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At a glance

Ivabradine is used for symptomatic treatment of chronic stable angina pectoris in coronary artery disease patients with normal sinus rhythm.

Indications
  • Symptomatic treatment of chronic stable angina pectoris (in coronary artery disease patients with normal sinus rhythm)
Pharmacology

Ivabradine is a pure heart rate lowering agent that acts by selective and specific inhibition of the cardiac pacemaker If current that controls the spontaneous diastolic depolarization in the sinus node and regulates heart rate. By decreasing heart rate, Ivabradine decreases the cardiac workload and oxygen consumption. Concomitantly, it prolongs diastole allowing increased perfusion of coronary arteries and increased oxygen supply to the heart.

Dosage

Adult Dose (Oral):

  • Initial: 5 mg twice daily (with meals)
  • May be increased after 3-4 weeks to 7.5 mg twice daily, depending on therapeutic response
  • 1 tablet in the morning and 1 tablet in the evening during meals
  • Heart rate <50 bpm: Reduce dose to 2.5 mg twice daily; if persists, discontinue
  • Elderly (≥75 years): Initial: 2.5 mg twice daily

Renal Dose: CrCl >15 mL/min: No dose adjustment; CrCl <15 mL/min: Caution required

Hepatic Impairment: Mild: No dose adjustment; Moderate: Caution; Severe: Contraindicated

Child Dose: Not recommended

Side effects

Common Side Effects:

  • Slow heart rate (bradycardia)
  • Headache
  • Luminous phenomena (Enhanced brightness)
  • High blood pressure
  • Visual symptoms (blurred vision)
  • 1st degree AV block
  • Ventricular extrasystoles
  • Dizziness
Use in pregnancy

Use in Pregnancy: Unsafe during pregnancy; definite evidence of risk to developing baby; contraindicated in pregnancy.

Precautions & warnings

Precautions:

  • Ivabradine may affect your ability to drive (transient luminous phenomena including phosphenes, especially when driving at night)
  • May cause dizziness or sleepiness; do not drive or do anything requiring concentration until you know how it affects you
  • Temporary changes in vision (enhanced visual brightness) may occur within first 2 months of treatment, gradually resolve
  • Monitor blood pressure (may increase)
  • Monitor heart rate (low heart rate is common side effect)
  • Caution in mild to moderate hypotension, atrial fibrillation, QT syndrome patients
Overdose effects

Overdose: Severe bradycardia may occur; symptomatic supportive treatment; for symptomatic bradycardia, consider IV atropine or pacing.

Storage conditions

Keep below 30°C temperature, away from light & moisture; keep out of reach of children.

Ivabradine — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.