your body, which may affect how ivabradine works. Examples include azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, telithromycin), diltiazem, HIV protease inhibitors (such as nelfinavir, ritonavir), nefazodone, rifamycins (such as rifabutin, rifampin), St. John’s wort, verapamil, drugs used to treat seizures (such as carbamazepine, phenobarbital, phenytoin), among others.

Ivabradine 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. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Ivabradine?

Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.

Ivabradine may interact with food or alcohol by altering the way the drug works or increasing the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Ivabradine?

Ivabradine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Do not take this medication if you have bradycardia (slow heart rate), hypovolemia (low blood pressure), decompensated heart failure, hepatic impairment, or are dependent on a pacemaker.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Ivabradine.

What is the dose of Ivabradine for an adult?

Usual Adult Dose for Congestive Heart Failure

Initial dose: 5 mg orally twice a day with meals.

After 3 to 4 weeks, increase the dose to 7.5 mg orally twice a day

For elderly patients: 2.5 mg twice a day.

Comments:

-In patients with a history of conduction defects or in patients whom bradycardia could lead to hemodynamic compromise, start with 2.5 mg orally twice a day.

-Assess after 2 weeks and adjust dose to maintain tolerability and achieve resting heart rate between 50 and 60 beats per minute (bpm); if resting heart rate is greater than 60 bpm, increase by 2.5 mg twice daily to a maximum of 7.5 mg twice daily; if resting heart rate is less than 50 bpm or bradycardia signs and symptoms occur, decrease by 2.5 mg twice daily (discontinue if current dose is 2.5 mg orally twice a day).

Use: To reduce worsening heart failure hospitalization risk in patients with stable, symptomatic chronic heart failure and left ventricular ejection fraction (LVEF) at or below 35%, who are in sinus rhythm with resting heart rate at or above 70 bpm and are either unable to tolerate or have a contraindication to beta-blockers.

Renal Dose Adjustments

CrCl 15 to 60 mL/min: No adjustment recommended

CrCl less than 15 mL/min: Data not available

Liver Dose Adjustments

Mild to moderate liver dysfunction: No adjustment recommended

Severe liver dysfunction (Child-Pugh C): Contraindicated

Other Comments

Administration advice: Take with meals.

Monitoring:

-Monitor cardiac rhythm regularly.

-Monitor heart rate decreases and bradycardia symptoms.

Patient advice:

-Apprise pregnant women of the potential risks to a fetus.

-Instruct females of reproductive potential to use effective contraception and to notify their healthcare provider with a known or suspected pregnancy.

-Encourage patients to report significant decreases in heart rate or symptoms such as dizziness, fatigue, or hypotension.

-Notify patients to report symptoms of atrial fibrillation such as heart palpitations or racing, chest pressure, or worsened shortness of breath.

-Advise patients of the possible occurrence of luminous phenomena (phosphenes) and to use caution if they are driving or using machines in situations where sudden changes in light intensity may occur, especially when driving at night.

What is the dose of Ivabradine for a child?

The dosage has not been established in pediatric patients. 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 your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Ivabradine, 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.

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

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