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Ivabradine

    Brands

    DEA Class; Rx

    Common Brand Names; Corlanor

    • I(f) Current Inhibitors
    Hyperpolarization-activated cyclic nucleotide-gated channel blocker
    Used for the treatment of stable symptomatic heart failure
    Contraindicated when used in combination with strong CYP3A4 inhibitors

    Indicated to reduce the risk of hospitalization for worsening heart failure in patients with stable, symptomatic chronic heart failure with LVEF ≤35%, who are in sinus rhythm with resting heart rate ≥70 bpm and either are on maximally tolerated doses of beta-blockers or have a contraindication to beta-blocker use

    Acute decompensated heart failure

    Clinically significant hypotension

    Sick sinus syndrome, sinoatrial block, or third-degree AV block (unless a functioning demand pacemaker is present)

    Clinically significant bradycardia

    Severe hepatic impairment

    Pacemaker dependence (heart rate maintained exclusively by the pacemaker)

    Concomitant use of strong CYP3A4 inhibitors

    Bradycardia (10%)

    Hypertension or increased blood pressure (8.9%)

    Atrial fibrillation (8.3%)

    Luminous phenomena (phosphenes) or visual brightness (2.8%)

    Syncope, hypotension

    Angioedema, erythema, rash, pruritus, urticaria

    Vertigo, diplopia, visual impairment

    Torsade de pointes, ventricular fibrillation, ventricular tachycardia

    Increases the risk of atrial fibrillation; regularly monitor cardiac rhythm and discontinue drug if atrial fibrillation develops

    May cause fetal toxicity when administered to a pregnant woman; inform women of childbearing potential to use effective contraception

    There are no adequate and well-controlled studies in pregnant women to inform any drug-associated risks

    Advise females of childbearing potential to use effective contraception

    Unknown if distributed in human breast milk

    Adults

    7.5 mg PO twice daily.

    Geriatric

    7.5 mg PO twice daily.

    Adolescents

    Weighing 40 kg or more: 7.5 mg PO twice daily.
    Weighing less than 40 kg: 0.3 mg/kg/dose PO twice daily (Max: 7.5 mg/dose).

    Children

    Weighing 40 kg or more: 7.5 mg PO twice daily.
    Weighing less than 40 kg: 0.3 mg/kg/dose PO twice daily (Max: 7.5 mg/dose).

    Infants

    6 to 11 months: 0.2 mg/kg/dose PO twice daily.
    1 to 5 months: Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Ivabradine

    tablet

    • 5mg (scored and can be divided into equal halves to provide a 2.5-mg dose)
    • 7.5mg

    oral solution

    • 5mg/5mL