Ivabradine

Dosage Forms Available

• Ivabradine is available in oral tablet form.

Age and Dose Restrictions

• Ivabradine is not recommended for children under 18 years.

Contraindications

• Ivabradine is contraindicated in patients with severe liver disease, very low resting heart rate (below 60 beats per minute), acute heart failure, or unstable angina. It should not be used in patients with severe low blood pressure, pacemaker dependence, or those taking strong CYP3A4 inhibitors (such as ketoconazole or clarithromycin).

Other Medications to Avoid

• Avoid taking beta-blockers (such as propranolol and metoprolol), calcium channel blockers (such as diltiazem and verapamil), antifungal medications (such as itraconazole), macrolide antibiotics (such as erythromycin), and certain heart rhythm medications (such as amiodarone). These medications may increase the risk of bradycardia or cause dangerous interactions.

Overdose and Missed Dose

• An overdose may cause severe bradycardia, dizziness, or fainting. If an overdose is suspected, seek immediate medical attention. 
• If a dose is missed, take it as soon as you remember. However, if it is close to the next scheduled dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one.

Management of Side Effects

• To manage dizziness and low blood pressure, rise slowly from sitting or lying positions and avoid sudden movements. If blurred vision or phosphenes occur, try to limit exposure to bright lights and avoid activities requiring clear vision, such as driving. If side effects persist or worsen, consult your doctor for dose adjustment or alternative treatments.

Use in Driving and Operating Machinery

• Ivabradine may cause visual disturbances, such as bright flashes of light, and dizziness. It is advised to avoid driving, operating machinery, or performing tasks requiring alertness until you understand how the medication affects you.

Use in Pregnancy and Lactation

• Ivabradine is not recommended during pregnancy, as it may harm the developing fetus. Women of childbearing age should use effective contraception while taking this medication. It is also not advised during breastfeeding, as it may pass into breast milk and affect the infant.

Caution in Other Conditions

• Patients with kidney or liver disease, low blood pressure, atrial fibrillation, or a history of stroke should take Ivabradine under strict medical supervision. This medication may worsen bradycardia and should be used cautiously in individuals prone to low heart rate.

Special Dietary and Lifestyle Recommendations

• Limit caffeine intake, as it can interfere with heart rate control.
• Reduce sodium intake to manage blood pressure and heart health.