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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › OTHER CARDIAC PREPARATIONS › Other cardiac preparations
ivabradine
C01EB17
Forms & Strengths
- 5mg, 7.5mg tablets
- Oral solution
Adult Dosing
- 5mg twice daily, titrate to 7.5mg twice daily
- Dose adjustment for renal impairment or concomitant use of strong CYP3A4 inhibitors
- Maximum dose: 7.5mg twice daily
Pediatric Dosing
- Not recommended for children under 18 years old
- Use in pediatric patients with heart failure only under close supervision
Indications
- Treatment of chronic heart failure
- Treatment of inappropriate sinus tachycardia
- Treatment of angina pectoris in patients with coronary artery disease
Mechanism of Action
- Selective and specific I(f) channel blocker
- Reduces heart rate by inhibiting the I(f) channel in the sinoatrial node
- No effect on blood pressure, ventricular repolarization, or myocardial contractility
Contraindications
- Sick sinus syndrome, 2nd or 3rd degree AV block, unless pacemaker is present
- Pregnancy and lactation
- Severe hypotension
Adverse Reactions
- Phosphenes and luminous phenomena, blurred vision
- Bradycardia, sinus arrest, atrioventricular block
- Headache, dizziness, fatigue
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) increase ivabradine exposure
- Barbiturates, phenytoin, and St. John’s Wort decrease ivabradine exposure
- Caution with beta-blockers, digoxin, and other cardiac glycosides
Curated Content: Needs Vetting Before Put to Clinical Use