Ivabradine

Administration

  • Type: Miscellaneous Cardiovascular Agents
  • Dosage Forms: Oral solution (5mg/mL) and Tablet (5 mg, 7.5 mg)
  • Routes of Administration: PO
  • Common Trade Names: Corlanor, Procoralan

Adult Dosing

  • 2.5mg to 7.5mg twice daily

Pediatric Dosing

  • Greater than 40kg: 2.5mg to 7.5mg twice daily
  • Less than 40kg: Starting dose is 0.05 mg/kg twice daily
    • 6 months to 1 year maximum dose - 0.2mg/kg twice daily
    • 1< year maximum dose - 0.3mg/kg up to 7.5mg twice daily

Special Populations

Pregnancy Rating

  • Benefit should outweigh risk; monitor for congestive heart failure destabilization, especially during the first trimester; monitor for preterm birth during the third trimester in pregnant women with chronic heart failure

Lactation risk

  • Use is not recommended. The effects in the nursing infant are unknown.

Renal Dosing

  • No dosage adjustment is required for patients with creatinine clearance 15 to 60 mL/min. No data are available for patients with creatinine clearance below 15 mL/min.


Hepatic Dosing

  • No dose adjustment is required in patients with mild or moderate hepatic impairment. Corlanor is

contraindicated in patients with severe hepatic impairment.

Indications

Reduction of angina and risk of hospitalization for patients with:

  • Stable symptomatic chronic heart failure with reduced left ventricular ejection fraction
  • Stable symptomatic heart failure due to dilated cardiomyopathy in pediatric patients ages 6 months and older

Contraindications

  • Allergy to class/drug
  • Acute decompensated heart failure
  • Clinically significant hypotension
  • Sick sinus syndrome, sinoatrial block or 3rd degree AV block, unless a functioning demand pacemaker is present
  • Severe hepatic impairment
  • Heart rate maintained exclusively by the pacemaker
  • In combination with strong cytochrome CYP3A4 inhibitors

Adverse Reactions

Common

  • Bradycardia
  • Hypertension
  • Atrial fibrillation
  • Luminous phenomena

Pharmacology

  • Half-life: 6 hours
  • Metabolism: Liver extensively; CYP3A4
  • Excretion: ~50% Urine (~4% oral dose unchanged); ~50% Feces

Mechanism of Action

Hyperpolarization-activated cyclic nucleotide-gated (HCN) channel blocker; Pacemaker current I(f) inhibitor


See Also

Congestive heart failure

References

FDA Corlanor Prescribing Information, https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/209964lbl.pdf

Retrieved from "https://www.wikem.org/w/index.php?title=Ivabradine&oldid=372220"