Ivabradine Brand Name– Corlanor
What is Ivabradine
Ivabradine is a hyperpolarization-activated cyclic nucleotide-gated channel blocker used in stable symptomatic heart failure.
In adult patients, ivabradine is indicated to reduce the risk of hospitalization for worsening heart failure in those with symptomatic (NYHA class II or III) stable chronic reduced ejection fraction (35% or less) heart failure (HFrEF) who are either receiving a beta blocker at the maximum tolerated dose or have a contraindication to beta-blocker use, and who are in sinus rhythm with a resting heart rate of 70 bpm or more.
In pediatric patients, ivabradine is indicated in those with heart failure due to dilated cardiomyopathy (DCM) who are in sinus rhythm with an elevated heart rate.
In The Systolic Heart failure treatment with the If inhibitor ivabradine Trial (SHIFT), treatment with ivabradine resulted in a significant reduction in the risk of the primary composite endpoint of hospitalization or cardiovascular death for worsening heart failure with the primary endpoint occurring in 24% of patients receiving ivabradine and 29% in the placebo group (HR 0.82, 95% CI 0.75 to 0.9, p less than 0.0001).
The treatment effect was mainly driven by a reduction in the risk of hospitalization for worsening heart failure. There was no significant reduction in the risk of cardiovascular death in the ivabradine group; however, deaths due to heart failure were significantly reduced.
Ivabradine has not shown benefit in patients with stable coronary artery disease with or without stable heart failure.
Indications
- heart failure
For the treatment of stable symptomatic heart failure
Side Effects
- angioedema
- atrial fibrillation
- bradycardia
- diplopia
- erythema
- hypertension
- hypotension
- pruritus
- rash
- syncope
- torsade de pointes
- urticaria
- ventricular fibrillation
- ventricular tachycardia
- vertigo
- visual impairment
Monitoring Parameters
- ECG
- heart rate
Contraindications
- acute heart failure
- AV block
- bradycardia
- breast-feeding
- bundle-branch block
- contraception requirements
- driving or operating machinery
- hepatic disease
- hypotension
- pregnancy
- reproductive risk
- sick sinus syndrome
- visual disturbance
Interactions
- Acebutolol
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Aldesleukin, IL-2
- Amiodarone
- Amobarbital
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Apalutamide
- Aprepitant, Fosaprepitant
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atazanavir
- Atazanavir; Cobicistat
- Atenolol
- Atenolol; Chlorthalidone
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Bendroflumethiazide; Nadolol
- Beta-blockers
- Betaxolol
- Bexarotene
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Boceprevir
- Bosentan
- Brimonidine; Timolol
- Butabarbital
- Carbamazepine
- Carteolol
- Carvedilol
- Cenobamate
- Ceritinib
- Chloramphenicol
- Cimetidine
- Ciprofloxacin
- Clarithromycin
- Cobicistat
- Cocaine
- Conivaptan
- Crizotinib
- Cyclosporine
- Dabrafenib
- Danazol
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deferasirox
- Delavirdine
- Dexamethasone
- Digoxin
- Diltiazem
- Dorzolamide; Timolol
- Dronedarone
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Enzalutamide
- Erythromycin
- Erythromycin; Sulfisoxazole
- Eslicarbazepine
- Esmolol
- Etravirine
- Fedratinib
- Felbamate
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluvoxamine
- Fosamprenavir
- Fosphenytoin
- grapefruit juice
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Idelalisib
- Imatinib
- Indinavir
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ketoconazole
- Labetalol
- Lasmiditan
- Lefamulin
- Lesinurad
- Lesinurad; Allopurinol
- Letermovir
- Levobetaxolol
- Levobunolol
- Lopinavir; Ritonavir
- Lorlatinib
- Lumacaftor; Ivacaftor
- Mephobarbital
- Methohexital
- Metoprolol
- Mifepristone
- Mitotane
- Modafinil
- Nadolol
- Nebivolol
- Nebivolol; Valsartan
- Nefazodone
- Nelfinavir
- Netupitant, Fosnetupitant; Palonosetron
- Nevirapine
- Nicardipine
- Nilotinib
- Octreotide
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Oritavancin
- Oxcarbazepine
- Pazopanib
- Penbutolol
- Pentobarbital
- Perampanel
- Phenobarbital
- Phentermine; Topiramate
- Phenytoin
- Pindolol
- Pirfenidone
- Posaconazole
- Primidone
- Propranolol
- Quinine
- Ranolazine
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Ritonavir
- Saquinavir
- Secobarbital
- Simeprevir
- Siponimod
- Sotalol
- St. John’s Wort, Hypericum perforatum
- Telithromycin
- Telotristat Ethyl
- Thiopental
- Ticagrelor
- Timolol
- Tipranavir
- Topiramate
- Trandolapril; Verapamil
- Tucatinib
- Vemurafenib
- Verapamil
- Voriconazole
- Zafirlukast
