Ivabradine: Uses, How It Works, Medicines
Ivabradine is a prescription medicine that slows the heart rate. It is used in some people with long-term stable angina or chronic heart failure whose heart rate stays high despite other treatment. It can cause a very slow heartbeat, atrial fibrillation and bright flashes in vision. It must not be used in pregnancy.
Also known as: Ivabradine tablet, Ivabradine 5 mg, Ivabradine 7.5 mg, Procoralan, Corlanor, Ivabrad
Pharmacist review in progress. This page is based on the sources listed below and is being checked by our registered pharmacist.
How does Ivabradine work?
Ivabradine blocks the If current in the sinus node, the heart's natural pacemaker. The pacemaker fires more slowly, so the heart rate falls and the heart needs less oxygen, without a large drop in blood pressure.
How to take Ivabradine
Follow the label or your doctor's advice. Ivabradine is usually taken twice a day with food, and your doctor decides the dose and may check your pulse and heart rhythm.
Side effects of Ivabradine
Most people take it without serious problems. Some side effects are common and mild, but a few need medical help.
Uncommon or mild
- Temporary flashes or patches of brightness in vision (phosphenes), mostly in the first months
- Slow heart rate
- Headache or dizziness
- Blurred vision
- Raised blood pressure
Rare but serious: get medical help
- Very slow heartbeat with fainting, severe dizziness or unusual tiredness
- An irregular or fast, fluttering heartbeat (possible atrial fibrillation)
- Swelling of the face, lips, tongue or throat, or difficulty breathing (a severe allergic reaction). Get medical help immediately
Who should be careful
Some people need to check with a doctor before taking ivabradine, or need extra care while taking it.
When the label says not to use it
- Allergy to ivabradine or any ingredient
- Pregnancy or breastfeeding
- Taking strong CYP3A4 inhibitors
- Very slow heart rate or very low blood pressure
- Pregnancy: do not take it; women who could become pregnant need to use contraception. Tell your doctor straight away if you become pregnant
- Breastfeeding: not recommended
- A low resting heart rate, very low blood pressure, heart block or sick sinus syndrome
- Recent heart attack, unstable or acute heart failure, or unstable angina
- Severe liver problems
- Atrial fibrillation or other rhythm disorders: your doctor will check your rhythm
- Driving at night: temporary brightness in vision can affect it
Medicines and things that interact with Ivabradine
Ivabradine can change how other medicines work, and some medicines change its effect. Tell your doctor or pharmacist about everything you take, including herbal products and medicines bought over the counter.
- Strong CYP3A4 inhibitors such as some antifungal medicines (for example ketoconazole), some macrolide antibiotics and HIV medicines: must not be used together
- Diltiazem or verapamil, and grapefruit juice: raise the level of ivabradine, so doctors avoid them
- Digoxin, amiodarone and beta blockers: heart rate can fall too far, so it is monitored
- St. John's wort, rifampicin and some epilepsy medicines: can lower the effect and are avoided
If someone takes too much
Taking more than prescribed can cause a very slow heartbeat, dizziness and fainting. If someone has taken much more than prescribed, call 112 or go to the nearest hospital and take the medicine pack with you.
Regulatory status in India
Approved for sale in India as a prescription medicine. Ivabradine is not on the CDSCO list of medicines banned under section 26A of the Drugs and Cosmetics Act as a single ingredient. Fixed-dose combinations that contain it with other medicines may be treated differently, so check the ingredient list on the pack.
Type of medicine
Ivabradine belongs to this type of medicine.
Medicines that contain Ivabradine
These medicines sold in India contain Ivabradine. They are listed A to Z, not ranked.
- Ivabrad 5 · 5 mg tablet
What is Ivabradine used for?
Medicines that contain Ivabradine are used for these conditions.
Common questions
What is ivabradine used for?
It is a prescription medicine that slows the heart rate. In the EU it is authorised for long-term stable angina and for chronic heart failure in people whose heart rate stays high. A doctor decides whether it suits you.
Is ivabradine safe in pregnancy?
No. The EMA says it must not be used in pregnancy or breastfeeding, and women who could become pregnant must use contraception. If you are pregnant or planning a baby, tell your doctor right away without stopping it on your own.
Why do I see flashes of light on ivabradine?
It can cause temporary patches of brightness in vision, called phosphenes, mostly in the first two months. They are usually mild. Take care when driving at night and tell your doctor if they bother you.
Can ivabradine cause an irregular heartbeat?
It can slow the heart too much and raises the chance of atrial fibrillation. Report dizziness, fainting, a very slow pulse or a fast, fluttering heartbeat promptly. Your doctor may check your rhythm from time to time.
Should ivabradine be taken with food?
The US label advises taking it twice a day with food. Follow the label or your doctor's advice, and avoid grapefruit juice.
Sources
- Procoralan (ivabradine): EPAR medicine overview. European Medicines Agency
- Ivabradine tablets: prescribing information (Novadoz). DailyMed, US National Library of Medicine
- ATC/DDD Index: C01EB Other cardiac preparations. WHO Collaborating Centre for Drug Statistics Methodology
- List of drugs prohibited for manufacture and sale through gazette notifications under section 26A of the Drugs & Cosmetics Act 1940. Central Drugs Standard Control Organisation (CDSCO)