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Ivabradine


What is ivabradine?

Ivabradine is a type of medication that slows the heart rate. It does this by inhibiting the electrical current made by the heart’s natural pacemaker.

Conditions

Ivabradine is used to treat heart failure.

How does it work?

Ivabradine works by slowing your heartbeat by a few beats each minute. This reduces the work of your heart (workload) and improves your ejection fraction. (Ejection fraction is a measurement of how much blood is pumped from the left ventricle with each contraction of your heart)

Your healthcare provider decides the right dose for you to take. This dose might be changed, based on your heart rate.

This medication could be added to your treatment. When used with other heart failure medications, it may:

  • slow the worsening of your heart failure.
  • improve your heart failure symptoms.
  • improve your ejection fraction.
  • prevent stays in the hospital for heart failure treatment.
How do I take it?

Ivabradine is taken 2 times a day, in the morning and in the evening.

If you miss a dose and it is more than 4 hours until your next dose, take the missed dose then take your usual dose at the usual time.

If you miss a dose and it is less than 4 hours until your next dose, just take your next scheduled dose. Do not take the missed dose. Never take 2 doses at the same time.

Interactions

Do not take any of the following without checking with your healthcare provider.

  • black licorice
  • alcohol
  • cough or cold medicines
  • St. John’s Wort
  • herbal or Chinese medicines
  • herbs used in Indigenous healing
  • anti-inflammatory medicines (such as Advil, Ibuprofen, Motrin, Naproxen, Aleve, Celebrex, Indocid)

Be aware

Ivabradine is not for you if:

  • You are allergic to this medication.
  • Your resting heart rate is less than 70 beats a minute before taking this medication.
  • Your blood pressure is lower than 90/50 (90 over 50).
  • You have a pacemaker.
  • You have one of these heart conditions:
  • You have severe liver problems.
  • You are pregnant or trying to get pregnant.
  • You are breastfeeding.
  • You are younger than 18 years old.
  • You are taking certain antibiotics, certain antifungal medicines, certain HIV medicines, and/or a certain medicine for depression. (Your healthcare provider knows which ones).
Side effects

Contact your healthcare provider if any of these side effects continue or get worse.

Common Side Effects

What to do

Slow heartbeat causing you to feel:
• tired or weak
• dizzy
• lightheaded

Get up slowly when changing position, such as moving from lying to sitting or sitting to standing.
Balance rest with activity.
If your heart rate is less than 50 beats a minute, your healthcare provider might lower the dose or ask you to stop taking it.

Palpitations – irregular heartbeat

Contact your healthcare provider. You might need your heart rhythm checked with heart tracing (electrocardiogram or ECG).

Vision problems, especially when the brightness of light around changes suddenly, such as: 
• blurred vision
• see bright spots of light
• see halos around objects
• see flashes of colour or patterns

These are temporary and happen in the first 2 months of taking this medication.

Wear sun glasses if the vision problems get worse with changes of light.

Check with your healthcare provider. They might want to lower the dose. 

Do not stop taking this medication without checking with your healthcare provider.

Nausea or stomach upset

Take this medication with food.

Get rid of strong smells.

Open windows to get fresh air.

Use a fan, air deodorizers, or air fresheners.

Less Common Side Effects

What to do

Diarrhea, constipation, abdominal pain
Rash, redness of the skin, itching

Contact your healthcare provider.

Trouble breathing

Difficulty swallowing

Swelling of your face, lips, tongue

Stop taking this medication immediately.

Go to your nearest emergency department.

Tips
  • Expect to go for an ECG  (electrocardiogram)
    • before you start taking this medication
    • 2 weeks after you start taking it
    • any time your healthcare provider changes the dose
  • Take your ivabradine exactly as directed by your healthcare provider, even if you feel well.
  • Do not suddenly stop taking ivabradine without checking with your healthcare provider first, except if:
    • You are having trouble breathing or difficulty swallowing.
    • You have swelling of your face, lips or tongue.
    • You are so dizzy you are falling down.
  • Do not drink grapefruit juice or eat grapefruits while taking this medication. Grapefruit changes how this medication is absorbed in the body, causing more side effects.
  • Certain medications can affect how this medication is absorbed in your body and can increase the side effects. Always tell your healthcare provider what other medicines you are taking, including:
    • antibiotics
    • medications to treat a fungal infection
    • medications to treat depression
    • medications to treat HIV
    • herbal, Chinese, or Indigenous natural remedies or medicines
    • medications for your heart or blood pressure
    • medications to treat epilepsy

If you have questions about taking your medications, or missed doses, contact your pharmacist, your healthcare provider, or call 9-1-1.

Lifestyle changes can help

Eating a healthy diet that is lower in fat, especially saturated and trans fats, being smoke free, limiting alcohol use, being physically active and reducing stress are also important in lowering the risk of heart disease. Talk to your healthcare practitioner about how you can achieve these lifestyle changes.

Related information

Your healthcare provider or pharmacist are your best sources of information. You can also learn more about medications at any of these trusted sites.

Health Canada - Drugs and Health Products Provides health and medical information for Canadians to maintain and improve their health. Learn more about:

Your ministry of health also offers health resources in your province or territory. For example, Ontario’s MedsCheck program provides free pharmacist consultations. And British Columbia’s Senior Healthcare web page provides information about important health programs.

Drug coverage

Living Well with Heart Disease is a comprehensive guide for heart patients like you, your family and friends to improve your success of recovery, understand the diagnosis and treatment you will receive and make healthy changes to your lifestyle.

Here are some tips for managing your medications.

This information was adapted from Living with Heart Failure - a collection of fact sheets on the most important things for you to know to help manage your heart failure.

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