Drug | Tablet

Chronic stable angina, Chronic heart failure (with reduced ejection fraction) in eligible patients to reduce heart rate

Ivabradine selectively inhibits the If (funny) current in the sinoatrial node. This slows the heart rate without reducing contractility or blood pressure significantly. Lower heart rate reduces myocardial oxygen demand and improves symptoms in suitable patients.

Take exactly as prescribed, usually twice daily with meals. Swallow whole with water at the same times each day. Do not stop abruptly without medical advice; monitor pulse and blood pressure as advised.

Bradycardia, visual phenomena (phosphenes/brightness), headache, dizziness, fatigue, atrial fibrillation, hypotension

Not for acute heart failure, cardiogenic shock, severe hypotension, sick sinus syndrome/SA block, pacemaker dependence, severe hepatic impairment, resting heart rate very low, or in combination with strong CYP3A4 inhibitors. Use caution in conduction disorders and in patients prone to atrial fibrillation; report palpitations or irregular heartbeat. Can cause temporary visual disturbances; caution while driving at night.

Strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, erythromycin, ritonavir), CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, St John"s wort), other heart rate lowering drugs (beta-blockers, diltiazem, verapamil, digoxin, amiodarone), grapefruit juice

Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.

Coralan 5 Tablet