ivabradine at a glance
Medicine class
Selective inhibitor of the sinus-node If current.
Licensed uses
Selected adults with chronic stable angina or chronic systolic heart failure who are in sinus rhythm.
Taking the tablets
Take during meals and follow the product-specific directions supplied by the prescriber.
Vision and driving
Temporary brightness, flashes or halos can occur. Take care when driving, particularly at night or when light levels change suddenly.
What is ivabradine used for?
Licensed uses represented by the selected product include:
Symptomatic chronic stable angina in selected adults with coronary artery disease and normal sinus rhythm when beta-blockers cannot be used or are not tolerated.
Symptomatic chronic stable angina with a beta-blocker when symptoms remain inadequately controlled.
Chronic systolic heart failure in selected adults with symptoms and sinus rhythm, alongside standard therapy or when beta-blockers cannot be used or are not tolerated.
How does ivabradine work?
Ivabradine inhibits the If current in the sinus node, slowing pacemaker activity and reducing heart rate without directly reducing heart-muscle contraction. A related effect on the retina explains temporary luminous visual effects.
ivabradine preparations and strengths
Tablet
Route: Oral
Strengths: 5 mg, 7.5 mg
How to take ivabradine
Take the tablets during meals, swallow them with water and avoid grapefruit juice. Do not stop or alter treatment without discussing it with the prescriber.
Check the pack leaflet before splitting a tablet because divisibility differs between formulations.
Tell the prescriber if dizziness, unusual tiredness, faintness, breathlessness or an irregular pulse develops.
ivabradine side effects
Common or expected effects
- Brief increased brightness, flashes, halos or other luminous visual effects
- Slow heart rate
- Atrial fibrillation or awareness of an abnormal heartbeat
- Headache or dizziness
- Blurred vision
Get urgent medical advice
- Swelling of the face, tongue or throat, or difficulty breathing or swallowing
- Fainting or symptoms suggesting an excessively slow heart rate
- A new irregular pulse or worsening palpitations
- Severe rhythm or conduction disturbance
ivabradine in pregnancy
Ivabradine is contraindicated during pregnancy. Effective contraception is required for those who could become pregnant while taking it. Anyone who becomes pregnant or has been exposed should promptly contact their prescriber and maternity or cardiology team for specialist review rather than changing treatment independently.
ivabradine while breastfeeding
Ivabradine is contraindicated during breastfeeding. The specialist team should discuss an alternative treatment or way of feeding the baby.
ivabradine interactions
Check all prescribed, non-prescribed and herbal products before starting ivabradine.
Verapamil or diltiazem
Contraindicated because they increase ivabradine exposure and add to heart-rate lowering.
Strong CYP3A4 inhibitors, including clarithromycin, oral erythromycin, itraconazole, ketoconazole and ritonavir
Contraindicated because increased ivabradine exposure can cause excessive bradycardia.
QT-prolonging medicines
The combination should generally be avoided because heart-rate reduction can increase the risk of serious ventricular arrhythmia.
Common questions about ivabradine
Answers are fully visible for fast scanning and source review.
Is ivabradine a beta-blocker?
No. It lowers heart rate by inhibiting the If current in the sinus node rather than blocking beta receptors.
Why can it cause flashing lights or halos?
It can temporarily affect a retinal current related to the cardiac If current, producing brief brightness, flashes or halos.
Can I drive while taking ivabradine?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.