Ivabradine

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Generic Name of Ivabradine - Learn More

Ivabradine

Ivabradine Precaution - What You Need to Know

Before initiating ivabradine therapy, it is essential to consult with your healthcare provider, especially if you have a history of heart rhythm disorders, liver disease, or eye conditions. Ivabradine is contraindicated in patients with sick sinus syndrome, sinoatrial block, or atrioventricular block of the second or third degree, as it may exacerbate these conditions. Regular monitoring of heart rate and rhythm is recommended during treatment. Additionally, ivabradine may interact with certain medications, including potent inhibitors of CYP3A4 such as ketoconazole, macrolide antibiotics, and certain antiretroviral drugs. It is crucial to inform your doctor about all medications you are currently taking to avoid adverse interactions. Patients should also be aware of potential visual disturbances, such as luminous phenomena, which are generally mild and reversible. Always adhere to your doctor's guidance regarding the use of ivabradine.

Ivabradine Indication - Uses and Benefits

Ivabradine is primarily prescribed for the symptomatic treatment of chronic stable angina pectoris in patients with normal sinus rhythm who cannot take beta blockers. It is also used to reduce the risk of hospitalization for worsening heart failure in adult patients with stable heart failure and an ejection fraction of 35% or less. In pediatric patients aged 6 months and older, ivabradine is indicated for the treatment of symptomatic heart failure due to dilated cardiomyopathy. Off-label uses of ivabradine include the treatment of inappropriate sinus tachycardia and postural orthostatic tachycardia syndrome (POTS). Clinical guidelines recommend ivabradine as an adjunctive therapy for heart failure patients who remain symptomatic despite optimal beta-blocker therapy.

Ivabradine Contraindications - Important Warnings

Ivabradine is contraindicated in patients with sick sinus syndrome, sinoatrial block, or atrioventricular block of the second or third degree, as it may worsen these conditions. It should also be avoided in individuals with hypersensitivity to ivabradine or any of its components. Due to its potential to lower heart rate, ivabradine is contraindicated in patients with a resting heart rate below 70 beats per minute. Additionally, ivabradine should not be used concomitantly with potent inhibitors of CYP3A4, including ketoconazole, macrolide antibiotics, and certain antiretroviral drugs. Age restrictions apply, and ivabradine is generally not recommended for use in children under 6 months of age.

Ivabradine Side Effects - What to Expect

Common side effects of ivabradine include visual disturbances, such as luminous phenomena, which are generally mild and reversible. Headaches and dizziness are also reported. Serious adverse effects, though less common, can occur, including bradycardia (unusually slow heart rate) and heart block. Regular monitoring of heart rate and rhythm is recommended during treatment to detect potential bradycardia early. If you experience symptoms like dizziness, fainting, or visual disturbances, seek medical attention promptly. To mitigate side effects, ivabradine should be taken with food.

Ivabradine Mode of Action - How It Works

Ivabradine exerts its therapeutic effects by selectively inhibiting the I_f (funny) current in the sinoatrial node, which is responsible for regulating heart rate. By inhibiting this current, ivabradine reduces the heart rate without affecting myocardial contractility. This mechanism is distinct from that of beta-blockers and calcium channel blockers, which also reduce heart rate but can decrease contractility. Ivabradine's selective action on the sinoatrial node allows for a reduction in heart rate, thereby decreasing myocardial oxygen demand and improving symptoms in conditions like angina and heart failure.

Ivabradine Drug Interactions - What to Avoid

Ivabradine has significant interactions with various medications. It can increase the plasma concentrations of drugs such as benzodiazepines, calcium channel blockers, and certain statins, leading to an increased risk of adverse effects. Conversely, ivabradine may decrease the effectiveness of drugs like rifampin and certain antiepileptics. Food intake can influence ivabradine absorption; taking it with a full meal enhances its bioavailability. Alcohol consumption should be limited during treatment, as it may increase the risk of liver toxicity. To manage these interactions, it is essential to inform your healthcare provider about all medications and supplements you are taking before starting ivabradine therapy.

Ivabradine Adult Dose - Recommended Dosage

For adults with chronic stable angina, the recommended starting dose of ivabradine is 5 mg taken orally twice daily with food. The dose may be adjusted based on heart rate and tolerability, with a maximum dose of 7.5 mg twice daily. For heart failure patients, the starting dose is 5 mg twice daily, which may be adjusted similarly. It is crucial to monitor heart rate regularly during treatment and adjust the dose accordingly to maintain a resting heart rate between 50 and 60 beats per minute.

Ivabradine Child Dose - Dosage for Children

Ivabradine is indicated for use in pediatric patients aged 6 months and older with symptomatic heart failure due to dilated cardiomyopathy. The dosing regimen varies based on age and weight. For infants and children weighing less than 40 kg, the recommended starting dose is 0.05 mg/kg taken orally twice daily with food. For children weighing 40 kg or more, the adult dosing regimen applies. Due to the potential for serious side effects, including bradycardia, close monitoring is necessary during treatment. Always consult with a pediatric specialist before initiating ivabradine therapy in children.

Ivabradine Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, ivabradine dosing requires careful consideration. While no specific dosage adjustments are recommended for mild to moderate renal impairment, caution is advised in severe renal impairment. Regular monitoring of renal function during therapy is essential. It is important to consult with your healthcare provider to determine the appropriate dosing regimen based on your renal function and overall health status.