Ivabradine

Ivabradine is a prescription medication used to treat long-lasting heart failure in patients who are stable and have a resting heart rate of at least 70 beats per minute. Patients must also be taking a beta-blocker at the highest dose they can tolerate.

Ivabradine belongs to a group of drugs called hyperpolarization-activated cyclic nucleotide-gated channel blockers. Ivabradine regulates the pacemaker activity of the heart.

This medication comes in tablet form and is taken 2 times a day, with meals.

Common side effects of ivabradine include slow heart rate, high blood pressure, irregular heartbeat, and seeing flashes of light.

Ivabradine can also cause dizziness. Do not drive or operate heavy machinery until you know how ivabradine affects you.

Ivabradine is a prescription medication used to treat long-lasting heart failure in patients who are stable and have a resting heart rate of at least 70 beats per minute. Patients must also be taking a beta-blocker at the highest dose they can tolerate.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Ivabradine may be found in some form under the following brand names:

• Corlanor

Serious side effects have been reported with ivabradine. See the “Ivabradine Precautions” section.

Common side effects of ivabradine include the following:

• slow heart rate
• high blood pressure
• irregular heartbeat, including atrial fibrillation
• visual disturbances, including flashes of light

This is not a complete list of ivabradine side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• CYP3A4 inhibitors such as itraconazole (Onmel, Sporanox), clarithromycin (Biaxin), telithromycin (Ketek), nelfinavir (Viracept), and nefazodone (Serzone)
• CYP3A4 inducers such as rifampin (Rifadin), carbamazepine (Tegretol, Carbatrol), diltiazem (Cardizem, Dilt-cd), phenobarbital, phenytoin (Dilantin, Phenytek), and St. John’s wort, verapamil (Calan, Covera-HS, Verelan)

This is not a complete list of ivabradine drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with ivabradine including the following:

• Increased risk of irregular heartbeat (atrial fibrillation or heart rhythm problems). Tell your doctor if you have symptoms of an irregular heartbeat, such as feeling that your heart is pounding or racing (palpitations), chest pressure, or worsened shortness of breath.
• Low heart rate (bradycardia). Tell your doctor if you have a slowing of your heart rate or if you have symptoms of a low heart rate such as dizziness, fatigue, lack of energy, or have low blood pressure. Low heart rate is a common side effect of ivabradine and can be serious.

Ivabradine can cause dizziness. Do not drive or operate heavy machinery until you know how ivabradine affects you.

Do not take ivabradine if you:

• are allergic to ivabradine or to any of its ingredients
• have symptoms of heart failure that recently worsened
• have low blood pressure (less than 90/50 mmHg)
• have certain heart conditions called sick sinus syndrome, sinoatrial block, or 3rd degree atrioventricular block
• have a resting heart rate lower than 60 beats per minute
• have severe liver disease
• have pacemaker dependence
• are using other medications that are strong inhibitors of enzymes that metabolize ivabradine

Grapefruit and grapefruit juice may interact with ivabradine and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Before taking ivabradine, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to ivabradine or to any of its ingredients
• have liver problems
• have heart problems
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

Ivabradine may cause harm to an unborn baby. You should not become pregnant while taking ivabradine. Women who are able to get pregnant must use birth control when taking ivabradine. If you become pregnant while taking ivabradine, tell your doctor right away.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if ivabradine crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Women who are taking ivabradine should not breastfeed.

Take ivabradine exactly as prescribed.

This medication comes in tablet form and is taken 2 times a day, with meals.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of ivabradine at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication

The recommended dose/dose range of ivabradine is 5 mg twice daily for 2 weeks. After 2 weeks, the dose is adjusted on the basis of heart rate and response to the drug. The maximum dose of ivabradine is 7.5 mg twice daily.

If you take too much ivabradine, call your healthcare provider or local Poison Control Center or seek emergency medical attention right away.

If ivabradine is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Store ivabradine at room temperature.

Keep this and all medications out of the reach of children.