Ivabradine
medication used for the symptomatic management of stable heart related chest pain and heart failure not fully managed by beta blockers
Ivabradine, sold under the brand name Procoralan among others, is a medication, which is a pacemaker current (If) inhibitor, used for the symptomatic management of heart-related chest pain and heart failure. Patients who qualify for use of ivabradine for congestive heart failure are patients who have symptomatic heart failure, with reduced ejection fraction, and heart rate at least 70 bpm, and the condition not able to be fully managed by beta blockers.
Ivabradine acts by inducing negative chronotropy in the sinoatrial structure, thus reducing the heart rate via specific inhibition of the pacemaker current. It operates by a mechanism different from that of beta blockers and calcium channel blockers, which are two commonly prescribed antianginal classes of cardiac drugs. Ivabradine has no apparent inotropic properties and may be a cardiotonic agent.
Medical uses
It is used for the symptomatic treatment of chronic stable angina pectoris in patients with normal sinus rhythm who cannot take beta blockers. It is also being used off-label in the treatment of inappropriate sinus tachycardia (IST). Ivabradine stands as a pharmacological option for controlling HR and rhythm without associated side effects in postoperative CABG patients with IST.
Chest pain
Ivabradine is as effective as the beta blocker atenolol and comparable with amlodipine in the management of chronic stable angina, as demonstrated by improvements in total exercise duration in non-inferiority trials, hence it can be an alternative therapy for those who cannot tolerate conventional therapies. In people not sufficiently managed with beta blockers for their angina, adding ivabradine can further reduce heart rate and improve total exercise duration.
Heart failure
It is used in combination with beta blockers in people with heart failure with LVEF lower than 35 percent inadequately controlled by beta blockers alone and whose heart rate exceeds 70 beats per minute.
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This entry incorporates text from “Ivabradine” on English Wikipedia. Contributors are listed in the page history. Text is available under the Creative Commons Attribution-ShareAlike 4.0 License. Selected authority identifiers and statements are retrieved from Wikidata under CC0; their references and qualifiers remain part of the verification path.