ivabradine hydrochloride at a glance
Medicine class
Selective sinus-node If-current inhibitor
Licensed roles
Chronic stable angina symptom control and selected cases of stable chronic systolic heart failure
Rhythm requirement
Licensed use requires sinus rhythm and an appropriately elevated resting heart rate
Administration
Take the tablets during meals and avoid grapefruit juice
Notable effect
Temporary flashes, halos or increased brightness can occur, particularly with sudden changes in light
What is ivabradine hydrochloride used for?
Selected UK products are licensed for adults in sinus rhythm whose resting heart rate meets the product criteria.
Symptom control in chronic stable angina when beta-blockers cannot be used or tolerated, or alongside a beta-blocker when symptom control remains inadequate.
Stable chronic heart failure with systolic dysfunction, alongside standard therapy including a beta-blocker, or when a beta-blocker is contraindicated or not tolerated.
How does ivabradine hydrochloride work?
Ivabradine inhibits the If current in the sinus node, slowing pacemaker activity and heart rate. This reduces cardiac workload and oxygen demand without directly weakening heart muscle contraction. Effects on a related retinal current explain temporary luminous visual phenomena.
ivabradine hydrochloride preparations and strengths
Tablet
Route: Oral
Strengths: 2.5 mg, 5 mg, 7.5 mg
How to take ivabradine hydrochloride
Take ivabradine exactly as prescribed and during a meal. Avoid grapefruit juice. Divide a tablet only when the leaflet for that product says it can be split equally. Visual effects warrant particular care when driving at night or when light levels change suddenly.
Check the label and leaflet because tablet appearance and splitability vary between manufacturers.
Do not stop treatment without discussing it with the prescriber.
After taking too much, contact a clinician promptly, particularly if breathlessness, unusual tiredness or symptoms of a very slow heartbeat occur.
ivabradine hydrochloride side effects
Common or expected effects
- Brief flashes, halos or increased brightness
- Slow heart rate
- Headache or dizziness
- Blurred vision
- Atrial fibrillation or awareness of abnormal heartbeats
- Changes in blood-pressure control
Get urgent medical advice
- Swelling of the face, tongue or throat, or difficulty breathing or swallowing
- Fainting or severe symptoms associated with a slow heartbeat
- New irregular rapid heartbeat or persistent palpitations
- Unexpected deterioration in vision
- Severe or prolonged bradycardia after an overdose
ivabradine hydrochloride in pregnancy
Ivabradine is contraindicated during pregnancy, and reliable contraception is required for those who could become pregnant. Anyone who becomes pregnant or has inadvertent exposure should contact their prescriber promptly for specialist review rather than stopping essential cardiac treatment without advice.
ivabradine hydrochloride while breastfeeding
Ivabradine is contraindicated while breastfeeding because human infant-safety data are inadequate and animal evidence indicates transfer into milk. A specialist should discuss alternative treatment or another way of feeding the baby.
ivabradine hydrochloride interactions
Ivabradine is metabolised through CYP3A4. Inhibitors may increase bradycardia risk, while inducers may reduce its effect.
Verapamil or diltiazem
Contraindicated because exposure and heart-rate reduction are increased.
Strong CYP3A4 inhibitors
Ketoconazole, itraconazole, clarithromycin, oral erythromycin, certain HIV protease inhibitors and nefazodone can markedly increase exposure and are contraindicated.
Common questions about ivabradine hydrochloride
Answers are fully visible for fast scanning and source review.
What is ivabradine hydrochloride used for?
It is licensed for symptom control in selected adults with chronic stable angina and as part of treatment for certain adults with stable chronic systolic heart failure.
Does ivabradine hydrochloride treat an acute angina attack?
No. Its angina role is ongoing symptom control, not rapid relief of sudden chest pain.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.